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Madam and Eve : The Trajectory of Conception of Lesbian Couples

*Assisted Reproductive Technology (ART) refers to a range of medical procedures used to aid couples or individuals who are having trouble conceiving a child naturally.

The perinatal period brings about several relational, biological, psychological, and social changes, which influence the surrounding system. Many times, research does not reflect the holistic experience of sexual minorities, which creates an invisibility of the same community during the perinatal period.

A study conducted in Malta aimed to gain insight on the stories narrated of lived experiences of same-sex couples, and protective and predisposing factors influencing perinatal mental health in the local culture. Two couples participated in semi-structured interviews, individually and together as a couple. The process of data analysis followed the narrative analysis guide offered by Josselson and Hammack (2021).

The results indicate that while both couples went through the perinatal period between 2020 and 2022, their accounts and perspectives varied significantly. This reflects how the Maltese culture is shifting, accommodating non-normative family constellations. The stories themselves reflect the socio-political climate of the time, the surrounding organizations, as well as family, interpersonal, and personal aspects.

The storylines of couples are impacted by an intersectionality of identities such as being a lesbian, age, and being the non-birth parent; institutions; and the heteronormative society.

The perspective of the non-birth parent is impacted by various life experiences of growing up non-heteronormative in a heteronormative society. An incongruence between the lesbian and maternal identities, complicated the transition.

Perceiving lesbian motherhood as unconventional, implausible and taboo, can lead to a need to accommodate to the new reality of becoming a non-normative family. On the other hand, having the narrative of having a family woven into the relationship from the outset was supportive.

The importance ascribed to external elements in the couples’ stories corresponded to the perceived external power. Social changes in media, legislation, and regulations, which may not always be apparent in social attitudes and discourse which can impact the experience of the couples. Many times, the system focuses primarily on birth parents, even amongst heterosexual couples, leaving an impact on the perinatal experience.

It is important to note that the perinatal and COVID-19 timeline coincided for the research participants. Healthcare was inundated and implementing stringent restrictions, which had an impact on the quality of support offered to service users, contributing to the strain experienced.

Belonging to a minority whilst using ART can be challenging, but personal coping mechanisms such as resilience, advocacy, reframing, meaning development and relationship and social support are crucial pillars in alleviating distress.

Implications for clinical practice and development

The narratives emphasized the relevance of the social and legal context. Malta's policies have adjusted to be more inclusive, but further efforts may be made to resolve shortcomings and promote equality in practice for enhanced quality of life (Human Rights and Integration Directorate, 2018; Ministry for Social Policy and Children's Rights, 2022). Additional laws and training can address the discrimination and stigma present in various settings, followed by the monitoring of policy implementation. The education system also has a role in increasing visibility of roles models, normalizing diverse family configurations and bringing awareness on the significance of the discourse used.

It is beneficial to provide suitable and accessible resources and support for non-heterosexual people during the perinatal period according to the country’s culture and reproductive access rights. Clients benefit from validation and expertise for optimal outcomes, through professionals being reflective of their attitude and possible prejudice, while acknowledging the role of the non-birth parent in the perinatal system.

These stories serve as an essential reminder of the value of resilience in overcoming obstacles. I remain grateful to the participants who volunteered to share their narratives, providing a window into their world. Only because of their trust and resilience can I share their stories, in the hope of supporting other LGBTQIA+ individuals. I hope that this study will inspire policymakers and professionals to be more sensitive to the needs of this demographic and to keep striving to support the family as a whole.

This is a guest blog article Written by Valentina Bezzina who did research on Assisted Reproductive Technology with lesbian couples. Valentina graduate from the University of Malta with Masters in Counselling Psychology, in her free time you can find her singing some opera, giving a training or travelling abroad.


  • Human Rights and Integration Directorate; Ministry for European Affairs and Equality (MEAE). (2018). LGBTIQ Equality Strategy & Action Plan 2018-2022. _20182022.pdf

  • Josselson, R., & Hammack, P. L. (2021). Essentials of narrative analysis. American Psychological Association (APA).

  • Ministry for Social Policy and Children’s Rights. (2022). A social vision for Malta 2035. Government of Malta: Ministry for Social Policy and Children’s Rights. ion%20for%20Malta%202035.pdf

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