Children raised in families of same-sex parents exhibit no significant clinical or social differences from those with different-sex parents, according to study published April 11 in the Journal of Developmental and Behavioral Pediatrics.

The research analyzed 190 households and looked at spouse or partner relationships, parent-child relationships, as well as children’s general health, emotional difficulties, and coping and learning behavior. The families, divided evenly into same-sex and different-sex parents, were matched in eight demographic characteristics, including parental age, education and children’s age.

“This study is the first to use a nationally representative survey to compare the two types of households by focusing only on those with parents that have been in a continuous relationship,” lead author Henny Bos, Ph.D., an associate professor at the University of Amsterdam, the Netherlands.

While the study found no differences in family relationships and child outcomes, same-sex parents reported more parenting stress.

“Future investigations might explore whether the cultural spotlight on child outcomes in same-sex parent families is associated with increased parenting stress,” psychiatrist and co-author Dr. Nanette Gartrell, MD, visiting scholar at the Williams Institute, said in the news release. “Some of our earlier studies have shown that lesbian mothers feel pressured to justify the quality of their parenting because of their sexual orientation.”

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The study used data from the 2011-2012  National Survey of Children’s Health, a nationally representative population-based survey on children’s health approved by the National Center for Health Statistics of the Centers for Disease Control and Prevention.