Pronatalism has no place in therapy
By Karina Westrick, LPCC
As a therapist in training, I was unaware of the childfree community. Despite my graduate program’s strong focus on multicultural issues, including a semester-long immersion project in diverse communities (I chose to complete mine at a mosque), we never covered how to support individuals who choose to be childfree. It wasn’t until I began reflecting on my own thoughts and feelings about having children that I discovered the childfree community through podcasts, books, and even meetup groups. I became aware of some of the challenges faced by this community, especially when I became vocal about my own decision to be childfree and faced pushback from family and friends. I found myself surprised to learn there weren’t more mental health resources tailored toward this population. Today, I have a deeper understanding of the role pronatalism plays in our society at large and in therapy, and I want to share some guidance for childfree people seeking an affirming therapy experience.
Pronatalism
“In contemporary Western culture, it ironically appears that one needs to have reasons not to have children, but no reasons are required to have them. People who are childless are frequently and rudely criticized and called to account for their situation… the choice to procreate is not regarded as needing any thought or justification” – Christine Overall
Pronatalism refers to the cultural and institutional forces that pressure individuals, especially women, to have children. It permeates various aspects of society, including religion, politics, economics, and family life. For instance, political pronatalism is evident in tax benefits for families, humorously captured in memes about claiming pets as dependents. Pronatalism grants parents a privileged status in our society. As Katie Maynard, LICSW, points out, our everyday language reflects this bias: terms like “family,” typically imply parents and children, while people who aren’t parents are defined by what they lack, using words like “non-parents” or “childless”.
Like other “-isms”, pronatalism can be psychologically harmful to those who deviate from the norm. Childfree individuals often face judgment and unsolicited comments, a phenomenon known in the community as being “bingo’d.” Imagine a bingo card, and each item on it is a pronatalist statement childfree people hear repeatedly, such as “You’ll change your mind,” “Your child could grow up to cure cancer,” and “You’ll never experience real love.” The idea is childfree people hear these comments so often, they could carry the bingo card around and check the items off.
Pronatalism in Therapy
Unfortunately, pronatalism has influenced the field of psychology. Psychotherapist Emma Palmer’s article “The ‘empty womb’ in the therapy room? The taboo and potency of the other than mother/childfree body,” details the way pronatalism impacts contemporary therapy. It begins with the theories of human development that many psychotherapies are built around. For example, Erik Erikson’s stages of development are characterized by a series of conflicts people must resolve to mature. One of these stages is called “Generativity vs. Stagnation/Self-Absorption,” where the developmental challenge is to find a way to impact the next generation. Traditionally, this was thought to occur through parenting. Perhaps because of this bias in the foundational theories of psychology, there is very little research on childfree people in general, and even less on therapeutic interventions for the childfree population.
This bias means many therapists are not knowledgeable about the childfree community, as my own story suggests. It also means therapists don’t have evidenced-based interventions for challenges specific to the childfree lifestyle. For example, while there are standardized protocols for helping people grieve a loved one, there are no protocols for helping childfree people cope with being “bingo’d.” Even more concerning are therapists who exhibit biased attitudes toward childfree clients. Palmer describes encountering childfree individuals who have been traumatized by pronatalist therapists who pathologize the decision to be childfree.
A viral Reddit post highlights this issue. User millllauy shared her experience of telling her therapist she did not want to have kids, only to be met with defensive responses like “opinions change” and even “you have no say in this since you’re 19.” Unfortunately, the comments section was full of similar stories of people encountering pronatalist attitudes in therapy.
Such attitudes are wildly unethical. As a licensed professional clinical counselor, I adhere to the American Counseling Association Code of Ethics, which instructs counselors to not impose their own values on clients. As counselors, we evaluate our own cultural, spiritual/religious, and political backgrounds, and think about the biases we might bring into the therapy room. Most of us can see how it would be unethical for a therapist to try to change a client’s religious beliefs, or to treat a client differently because of these convictions. Similarly, therapists should not act in a biased way toward childfree people or attempt to influence a client’s reproductive decisions. Particularly for clients seeking help for trauma or other experiences of feeling out-of-control, a therapist behaving this way can be very damaging. Therapists must examine their own experiences and beliefs about what it means to be childfree and be aware of how this background impacts their work with clients.
Tips for childfree people seeking therapy
While the field of therapy is evolving, finding a supportive therapist can still be challenging for childfree individuals. There are no clear marks, certifications, or accreditations signaling a therapist is childfree affirming, but there are other ways you might screen for this. Here are some tips to help you have an affirming therapy experience:
1. Consultation Calls: When looking for a therapist, it’s always a good idea to engage in a consultation call to see if the relationship feels like a good fit. During this call, you can ask the therapist about their experience and comfort in working on issues around being childfree. While you might not find someone who specializes in this population, you can least feel the temperature around it.
2. Feedback: If your therapist ever makes you feel uncomfortable about your reproductive decisions, you can bring this up to them! Many therapists want to improve, and one of the key ways to do that is by getting feedback. This gives an opportunity to repair the rupture in your relationship and develop a plan for helping you feel supported.
3. Referrals: If a therapist continues to exhibit pronatalist bias or doesn’t seem to hear your concerns, do not hesitate to ask for a referral to another therapist. Many therapists have access to listservs and other networking tools, which can help identify other providers with niche specializations.
Therapy should empower and inspire you to create the life you want, not the one society has ascribed to you. Pronatalism has no place in therapy. Instead, a healthy therapeutic process can help you cope with biases you might be facing due to your decision to be childfree. Maybe you’re in a place where you’ve decided your genetics aren’t the mark you want to leave on this world, but you’re not sure what is. Therapy is a place where you can explore your values, passions, and ultimately how you want to make a meaningful impact with your life.