Dear List, First of all, I respect but totally disagree with Graham's initial post on this subject. I know he is an excellent physician and long time contributor to this list. I know that as an adoptive parent, he has strong feelings about adoption. From the text of his post, I think he also has very strong, negative feelings about homosexuality. Let me tell you up front that I DO NOT have negative feelings about homosexuality. My 25 year old daughter, one of the finest people on the planet, is lesbian. She is mature, intelligent, emotionally strong and beautiful. She graduated from a top college at the top of her class three years ago summa cum laude. She has been working for an outstanding non-profit educational institution since then. She plans to enter law school this fall. While she's not perfect, I know of no finer human being. She discovered her sexual orientation during her college years and she is in a wonderful committed relationship now. It may become permanent and if it does, she and her significant other may choose to adopt. If they do adopt, their children will have two excellent parents. The AAP policy concerns adoption by a second parent in a homosexual relationship where the first parent is already is the legal custodian. This usually comes about by the first parent having the child within a traditional heterosexual marriage, and then the marriage dissolves or whatever. It doesn't usually come about by having a lesbian or gay couple adopting de novo. However, I do have a lesbian couple in my Wyoming practice who six years ago adopted an infant they had in foster care. The AAP policy is backed up by a technical report with thirty-one references. The policy is based on the current state of science. There is every reason to believe that children in gay or lesbian parented families do as well as children in heterosexual families. Isn't that what the AAP is supposed to do: base policy on the best science. Many members may have have "feelings" or "beliefs" that homosexuality is wrong or is a disease. That is a prejudice. It is not based on science. Even if a vast majority of the members believe homosexuality is wrong, the AAP, if science supports the policy, has a higher standard: good science. The AAP must advocate for children's health, even in controversial areas where members diverge. This is true about circumcision, immunizations, breast feeding, smoking, alcohol use, gun use, vehicular safety, family violence and many other areas. In each of these areas, good science not popularity, should guide policy. I applaud the AAP's stand on this issue. As the Wyoming Chapter Vice-President, I have become more familiar with how the AAP adopts policy. The process often begins with proposals from individual members or chapters. These are brought to District meetings and then to the annual national Chapter Forum. At the Chapter Forum each Chapter's President and Vice-President have one vote. The Chapter Forum makes recommendations to the Board of Directors. The Board of Directors is the ultimate governing body. It consists of the ten District Chairmen, each elected from the ten districts covering the United States and Canada. AAP Policies pass through appropriate scientific review from Committees and Sections on their way to be considered by the Board. The process is not perfect, but it is certainly both representative by means of election of Board Members and it is based on scientific evidence by means of scrutiny by the best experts on the AAP Committees and in the Sections. This same process is how we get policies on Prevnar, policies on car safety and policies on adoption by homosexual couples. The fact that it is upsetting to some of the membership speaks well for the bravery and commitment of the leadership. Barry in Sheridan, Wyoming