For queer people, issues like harassment and discrimination are common when navigating public institutions, including hospitals and other spaces that offer medical services. And when it comes to family-building and planning, there are things that queer people seeking fertility treatment deserve that they aren't getting, even in the year 2019. If the first step to eradicating a problem is admitting one exists, then it's helpful to look at what LGBTQ people need when starting their families, and how we can assist them, whether it be legally, legislatively, or personally.
In an effort to better understand how lesbian, gay, bisexual, transgender, and queer adults in the United States approach the topic of family-building — especially in the aftermath of Obergefell vs Hodges, the 2015 Supreme Court case that ruled in favor of same-sex marriage — the Family Equality Council (FEC) conducted a nationwide survey to account for gaps in current research that rely on outdated information. The data gathered by the FEC revealed that 77% of LGBTQ millennials, ages 18-35, are either already parents or are considering having children, 63% of all LGBTQ individuals 18-35 are considering expanding their families in the coming years, and only 37% of all LGBTQ people reported considering intercourse as a method for family building. The survey also revealed that many queer families rely on Assisted Reproductive Technology (ART) — like intrauterine insemination, at-home insemination, and in vitro fertilization — to start their families.
People who are a part of marginalized communities are more likely to experience discrimination or microaggressions when seeking medical care. And, unfortunately, the current administration's anti-LGBTQ policies are making it that much more difficult for LGBTQ people to access comprehensive, compassionate health care. But like anyone trying to start their family with their significant other, there are a few basic things that LGBTQ families deserve when making this big life decision, including the following:
1. Legal Advocacy
Romper spoke with Dr. Aimee Eyvazzadeh, a globally recognized fertility doctor who’s worked with many queer families who’ve experienced barriers to family building, to better understand what these families need. Some queer families are used to dealing with “doctors and other health care providers who are prejudiced and aren’t queer-friendly," she said, adding that in addition to hurt feelings, queer families sometimes face prejudice that can impact their treatment.
There’s a fine line between microaggressions and legally questionable behavior. One thing that queer families deserve is legal advocacy in case they do have to navigate situations involving mistreatment, harassment, or discrimination while seeking treatment. Further, they deserve legal advocacy that is affordable, culturally-competent and committed to respecting them.
2. Public Education
Not only would public education about how different family planning can look depending on a family’s needs be a great way to change heteronormative conversations, it could also help to reduce stigmas. In sexual education classes across the country, it’s rare to find curriculum that includes lessons about queer families and the unique experiences of queer people who want to have children.
What’s normalized are heterosexual relationships in which a cis man and a cis woman have intercourse in hopes of conceiving. That’s not how it always happens. Queer and heterosexual couples trying to conceive use many different methods to conceive, and it’s important for those methods to be common knowledge. A universal understanding of the numerous ways one can start a family, could very well lead to fewer assumptions and possibly offensive conversations and questions.
3. Family Support
Whether they’re your family by blood or by choice, support from people you know and love the most is incredibly important. Struggling with fertility issues can be difficult, and it’s necessary for queer families in that position to have a solid support network.
You can “go to appointments, help with record keeping, and ask questions,” Dr. Eyvazzadeh says. If someone you love is undergoing fertility treatments, asking them what they need can be the easiest way to find out what will actually help them. What you can offer them in terms of support. Be there.
4. Culturally-Competent Care
“Straight people never have to wonder if a clinic will offer treatment,” Dr. Eyvazzadeh says. “When you’re queer, it’s a different story. You may see a doctor who is prejudiced against different groups of people and refuse to help you.”
There are countless examples in recent history of queer people being denied service, resources, or medical treatment simply because the provider was prejudiced. And in May of this year, the Department of Health and Human Services (HHS) issued a rule that would allow health care providers to deny service to LGBTQ people under the guise of "religious freedom." Queer families deserve culturally-competent care so that their family-building journey can be marked by support and comfort, instead of discrimination and fear.
5. Access To Support Groups
"Oftentimes, heterosexual couples can receive an infertility diagnosis after one year, but queer couples would have to go through six cycles of failed Intrauterine insemination (IUI) cycles before being given an infertile diagnosis," Dr. Eyvazzadeh says. "Oh, and they would have to pay for those six IUI cycles.”
Those failed Intrauterine insemination (IUI) cycles can be devastating. Queer families struggling with ART-related complications may not have anyone to talk to who understands what they’re going through, so support groups can be a place to turn to.
“Not everyone is as lucky as the patients in [my] area,” Dr. Eyvazzadeh explains. “You can drive one hour outside of the city and suddenly encounter a very different response to seeking fertility treatment. I’ve had patients tell me stories of their doctors refusing to treat them because it was against their religion. It’s very sad to me that this still happens today.”
Queer families deserve to have access to support groups to connect with others and feel less alone. They may also even learn about resources they didn’t know about before from other queer families on a similar journey.
6. An Informed Village
If you have stable access to the internet, take some time to research information about things the LGBTQ person in your life has mentioned needing or wanting. That could mean any number of things, and will depend on the person, but it’s a good idea to stay informed. If you plan to be there for them through their family-building journey, make sure they know you’re genuinely available to help and support them with whatever they may need. It helps to stay informed and up-to-date on different topics that they deem important.
7. Loved Ones Who Listen
Dr. Eyvazzadeh says that we all should “listen to what they’ve been through” when talking with friends or family going through fertility treatment. Sometimes, all someone wants is someone to talk to, to share their experiences with, and for someone who cares about them to just be there. They may not need any answers, advice, or guidance from you. They may just want some of your time to vent or process their experiences. You can be that ear or that shoulder for them to rely on, especially when they’re struggling or feeling helpless.
8. Assumption-Free Conversations
"You may have two women and the assumption could wrongly be that both women want to carry a baby," Dr. Eyvazzadeh says. "You don’t know until you ask. For that reason, it’s very important for a provider to ask things like, 'What does your family look like to you in five years?'"
If a family wants to include you in intimate details about family planning, then you can find out more about what they’re going through. If they don’t, then it's best to avoid making assumptions about what you think they want or what you think they're experiencing. These assumptions aren't just awkward, they're invasive. Instead, ask questions, and depending on their level of trust and comfort, they may offer deeper insight. Either way, don’t assume things based on what you think you understand about their goals.