LGBTQIA+ Folks Have Options For Creating A Family — But There Are Major Hurdles Too

Despite being bombarded with the heteronormative narrative in media, advertising, books, music, and in all of the other spaces that sell the idea of “normal,” not everyone is cisgender and straight. Shocking, I know.

Not only do queer folks exist, but our numbers are rising. Cue evil laughter as we check another box off of our agenda. A 2017 Gallup poll showed that the number of Americans who identify as lesbian, gay, bisexual or transgender (LGBT) rose from 4.1% in 2016 to 4.5%, or roughly 11 million Americans. In the course of the few years since that data has been collected, I promise you America is even queerer than before. But within the statistics we know, there are 6.1 million 18-35 year old LGBTQ identified people in America. Family Equality reported that 63 percent of these LGBTQ millennials are looking to start, or add to, a family through one of many options.

I will acknowledge that fertility and the ability to conceive and then carry a baby to birth is not guaranteed for anyone, no matter their identity or sexuality. So before you say “not all straight people,” please know that I appreciate and see you. My point going forward is that for most queer folks, the option to build a family in the same way cis-het people try to start a family is not there.

Making a family is not as easy as removing the goalie from the net. (I hate that phrase, BTW.) For many LGBTQIA+ folks, building a family means relying on someone outside of your home to bring a child into it. The desire to become a parent isn’t less when you identify as LGBTQIA+, but the path to get there is harder and much more expensive than that of our cis-het friends.

I am also going to remind folks that I will not over-label the process. Pregnancy is not just for women; transgender men can and do become pregnant. Sperm and eggs can and are retrieved from all genders. And no matter how a relationship or individual looks to you, the ability to carry a child or contribute to making one shouldn’t be measured by your assumptions.

Sperm Donors

When my ex-partner and I were ready to start our family more than 10 years ago, our Vermont Civil Union wasn’t recognized by the federal government or by most states. This meant that even before we knew how we would bring a baby into our lives, we knew we would need a lawyer to defend our rights as same-sex parents.

At the time, I was then identifying as a woman who was in a relationship with another woman. Even with the Marriage Equality Act and SCOTUS upholding LGBTQIA+ rights in the workplace, queer folks are still discriminated against in all sections of our lives, including the ability to become parents. We also have to fight for access to health care and insurance which are both necessary in our ability to take care of our children.

Even with a uterus, I had no desire to be pregnant; however, my ex-partner did, and we conceived our children through Intrauterine Insemination (IUI) via an anonymous sperm donor. We spent nearly $10,000 to purchase sperm, access care at a fertility clinic, and file legal documentation that states I am my children’s legal guardian.

A cheaper option for some individuals or couples is to use sperm from a friend or family member in order to conceive a baby. This is called a known donor and, like frozen sperm from a cryobank, can be done at home via in-home insemination or a fertility clinic.

For folks who can’t conceive via insemination, the use of In Vitro Fertilization (IVF) may be necessary. This is another layer of invasiveness and expense that can both increase and reduce queer people’s chances of building a family.

Egg Donor/Surrogacy

Some LGBTQIA+ folks have sperm but don’t have eggs or a uterus to carry an embryo. Individuals may choose to purchase donor eggs and then fertilize them via IVF. Healthy embryos are then transferred into a gestational carrier’s uterus. Sometimes a surrogate may be the egg donor. In this case a child conceived will have both the intended parent and surrogate’s genetics, so parental rights of the surrogate will need to be removed. Another option is to use a surrogate to carry a donor embryo. Surrogacy is very expensive, and while using a known egg donor or known surrogate is a bit cheaper, the costs can range from $70,000-$150,000.

Adoption

Fostering to adopt, adoption through private agencies, and international adoptions are options for LGBTQIA+ folks. However, queer folks are still openly discriminated against when it comes to applying to foster or adopt a child. International adoption can range from $25,000-$70,000.

Yes, LGBTQIA+ people have options, but there are also ridiculously high expenses. Scary Mommy asked Dr. Briana J. Rudick, MD, Director, Third Party Reproduction at Columbia University Fertility Center about what can be done to help LGBTQIA+ people avoid bankruptcy while trying to build a family.

Dr. Rudick says, “There are some insurance companies which have specific policies for IUI without a diagnosis of infertility first – but they are few and far between. Since insurance is employer based – the push will need to come from employers to get coverage for LGBTQIA+ patients.” After Trump’s announcement that he would roll back health care protections for transgender patients, I am not optimistic about better health care coverage, if any. Rudick suggests that in-home sperm donor inseminations could be more affordable for those who use sperm donors, but insurance companies do not cover the cost of donor sperm. They don’t cover egg donors, surrogacy, or adoption costs either.

And just when we thought our odds were disproportionately stacked against us, COVID-19 stopped all fertility treatments. Rudick says that did prompt some cryobanks to offer more patient-friendly at-home insemination kits. Many places have reopened their fertility clinics, but with the addition of extra precautions and counseling. “There is still a lot that we don’t know about this virus and pregnancy,” says Dr. Rudick.

I have my babies—now nine and seven. As a seasoned member of the queer community, I love offering advice and stories about my journey to parenthood. As an advocate for LGBTQIA+ folks, I make it my job to educate businesses, work spaces, and health care spaces on how to practice inclusivity for all genders and sexualities.

Regarding what is being done in her clinic to be sure all patients feel safe, respected, and understood, Dr. Rudick says this: “We examine all aspects of the patient experience from the first person that they speak to on the phone, to the environment that greets them in the waiting room, to their intake questionnaires, to front desk staff, medical assistants, nursing, bathrooms – all of this should be taken into consideration when making patients feel respected and supported. Particularly for transgender patients, taking a multidisciplinary approach is important in pursuing fertility goals.”

LGBTQIA+ folks have options when it comes to family building, but we have hurdles too. Do us a favor and vote people into office who support all families, and push your employers to do the same.