Inclusive Family Planning: The Specific Challenges Facing LGBTQ Couples

Though there has been a lot of progress in recent years, even now, not all fertility clinics are accepting and inclusive of non-heterosexual couples. This comes from a long history of discrimination, often codified by national institutions. For years, the “fertility industry [has been] a largely unregulated field” with recommendations from the Food and Drug Administration and American Society for Reproductive Medicine that have often been used to discriminate against the gay, lesbian, and transgender communities.

Though LGBTQ couples and individuals may face some unique challenges in growing their family - from the specific treatments or donor services needed - they should not be limited in their access to care. If you are a part of the LGBTQ community and are hoping to have a child of your own, here are some of the steps and procedures that you can expect.

Growing Your Family

Most LGBTQ couples will need a combination of fertility treatments, donors, and surrogacy to achieve their family building goals. There may also be some legal decisions to consider before beginning your journey to parenthood.

Couples With Two Male Partners

An important decision to make is the type of surrogacy that you will use. There are two main types of surrogacy: traditional surrogacy and gestational surrogacy.

Gay FamilyWith traditional surrogacy, the woman carrying the pregnancy is also the biological parent of the baby. This method is sometimes preferred for couples who want both partners to have a genetic relationship with their baby - for example, one partner may donate the sperm while a relative, a sister or cousin, of the other partner acts as the surrogate. This type of arrangement may only require intrauterine insemination (IUI) rather than a full round of in vitro fertilization (IVF) making the process somewhat less invasive and expensive. Traditional surrogacy does come with some specific legal challenges, and depending on where you live your surrogate may maintain parental rights.

Because of these complications, many couples instead choose gestational surrogacy. In this situation the surrogate is carrying a fetus created through IVF from a donor egg and is not the biological mother. While most states have protections with either type of surrogacy, the clear separation with gestational surrogacy can be comforting.

Couples With Two Female Partners

There are a few major decisions to be made as you begin fertility treatments:

  • Who will carry the pregnancy
  • Who will supply the egg
  • Who will be your sperm donor

There are many different ways to share in a pregnancy. Some couples choose to have one partner donate the egg while the other partner carries the pregnancy, a process called reciprocal IVF. Some choose to have the partner carrying the pregnancy also be the biological mother of the baby. And some couples will choose a family member of one partner as the sperm donor so that the baby will be biologically related to both parents. This method has some of the same legal complications as traditional surrogacy, so before choosing this method you may want to consult with a lawyer and establish you parental rights.

Lesbian Family

Depending on which direction you decide to go, you or your partner will likely undergo either intrauterine insemination or IVF using sperm from either a known or anonymous donor.

Couples With a Transgender Partner


Transgender FamilyIf one or both partners in a couple are transgender, there are few different steps that may need to be taken for you to conceive. Depending on pre- or post-operative status, if the transgender partner wants to either carry the pregnancy or provide sperm or eggs for fertilization, they may have to stop their hormone therapy during that time.

Many doctors are now recommending that transgender patients freeze and preserve their sperm or eggs before transitioning, so if you are in that position it may be more a matter of finding a donor or a surrogate to support your pregnancy. Whatever your situation, know that your dreams of a family are possible with the right treatment and support.

Individualized and Inclusive Care

Every couple and every situation is different. That’s why there is no one-size-fits-all method to fertility treatment. From the beginning, we have been committed to highly personalized and inclusive fertility care for all. We offer a free 30-minute phone consultation for anyone starting on the journey to parenthood. Our fertility experts are always happen to answer any questions you might have as well as advise you on the best next steps. We can’t wait to work with you to build your dream family - contact us today!

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