In 2022, it may seem like we have made lots of progress when it comes to supporting members of the LGBTQ+ community on their road to parenthood. In society and on social media, there are more diverse examples of family life than ever before and medical advancements have made it possible for same-sex couples to become parents and even for men to carry their babies.
However, it would be naive to think that there are still not huge disparities in how fertility support is offered – and that LGBTQ+couples are getting a rough deal. Here are just 4 examples of discriminatory barriers LGBTQ+ couples face, if and when they decide to become parents.
Harder for LGBTQ+ couples to get IVF on the NHS
We are all aware that the NHS postcode lottery is unfair. In England, the country is split into separate Clinical Commissioning Groups (CCGs) – and each CCG has its own rules on how to assign free IVF treatment. It means that some couples can have more NHS-funded support, depending on where they live – in some areas you can have three rounds whereas elsewhere it’s only one. This process affects many couples and definitely needs to change, but for LGBTQ+ couples it is even more unjust.
Most of the time, heterosexual couples qualify for NHS-funded IVF if they can’t conceive after two years of unprotected sex. However, in many CCGs, female LGBTQ+ couples and single women have to self-fund private rounds of artificial insemination before they can even be considered for free treatment. This process is not only long and stressful, but it can also be incredibly expensive – which brings us to our second point…
Home Insemination is increasingly expensive
Whilst at-home insemination might sound simple – it’s far from it – and can come with lots of risks and/or a huge bill. In 2005, rules were changed which means it’s no longer possible for sperm from sperm banks to be shipped to private homes. That means that if you want to go through artificial insemination you have two options.
One is to use sperm from a sperm bank and have the insemination done at a clinic. This comes with lots of costs involved. A vial of donor sperm costs around £1000 and that’s before you even pay for the insemination process itself.
The other option is to use a private sperm donor – and for some couples, this is the right choice and one they are happy with. You might decide to choose a donor who is a close friend or family member, so you and your child can have an ongoing relationship with them and it’s a lot more affordable than going through a clinic. However, private sperm donation can also come with risks. There can be legal complexities when using a known donor and you can’t always be sure that the sperm has been tested for STIs or that the donor hasn’t already fathered multiple children (in clinics there is a limit). There is also a growing number of men who offer sperm donation via social media. Whilst some of these guys are offering to do this with good intentions – there are some people out there using it as an opportunity to prey on vulnerable couples. You can read more about private sperm donation here.
In forcing LGBTQ+ couples to go through artificial insemination before they can get any support for IVF, we’re putting them in a tough situation – spend thousands of pounds on treatment or put yourself at risk.
Other countries banning LGBTQ+ couples completely
For heterosexual couples, when NHS funding is not available – or if they are struggling to pay for expensive private treatments – they do have another option: go for IVF abroad. IVF in other countries is often a lot cheaper than treatments in the UK – and significantly cheaper than in the States.
However, for LGBTQ+ couples, their options for cheaper IVF are limited as there are still some countries that refuse to help them. Popular countries for affordable IVF – such as Greece and Turkey – still have discriminatory legislation that means same-sex couples can’t access affordable treatment. Even if in the UK we are constantly working towards improved gay rights, for couples to have complete equality when it comes to fertility, it’s essential that other countries follow suit and at least make it possible for LGBTQ+ couples to attempt IVF.
Trans Fertility Preservation
It’s not only IVF that is controlled by CCGs. Other processes involved in fertility treatments – including fertility preservation – are also impacted by geography. This can be a big problem for members of the trans community.
In the UK, if you are having medical treatment that could affect your fertility – for example, radiotherapy for cancer – you will be offered the option to freeze sperm or eggs for free on the NHS. However, there is no blanket rule to support those transitioning, despite the fact that their fertility will definitely be affected as they go through the process.
Once again, the chances of you getting affordable support are dictated by your local CCGs, but even then the chances of receiving help are low. At present, the National Institute for Health and Care Excellence (NICE) guidelines – which provides advice to CCGs on who should be treated on the NHS, does not provide guidance around fertility preservation for people with gender dysphoria.
It’s clear that for LGBTQ+ people, the road to parenthood is not always easy – and it certainly isn’t cheap. We need to keep pushing for fair fertility treatment for all, no matter who they are and who they love.