More LGBTQ Millennials are Considering Children and Reproductive Technology

Monday March 11, 2019

A new report published by the Family Equality Council reveals a strong interest in parenting among U.S. LGBTQ Millennials compared to previous generations; 77 percent of those aged 18 to 35 already have or are considering having children, 63 percent in the 36 to 54 age group and 33 percent of those aged 55 and older.

Among all LGBTQ prospective parents, 41 percent are considering assisted reproductive technology (ART) such as intrauterine insemination (IUI), in-vitro fertilization (IVF), or surrogacy. Dr. Mark P. Trolice, Director of Fertility CARE: The IVF Center, supports LGBTQ patients looking to start or expand their families, and he calls on lawmakers and health insurers to extend equal rights and ART access to aspiring LGBTQ parents.

Following the 2015 Supreme Court ruling in favor of marriage equality, advocates projected an increase in the number of LGBTQ families. The Family Equality Council survey found that 48 percent of LGBTQ Millennials are currently planning to have children, compared to 55 percent of non-LGBTQ Millennials. While only 5 percent of existing LGBTQ families used assisted reproductive technology, 41 percent are considering using it to start or grow their families. Yet they are more likely to face obstacles than heterosexual couples; the authors of the Family Equality Council report noted that "insurance policies are rarely created to meet the needs of LGBTQ family building, and discrimination against LGBTQ prospective parents by agencies and providers remains widespread.

"Assisted reproductive technology expands family-building options for same-sex couples and allows them to have biologically related children of their own," explained Dr. Trolice. Reproductive treatments for gay and lesbian couples can vary depending on whether the prospective parents are male or female but are similar to the choices available to single men and women.

Lesbian couples may opt to have one partner donate the egg and the other carry the pregnancy, which would involve IVF; if one partner will fulfill both roles, IUI or IVF may be used. In either case, they would use donor sperm from a friend or sperm bank. Gay couples require an egg donor and a separate gestational carrier. During the IVF process, the prospective fathers may choose to fertilize the egg with the sperm of one or both partners through a procedure known as intracytoplasmic sperm injection, or ICSI.

With a growing number of fertility clinics welcoming same-sex couples, prospective LGBTQ parents can avoid the discrimination some have previously faced from healthcare providers and adoption agencies. However, the cost of ART remains a challenge not only for those whose health insurance does not cover fertility treatments but for those whose healthcare plans require proof of infertility and/or mandate six to 12 cycles of IUI to be paid out of pocket before coverage for reproductive assistance kicks in.

A single round of IUI can run between $300 and $1,000, or upwards of $1,500 with donor sperm, while IVF can cost tens of thousands of dollars. One study found couples who undergo an IVF procedure spent on average $15,435 more than those who underwent IUI. A USA Today article noted it can cost a lesbian couple $20,000 to $30,000 just to get pregnant, while a male couple could be looking at six figures including a surrogate to give birth to their child.

That's why Dr. Trolice is a vocal advocate of fair and equal health insurance policies for infertile and LGBTQ couples. "Parenthood is a closely held dream for many couples, and employers and insurers have the power to make that dream a reality through equal and inclusive healthcare plans," he asserted. "The goal of a fertility specialist is to present patients with treatment options that offer the best chance of a successful and healthy pregnancy, while taking cost and time considerations into account."