Posted on February 19th, 2019by Dr. Jovana Lekovich

From My Perspective: Family Equality Council's LGBTQ Family Building Survey

The 2015 marriage equality ruling that legalized same-sex marriage nationwide evoked rapid change in the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community, particularly within family building options. In an effort to better understand the landscape of family building for LGBTQ adults in America, the Family Equality Council commissioned the LGBTQ Family Building Survey in 2018. This study marks an important step in recognizing the needs, fears, and aspirations this unique community experiences around the prospect of becoming parents. By recognizing these needs we can take steps to better serve this community and address their concerns.

The survey revealed that more than ever LGBTQ millennials want to expand their families by becoming first time parents or adding more children to their family. This shift in perspective can certainly be attributed to Assisted Reproductive Technology (ART) that has allowed individuals to build a family outside of the traditional mother-father roles. Advances in ART indisputably allow for more options for family building in the LGBTQ community. Specifically, reciprocal or co-IVF, a procedure in which one female partner’s oocytes are used to make embryos that will be transferred into the uterus of the other female partner who then carries the pregnancy, allows for both members of the couple to be organically and biologically involved. Fertility preservation for trans-men and trans-women is another important advancement. Ultimately, significant improvement in the public’s acceptance of same sex couples, legalization of marriage and family pursuit are the most important factors contributing to more members of this community pursuing family building.

From the findings, the Family Equality Council recommends that family building providers begin preparing their practices to be more inclusive and welcoming. First and foremost, it is essential that family building providers – from reproductive endocrinologists and obstetricians to neonatal social workers – be LGBTQ sensitive and friendly. When treating transgender individuals, for example, it is imperative to use preferred pronouns and be informed about and sensitive to the specific vocabulary used. If the patient finds any terms offensive or inaccurate then those words should not be used in communication with that patient.

Many treatment protocols are typically based on heterosexual couples with infertility. It is important to bear in mind that adjustments may need to be made depending on who is building a family. For example, oftentimes there is no need to use hormones for ovarian stimulation in conjunction with insemination in female same sex couples as would typically be used in heterosexual couples. Timed insemination of donor sperm around ovulation is often the only intervention needed in the above scenario. For the same reason, the success rates of these treatments, which again, usually come from studies on heterosexual couples with infertility, might not be accurate when we talk about same sex couples. It is necessary, therefore, for providers to follow new publications analyzing success rates in this population specifically in order to provide accurate and helpful information.

I am proud to be a physician at RMA of New York, one of the leading reproductive health centers in the nation. Because we are located in the heart of New York City where the LGBTQ community is greater than anywhere in the nation, we have the unique opportunity and pleasure to provide care for members of this group. Our physicians and staff are actively involved with Callen-Lorde and the LGBTQ Center in New York, providing valuable information and giving lectures and seminars on LGBTQ reproduction. We also work very closely with the Center for Transgender Medicine at Mount Sinai. We are extremely motivated and devoted to being pioneers of reproductive care for the community and take great pride in our work. I am eager to see more advances that will help the LGBTQ community build the family they desire.

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