Posted on June 9th, 2022by RMANY

Ep 91: Fertility and Family Planning for the LGBTQ+ Community

Fertility Forward 91:

Everyone’s fertility journey is different, and this is particularly true for members of the LGBTQ+ community. Joining us today for Pride Month are two very special guests, Finn Brigham and Dr. Juliet Widoff from Callen-Lorde. Dr. Juliet Widoff is an internist with a specialization in HIV care. She has been a primary care provider in a myriad of settings, and, for the bulk of her career, she has been providing services primarily to the LGBTQ+ communities. Finn Brigham is the Director of Project Management at Callen-Lorde and has extensive experience working with the LGBTQ+ community, HIV-positive individuals, people experiencing homelessness, and individuals affected by mental illness and substance use. In this episode, we discuss the various barriers to care that LGBTQ+ people face in reproductive health, as well as the lack of support around fertility and parental rights for LGBTQ+ families. Our guests explain why it’s important to start the family planning conversation with people of transgender experience early on in their transition process, how LGBTQ+ families differ from the nuclear heteronormative family, and the challenges faced by ‘queer spawn’. Tune in to stay informed and find out where to find support, if you feel misunderstood by the medical field and the world at large.

Transcript of Episode 91

Rena: Hi everyone. We are Rena and Dara, and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward podcast brings together advice for medical professionals, mental health specialists, wellness experts, and patients, because knowledge is power and you are your own best advocate.
Dara: We have two very special guests on today for Pride Month. We have Dr. Juliet Widoff and Finn Brigham. Dr. Juliet is an internist with a specialization in HIV care. She has been a primary care provider in many different settings, including the NYC public hospital system, homeless shelters, and for the bulk of her career at a federally qualified health center, providing services primarily to the LGBTQ+ communities. Her work has included a harm reduction programs and alternative insemination program running the medical service in a hotel housing unhoused folks with COVID and creating a project providing free medical care to anyone in need and book spaces. Finn Brigham is the Director of Project Management at Callen Lorde, where he has worked for 12 years serving in various roles from care coordination to special population services. He has a 22 year history serving LGBTQ+ HIV communities including work at the Ali Forney center and Vermont cares as well as various community organizing rules with the young leader council of the LGBT center and mental health, and has presented on LGB and transgender health issues across the country, including at the White House. He has a Masters of Nonprofit Management from the New School in the New York City and is a frequent media spokesperson on transgender issues for outlets, such as Vice, New York 1, NBC and BET among others. Wow! Thank you so much for both being here today. Both of you have had a lot of experience in this field.
Dr. Juliet: Thanks so much for having us. It’s a pleasure to be here.
Rena: We’re excited to have you on and talk about this really important topic that you know, impacts so many. And of course, it's great that we have now a month, you know, to recognize it, but I think it should also be, you know, 12 months, not just one month to really talk about this stuff.
Finn: For sure. Yeah. LGBT people access care all year long.
Rena: Exactly. So maybe start out by telling us a little bit about sort of Callen Lorde and the services that you do in terms of fertility.
Dr. Juliet: Do you wanna do the general Callen Lorde intro, Finn, and I'll do the more specific fertility stuff?
Finn: Sure. Yeah. So Callen Lorde is an LGBT focused community health center. We have clinical spaces in Chelsea and Manhattan, in the south Bronx, as well as Brooklyn. And we provide mostly primary care. Obviously a lot of our patients are living with HIV. A lot of our patients identify as transgender or non-binary. We have dental care. We have pharmacies on site. We have case management. We have a large behavioral health program that includes psych and we do have a youth program as well for LGBTQ youth folks.
Dr. Juliet: So the types of services we offer in terms of fertility have changed dramatically over my close to 12 year tenure here. When I first started here, we did have what we referred to as an alternative insemination program and we were tissue bank licensed, so we did do inseminations on site. As a federally qualified health center whose mandate is to care for people regardless of their ability to pay that was both a wonderful thing, but also a very complicated thing because it was a fee for service program because insurances don't cover that sort of thing. And it requires a level of attention to detail and willingness to be ready at any point, which I'm sure as you all know, working where you do, you need to, you know, you can't predict when someone is going to ovulate and need services. And so we transitioned out of providing those direct services to providing the less direct services of counseling and education around fertility and then referrals out as needed for folks. So I would say the majority of what we do now is providing care in terms of engaging people in conversations around fertility planning and in providing whatever education and resources they need in order to make their family planning goals a success.
Rena: Wow! What an amazing place and an incredible amount of services that you offer.
Dara: It sounds like it's evolved over the years, too, in terms of the care. When did fertility care begin or when did that the subject actually come to fruition in terms of the evolution?
Dr. Juliet: So I think it was, it was actually a couple of years prior. I started here in 2010 and I think it was a couple years prior to that. One of the medical providers who was working here before me started the, you know, introduced the notion of providing sort of full service care, primarily directed at women assigned at birth who were interested in carrying pregnancies. And as time has gone on, obviously we have become more interested in, you know, providing education and referral services for everyone who's interested in considering fertility and considering family planning. And yet it's a messy, complicated thing again, because we are a community health center and a federally qualified health center. Our patient population ranges quite dramatically in terms of access to care and in terms of money to pay for out of pocket sort of expenses that insurance does not cover. And so trying to provide the education and resources and means to meet people's family planning goals when those goals are not always covered by insurance is a messy and complicated thing and requires sort of inevitable evolution over time.
Rena: Sure.
Finn: And I think, I will say too, you know, this LGBT health and reproductive services has become more mainstream as things have evolved. You know, obviously since Juliet I've been doing this work, gay marriage has become legal in all 50 states. And so, you know, there are places like RMA that we feel more comfortable referring our patients to actually, you know, have more services than we can provide. Where I think when this got started at Callen Lorde, there was almost nowhere that we felt comfortable sending places or that people felt comfortable going that identified as LGBT to try to pursue these services. So that, that has been nice that there are now places we feel comfortable referring our patients.
Dara: Well, Yeah, Finn, I feel like I've known you for a number of years. Finn comes to RMA every year to do an in-service with our staff to educate us, and I've listened to various talks of his and really I've become so much more educated I feel like in this area.
Finn: Well, I'm sure we'll talk more about it, but you know, part of the education is talking about the barriers that LGBT folks have, particularly in reproductive health. And again, we can talk about that, but that's been wonderful to work with RMA to, to make you all understand what those barriers are. So hopefully when our patients try to access this, at least we're aware of the barriers even if we can't solve all of them.
Rena: Yeah. So I was gonna ask you, you know, we, we talk a lot on here about sort of, you know, cost barriers to care, but what are some specific barriers to care that people of the LGBTQ community face?
Finn: I mean, I think I'll list a couple and obviously Juliet, if you have stuff to add, please do. You know, I think one of the biggest concerns we hear is just the lack of providers that are trained to work with the LGBT population. You know, there might be providers that are more than willing to work with LGBT folks. That doesn't mean they're trained in how to do it, right? So, you know, if you have a transgender patient that says, you know, how often should I get a mammogram, if I'm a trans woman and a provider being like, I really have no idea. So even finding someone that's willing to work with you let alone having that training is really difficult. So that's a huge barrier. And we've talked already a little bit about insurance pieces and, you know, fertility in the insurance world is super complicated, but it becomes even more complicated for queer people because as you all know, you often have to prove you're infertile for insurances to cover fertility services, but that's virtually impossible for queer people to do. You know, if two women are together, how can they prove one is infertile and they're not getting pregnant together. That's obviously never gonna happen. Or a transgender man who has a cisgendered female partner. How can he prove that he's infertile and unable to provide sperm to his partner? So, you know, that becomes really complicated. So even the insurance coverage that does often happen for straight identified folks might not be available for LGBT folks.
Dr. Juliet: The only thing I would add is that, you know, the barriers continue sort of throughout. I know that I have had several trans guys who have carried pregnancies and literally every single time they go to the obstetrician, they are met with a confused, at best, uncertainty about what exactly they are doing there. And it goes on and on throughout the lifespan of, of having a family basically.
Dara: Wow. Yeah, for me, I guess, but I feel like, you know, how in nutrition you have to, there's continuing education credits that are required to keep your accreditation. I feel like that should be a requirement in the medical field for anyone in the medical field, really to be kept abreast with health and wellness for every community.
Dr. Juliet: Right. And that is becoming more and more widely accepted. And yet the truth of the matter is that the actual amount of education that anyone is provided with is exceedingly small and learning some basic facts doesn't always translate into inability.
Dara: True.
Finn: Sure. Yeah. And I will say, you know, most of our providers and I think, I think any providers would report that, you know, in nursing school, in medical school, there was very little attention given to LGBT health and if there was even if they had a half an hour lecture or something, it's often focused on HIV care, which of course is important, but is not the entirety of LGBT health at all. And, and to Juliet's point, even if you do sit through a few lectures, doesn't mean you're competent or not discriminatory, or are not making assumptions about patients. So that's a huge barrier across the board. And, you know, it's a barrier in New York City. So you can imagine what it's like, you know, in more rural communities and more red states, it just gets harder.
Dara: So in terms of someone in the LGBTQ community wants to start the fertility process kind of walk us through perhaps how Callen Lorde can, you know, the services or, you know, how you can get started in terms of like even where to begin kinda the first steps of care.
Dr. Juliet: So I think it depends dramatically on who that person is, right? So I'll give you a basic rundown for someone who is female assigned at birth. And then we can talk a little bit more about what that would look like for someone who is male assigned at birth, but for someone who is female assigned at birth, the first step in the process, well, there's two first steps. One is figuring out where you're gonna get that other stuff that's required. And then the other is figuring out your own body and what your own body is doing. And so in terms of resources, we do a whole education with folks about exactly how to chart your fertility, how to maximize your chances of conception during any given cycle and all the various medical pieces that are a part of figuring out, are you ovulating each month? When do you ovulate? And when do you do an insemination in order to maximize your chances? I can also provide people some guidance in terms of options, in terms of getting the other, the other side of things, getting sperm. So I can certainly give people some guidance about what to do in terms of considering using a known donor and then what to, you know, some basic things to think about in terms of using an unknown donor or a sperm bank. There used to be a lot of resources available at the LGBTQ community center. And that is less the case now, but there used to be both groups for folks who were seeking biological parenthood. There were folks who were, there were some meetups for people who were interested in working with other people around biological parenting, and then, you know, other forms of considering family planning was also part of that programming. And I believe that most of that was defunded just a little bit before the pandemic hit. And so that hasn't really come back in the same way, unfortunately.
Dara: Wow.
Rena: What about any suggestions, you know, we, we talk a lot in here about how to support people going through the process, how friends and family can help. Do you think that there are any unique challenges or emotional stressors that people specific in this community face that may be different than in a, a hetero couple?
Dr. Juliet: So, yes and no. I mean, so first I just, I just wanna take a step back and just say that the process is even more complicated for folks who are male assigned at birth and for folks of transgender experience, it's incredibly important for conversations about family planning to occur very early in the stages of transition.
Rena: I was actually gonna ask you, I was gonna say what, because, you know, we, we get a lot of patients who come into preserve fertility, but I was wondering, you know, if you're an onco patient, that's brought up kind of right away about fertility preservation, right? If you're gonna undergo treatment that's going to potentially, you know, cause damage to sperm or eggs. But is it, is that the same way if you're undergoing?
Dr. Juliet: So yes, absolutely. It is the same. You know, the conversation is actually built into our initial counseling with folks about beginning hormone therapy and beginning the transition process. The problem is, is that when you're an oncology patient, you, not always, obviously, but presumably you have some insurance, you're sitting there with a doctor having that kind of discussion. A lot of times for our patients who are beginning the transition process, they're quite young, they aren't thinking, you know, future for their, you know, what their, you know, future family looks like. They're thinking about preserving their life right now, not preserving the possibility of family planning in the future. You know, it's an interesting and complicated thing to try to address this thing that most folks of trans experience don't, you know, most young people don't have that much forward thinking about, you know, what life is gonna look like 10, 15, 20 years in the future. Obviously for folks who are transitioning at later points in their lives, that's sometimes an easier conversation, but it's also a question of financial means because the possibility of preserving your fertility when you're an oncology patient, I think is sometimes covered to some extent by insurance. But in terms of transitioning, it is not a covered expense. And so it is a fully out of pocket expense if someone wants to ensure the maintenance of their fertility, as they begin the process.
Rena: I could be incorrect, but I believe that it was built into the new New York insurance coverage that it is covered if your fertility treatment or preservation is covered if you're undergoing cancer treatment. But I'm wondering if there's any push now to also to expand that, to include if you're undergoing gender reassignment because that seems very exclusive. And as you mentioned, most people doing that are young and can't necessarily afford the thousands of dollars, you know, that it costs for preservation, you know, kind of similar to many people that are looking to freeze eggs. You know, usually they're, you know, women on the younger side and, you know, I think many women don't end up doing it because they have sticker shock, you know?
Dr. Juliet: Absolutely. No question. That happens an enormous amount. And in some cases prior to surgery, it is possible to, to reverse the effects of hormone therapy and be able to do family planning and to, and to become a biological parent. But in some cases it is not. And so built into our conversation around beginning the transition process is that we cannot, you know, we can't provide any, any definitive certainty about whether or not that is a possibility. And now I've forgotten what your initial question was that I went back and
Finn: Yeah, I think it was about like LGBT families and what sort of support or lack of thereof they may have, you know, in, in society and with their families. You know, I've been thinking about it while you've been talking. You know, I think that for one thing is, you know, LGBT families may or may not have their family of origin support in general and that's obviously really an important factor for a lot of people when they're raising their kids is, you know, that support from their family of origin. And so, you know, they may not have their support at all, let alone support around their children. Right? And so, you know, for example, if grandparents are like, if it's not their biological grandchildren feeling some kind of way about that and not being on board and not being supportive in the same way. And I think that there's, you know, there's a lot of services, I think for straight couples who are struggling to, you know, get pregnant or have had miscarriages, you know, there, there is support around fertility, which is very important, but not so much for LGBT families. And there also where there are laws and, you know, I think Julia can speak to this too, but around second parent adoption and what needs to happen for people, even if they're legally married around one person birthing a child, and it's harder in that way. You know, if, if two women, say, are legally married and one of them has a child, they still need to have that second parent adoption, even though they are married. So, you know, society doesn't really reflect sort of the reality of what's going on.
Rena: I know I'm so like I was gonna bring that up too, because I think that's so crazy. And it's so antiquated, righ? You know, now gay marriage is legal so why does one parent now have to adopt the child? And I, I think a lot of people, they don't know it, or they don't end up doing it because the legal expenses or, you know, the headache, whatever. But I think it leaves you, you know, really exposed, you know, if you end the partnership and you have no legal rights to your child,
Dr. Juliet: Not only if you end the partnership, but also depending on where you may move to it may have, it may have an impact as well. So, so yeah, so there's the financial barrier of having to go through the process of doing a second parent adoption or the uncertainty of what the future may bring. I know that there are some questions about if Roe v Wade is overturned, what may happen to gay marriage in the future. So we're talking about a very uncertain future in terms of acceptance and legal rights. Definitely.
Rena: It’s super scary. I mean, it, it's, it's so scary and there's already so many barriers to family building when you're in a space of needing fertility treatment. And so it, it just seems like that's sort of this added burden on people.
Dr. Juliet: It is. It is a messy and complicated thing. I know there is some, there's all kinds of things that are happening in terms of legal precedence around what makes a family and who is a parent. But again, in terms of ensuring your rights and ensuring, you know, the, the future of your family, second parent adoption has to be included at this point in time in family building. I think that probably, you all see people in a somewhat similar state to the way that at least folks who are female assigned at birth, who are, who are in, within the LGBT community and are family building have a similar sort of experience, heterosexual folks who do not have fertility complications, don't spend their time preparing to become pregnant, having their lives parsed up into these very particular segments of time, where they are waiting to ovulate, waiting to determine if they are pregnant or not. And I think that that part of the process is another way that, again, it's very similar to folks who are in the process of undergoing fertility treatments, but very different than how the heterosexual community generally manages the question of pregnancy where your life becomes all about, you know, are you ovulating? Are you pregnant? Are you ovulating? Are you pregnant? On and on?
Rena: I wanna, I wanna ask a question, which is probably gonna sound ignorant, but I feel like our podcast is all about, you know, we, we wanna learn and we wanna keep it real and be authentic. So this is me not knowing and needing to be educated. So I noticed both Dara and I said, LGBTQ and you and Finn are both saying LGBT. Is there a difference? I mean, I obviously know the difference in what each means, but in this space, how come you're not saying LGBTQ?
Finn: I mean, I, I would love to hear Juliet's answer to that. You know, I get asked this sometimes when I'm doing presentations and, you know, my answer is that there is not a, like a decided upon correct acronym that some entity has deemed as, like, THE answer. I think both LGBT and LGBTQ are common. I think, you know, there's even a question of whether the Q means queer or questioning, you know, sometimes there's like LGBTIA, including intersex and allies, you know, so there's, I just, don't, there's first of all, no entity that would make that decision. And, and so I think it's just sort of like how individual folks do that. I certainly don't mean to leave out the Q. And, and to that point, I actually just, you know, for your listeners wanna say that I really enjoy the word queer, not everyone does, especially, I'm generalizing, but the older community is less likely to embrace it because it had been used as a slur. But as a transgender man, you know, with a female partner, I can say I'm queer and I don't have to further say, well, I'm a transgender man, but I was a lesbian for a long time, and I'm mostly attracted to women, but, you know, to be honest, there's some men and, you know, some drag Queens that I, you know, you don't have to like, sort of put yourself in this really specific box. I can just say I'm queer and that means I'm part of this community sort of end of discussion. So that's my answer. I dunno if Juliet, you would have anything to add or change.
Dr. Juliet: No, and I also, I would love there to be like a single syllable word that we could use that part of the truth of the matter. And, and again, and I, I mean, no, no offense, and I wouldn't wanna un-include anyone, but that probably part of the reason I dropped the Q is just, it's just too many syllables when I'm kind of trying to get a thought out, rather than that, I don't wanna include someone within the mix.
Rena: Okay. I didn’t want to say something incorrect or not, you know, so that's how I wanted to know for my own self.
Finn: They’re all correct!
Dara: Rena, I was thinking the exact same thing! I was like, did I say the wrong thing in, in the beginning? And then also there's a plus, did I, you know?
Rena: I know, I know. Do I say the plus, do I say the IA that's, that's getting a lot of, of letters in my head and that's….
Dara: But I think that's good to know that that the queer could encompass a little bit more.
Dr. Juliet: Yeah. It depends very much who you're talking to and who you're, who's listening as to whether queer is considered acceptable or not. A lot of folks don't accept it. You happen to have two who are perfectly happy with it.
Rena: So we were emailing and Finn said, oh, Juliet's an expert in queer fertility. So I said, okay, so I'll use the Q, but, you know, I, I mean, what I, what think is great about this field is everything is always evolving and changing, right? I mean, look at how different this space is now than a few years ago, which is really incredible. You know, I, I know obviously the four of us are, are in this, and, but I think for general population and whole, I think there is much more acceptance and knowledge and understanding.
Dara: I had a question in terms of getting some legal support. Is that something that either of you have a discussion with your patients with, with the community of people that come to see you, is there ever a discussion of working with a lawyer to know your rights and to be kept abreast with what's going on in, in the care that they get?
Dr. Juliet: Absolutely. In some of the workshops that I used to do with a lawyer friend of mine who does a lot of family building and mediation work and has been involved in second parent adoptions and known donor agreements for many years. And so that was actually a really fun workshop that I've, again, we, we would shop around a little bit. It was great to have both the medical and the legal perspective at the same time. At the, the community center there are legal clinics and there are lawyers who specialize in this. I don't know whether we have a, a link with some legal services at Callen Lorde and I don't know how much of those legal services are able to provide family building support. Finn, do you know about that?
Finn: You know, I think it's, yeah, we have legal clinics for our patients. I don't think that it's their specialty. I think that they could get the ball rolling and, and refer out, but I'm glad you brought it up because it is super important. You know, we're talking about second parent adoption. I mean, these, you can't be too careful around the legality of these pieces, but it is a barrier, right? It costs a lot of money and there are some lawyers that will do it, you know, at a cheaper rate, or even for free, but that's not most of them. So that can become, become a huge barrier. And something that we haven't brought into the conversation, but I think when talking about the legality, it brought it up with surrogacy, which for a lot of gay men is something that they're pursuing more and more. I mean, I'm generalizing, there are, of course other people that pursue surrogacy, but, you know, the laws are changing in, in New York it used to be just straight up illegal to, to, to do that, at least on paper. You know, certainly you could do it, you know, unofficially, but those, those surrogacy laws are changing so that it is legal for folks to pursue that. But you would definitely need a lawyer. You need to be very, very cautious. So just to say, it is very important to involve a lawyer, but it's also very expensive.
Rena: I would say a great resource for that is connecting rainbows, which is we had her on our podcast probably a year ago at this point. Jenna Jaffe. She has a big Instagram, it's just @connectingrainbows, but it's, it's a ton of resources for the community, a lot of legal referrals. So that's a really good resource for people that are looking.
Dr. Juliet: I think this brings up one of, I think the most striking differences is that queer folks tend to create family rather differently than straight folks do. And part of that is, I think there's so many different reasons, but I know that some of the remarkable families that I know and that I'm blessed to be a part of are partially a creation of the desire to have kids, but to have them in ways that make sense to us. And so I, you know, just to bring that up, that, you know, family is not always this dyadic, nuclear family, especially in the queer community. I mean, that certainly happens, that certainly exists, but I think that as a, you know, more common rule that we have a more expansive notion of family.
Rena: I love that. And I think it's super important. I think, you know, really lucky to live in New York City where it is more common to see various types of families. But I, I know, especially, you know, out of this area, it's still sort of, you know, shocking when a family doesn't have a mom and a dad and there's all sorts of ways to make a family.
Dr. Juliet: And even here there is certainly, I mean, you know, my kids and kids and my, my friends have often come home from their elementary school feeling a certain amount of pressure about the fact that they don't have that standard one mom, one dad, often they have, you know, two moms and a dad and 20 aunties and 30 uncles and all sorts of godparents, but there is this pressure to have this, to have this very standard looking family still, even in New York City.
Rena: Yeah, totally. I mean, I'm a single parent, divorced and I mean, I know even myself, my daughter who's in kindergarten, you know, starting to ask questions cause her, she has a stepmother and, and you know, so we have a different sort of family structure and sort of navigating that is, it's, you know, it's tough.
Finn: Yeah. I mean, I'm glad we're talking about this cause I think, you know, we're talking about how people create, you know, families and almost in every LGBT creation of a child, there is at least one other person that was a part of it, whether they're a known donor or not, whether there was a surrogate, whether it was an adoption, like it's virtually impossible for, you know, two women or two men to create a child without some other human as a part of it. And, and what does that person mean to the family? Are they known to the family? Are they not? And, and to Juliet's point too, there's often just like more people around. And so I think it is important and you know, something I, I've started talking more and more about when I do presentations is the term queer spawn, which is an identity term that people, children of LGBT parents often take on. And you know, they're not always children, right? There are adult queer spawn people that have LGBT parents who are, you know, in their thirties and forties and fifties, but you know, something that Juliet brought up about queer spawn that I think is important to highlight is how important queer spawn feel like it is to have other queer spawn in their life to talk about the fact that, yeah, like people always assume I have a mom and a dad and I don't or whatever it may be and something that they there's two issues that I feel like that they've brought up to me that I think is important. One is feeling like you have to be this like perfect kid like that if you get in trouble at school, for whatever reason, it might be blamed on the fact that you have two moms or two dads and that your gay parents aren't bringing you up right and that's why, so you feel like you can never mess up. And the other part is if you're bullied because you have parents, are you likely to go home and tell your parents that cuz they're gonna feel bad, right? Like, so you might be alone in that. Whereas if you share a racial identity or a religious identity with your family, you might very well share that you're being bullied because of that, it'd be really hard to go home to your two gay dads and say I'm being bullied cuz I have two gay dads. And so you sort of hold that inside without anyone to talk to about it.
Rena: Sure.
Dara: I never thought of that. You made a good point.
Rena: I thought a lot about it on Mother's Day because my daughter in her school, they did Mother's Day projects, you know? And so they spent active time in school making stuff for mom and she came home, which okay, great for me, but it really made me think, not everyone has a mom. And is that, I mean, I have my own feelings about Mother's Day and Father's Day. I think I would say mother's day is one of the hardest days of the year for my patients, hands down my work always spikes and I have to prepare people for that holiday. So I don't really love it in general, but I think it's very exclusive, you Know? And especially to bring it into a, you know, a school curriculum where family structures are so different now.
Dr. Juliet: Sometimes, sometimes folks only have a grandma or a grandpa.
Rena: Right.
Dr. Juliet: Absolutely. No question.
Finn: I think the culture is slowly changing about that. I mean, I know my mom has passed and so Mother's Day is hard for that reason. Right. But I recently got an email from a company that said, we know that Mother's Day is hard for a lot of people. So if you wanna opt out of Mother's Day emails, like just let us know. And I was like, wow, that's amazing.
Rena: That was Etsy, right?
Finn: Yeah. Yeah. And so I was like, how cool to just acknowledge that, that maybe I don't want a million, like, what are you getting your mother on Mother's Day? But you know, there's a bunch of reasons that these holidays are complicated. And I think there is some slow beginning of understanding of maybe at being more inclusive about them.
Rena: I think it just puts kids, especially in a hard position because how's it, you know, a kindergartner gonna say I'm gonna opt out of this project?
Finn: Right.
Rena: But I think that is sort of the, but I think that is sort of the, the next thing, hopefully that people start talking about it. I think the holidays are very, you know, they're difficult for people in so many ways. Right? What if you've had a loss of a parent or you never had that parent and to make it part of a school curriculum, I just, I'm not super on board with that.
Dara: I think we still, you know, we have to keep on having these conversations and these discussions and, and hopefully, you know, I since said bit by bit, slowly, the conversation will, will continue and things will change.
Rena: So any final thoughts, any burning desires that you wanna share that you think would be super important for our listeners to know that we didn't touch upon?
Dara: Or even what you hope to see down the road?
Finn: Yeah. I mean, I think my final thought, and I would love to give Juliet the final final thought, but is just, you know, for providers or, and virtually anyone listening is just not make assumptions about families, about parents, about, you know, how kids were born about, you know, with assuming everyone has a mom and a dad, assuming people are straight, assuming people are not transgender. Like you're going to be wrong about these assumptions. So, you know, when you meet people or meet families or whatever it may be just don't assume you know their story because you probably don't and it's probably a little more complicated than you think. So do your best to just sort of ask open-ended questions other than making any assumptions about people. And on a, I don't know, an optimistic note, I guess, you know, the younger people in my life, my niece and nephew are so confused by homophobia and transphobia. Like they genuinely don't understand, you know, I picked my niece up once from a school dance and I said, you know, well, if two girls like dance together or two boys dance together, like would anyone care? She was like, no, like she genuinely didn't understand why I was asking that or why that would be a problem. And it was so wonderful. And so I'm very optimistic about the next generation, really continuing to expand the LGBT definition and continuing to expand what families mean and just having more awareness of these types of issues. So we'll see how things continue to evolve slowly but surely in the right direction I think.
Dr. Juliet: I'm gonna just add one little thing to what you said, Finn, which is absolutely don't make assumptions and don't assume that whoever it is that you've made assumptions and then found out that they were not correct. They're the person to ask the questions of. Do the work on your own and ask the questions of the professionals. I think one of the things that's very difficult for folks is to always feel like they have to be the educator for everyone else. So that would be the one additional thing I would add just to what you're saying. I don't think I have another brilliant, additional thing to add generally.
Finn: Well, I know to that point, if, if the final point can be a plug for Callen Lorde, just to say, we do offer these trainings, we do do LGBT competency trainings and whatnot. So if, you know, if your agency, if your family, if whatever it is could use this training so that you're not asking it of your patients or your clients, we are happy to be those folks and do those educations
Rena: Amazing. What a wonderful.
Dr. Juliet: Nice to bring it around.
Dara: Yeah. And beautiful. And, and I mean, I think that's beautifully said is, is don't make assumptions and get educated and so wonderful that Callen Lorde is a great resource out there. And we are so appreciative of both of you for, for being on. How we like to end our podcast is a note on gratitude. So Juliet and Finn, what are both of you grateful for today?
Dr. Juliet: I do this every night with my family, actually. And it drives my kids bonkers! But so, and I think that gratitude is, I'm grateful for gratitude. I think that it opens us up in so many wonderful ways. And so I guess today because of what we were talking about, I am grateful for my loving partner of 20 something years. I am grateful for my beautiful kids. The one I birthed, the one she birthed, the one neither of us birthed, and our incredible community and all the, the gaybies and queer spawn out there.
Finn: That's hard to top, I guess I'll just say, you know, it's early in Pride month and I am, I'm really grateful to be a part of the queer community. I've learned so much. I mean, you know, Juliet mentioned the definition of family and the ways that the queer community does that is just such a wonderful thing to be a part of. So I'm grateful to be queer and I'm certainly grateful to all the allies that continue to make things safer for us.
Rena: I love that! Dara, what about you?
Dara: Rena? Oh, I was just thinking about my friends today. I was yeah. Thinking how I've made such a great group of, of people, you know, that I've, that are part of my life. So I'm yeah, I'm grateful for my community who accepts me and loves me for who I am, you know, good, bad and ugly. And yeah. And grateful also for this conversation today. I, you know, I, I love being a part of this podcast for many reasons, predominantly to learn myself and, and really be educated. There's always something that we can learn. And today I learned a whole lot. Rena?
Rena: I guess the same sort of theme. I'm grateful for community and acceptance as I have reached out to my own sort of community that I'm creating of late and just found this sort of amazing acceptance and, and no judgment from people and just real human kindness. It's been really nice to be back in a space with people and, and knowing that that still exists. So I'm, I'm really grateful for that.
Dara: Lots of love. Lots of gratitude. Thanks again for, for being on both of you.
Finn and Dr. Juliet: Thank you for having us.
Dara: Thank you so much for listening today and always remember: practice gratitude, give a little love to someone else and yourself, and remember - you are not alone. Find us on Instagram @fertility_forward and if you're looking for more support, visit us at and tune in next week for more fertility.

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