LGBTQ People and Assisted Reproduction Services

Creating Our Families: A pilot study of the experiences of lesbian, gay, bisexual and trans people accessing assisted human reproduction services in Ontario

Many lesbian, gay, bisexual, transgender, transsexual, two-spirit, and queer (LGBTQ) people choose to parent. However, many must rely on outside assistance to create their families, including adoption and assisted human reproduction (AHR) services. We conducted 40 interviews with 66 LGBTQ people across Ontario, Canada to find out if AHR services are meeting their needs. Unfortunately, we found that many LGBTQ people, in particular trans people, those who wish to use a known (sperm) donor, and those who desire surrogacy, encounter barriers accessing AHR services. 

“Despite being significant AHR service users, the AHR system is not traditionally set up with LGBTQ people in mind; it assumes that clients are heterosexual and cisgender (non-trans), partnered or married with access to two incomes, and dealing with [biomedically defined] infertility. Some or none of these assumptions may be true for LGBTQ AHR clients, and this can cause unnecessary confusion and hardships.” – green, Tarasoff, & Epstein

More about the “Creating Our Families” project, including who was involved, can be found on the Re:searching for LGBTQ Health and the LGBTQ Parenting Network websites.

A number of knowledge translation and exchange products were developed from this project, including a number of academic articles, a fact sheet for service providers, an interactive theatre workshop, and a set of educational videos.

November 2016: Recently, the Government of Canada issued a call for public input on the development of regulations under the Assisted Human Reproduction Act. Here are many of the products and publications (including 2 PhD dissertations!) that have come out of the Creating Our Families project that we hope policymakers will consult as they work to revise the AHRA to ensure that LGBTQ people’s unique experiences and needs are included.

Academic Article:

Sexual and gender minority peoples’ recommendations for assisted human reproduction services, L.E. Ross, L.A Tarasoff, S. Anderson, d. green, R. Epstein, S. Marvel, & L.S. Steele (Journal of Obstetrics and Gynaecology Canada)

ABSTRACT: Objective: To determine what recommendations lesbian, gay, bisexual, trans, and queer (LGBTQ) people have for provision of assisted human reproduction (AHR) services to their communities. Methods: Using a semi-structured guide, we interviewed a purposeful sample of 66 LGBTQ-identified individuals from across the province of Ontario who had used or had considered using AHR services since 2007. Results: Participants were predominantly cisgender (non-trans), white, same-sex partnered, urban women with relatively high levels of education and income. Participants made recommendations for changes to the following aspects of AHR service provision: (1) access to LGBTQ-relevant information, (2) adoption of patient-centred practices by AHR service providers, (3) training and education of service providers regarding LGBTQ issues and needs, (4) increased visibility of LGBTQ people in clinic environments, and (5) attention to service gaps of particular concern to LGBTQ people. Conclusion: Many of the recommendations made by study participants show how patient-centred models may address inequities in service delivery for LGBTQ people and for other patients who may have particular AHR service needs. Our results suggest that service providers need education to enact these patient-centred practices and to deliver equitable care to LGBTQ patients.

Presentation Slides:

Reframing Assisted Human Reproduction: Experiences of LGBTQ people in Ontario, L.A. Tarasoff (Social and Behavioural Health Sciences Divisional Seminar, Dalla Lana School of Public Health, 2013)

This photo by Lindsay Foster shows new dads Frank Nelson, 44, and BJ Barone, 34, hold their son Milo for the very first time on June 27, 2014 in Kingston, Ontario. This family was not part of our study but I can't help but share this beautiful photo. Click here for more about their story.

This photo by Lindsay Foster shows new dads Frank Nelson, 44, and BJ Barone, 34, holding their son Milo for the very first time on June 27, 2014 in Kingston, Ontario. This family did not participate in of our study but I can’t help but share this beautiful photo. Click here to learn about their story.

Fact Sheet:

Meeting the Assisted Human Reproduction (AHR) Needs of Lesbian, Gay, Bisexual, Trans and Queer (LGBTQ) People in Canada: A Fact Sheet for AHR Service Providers, d. green, L.A. Tarasoff, & R. Epstein (LGBTQ Parenting Network)

Guidebook:

A Guidebook for Lesbian, Gay, Bisexual, Trans and Queer People on Assisted Human Reproduction in Canada, d. green, L.A. Tarasoff, & R. Epstein (LGBTQ Parenting Network)

Related Research and Resources:

“Married, Single, or Gay?” Queerying and Trans-forming the Practices of Assisted Human Reproduction Services, R. Epstein (PhD Dissertation, York University)

Tracking Queer Kinships: Assisted Reproduction, Family Law & the Infertility Trap, S. Marvel (PhD Dissertation, York University)

Listening to LGBTQ People on Assisted Human Reproduction: Access to Reproductive Material, Services and Facilities, S. Marvel, L.A. Tarasoff, R.Epstein, d. green, L.S. Steele, & L.E. Ross (book chapter in Regulating Creation: The Law, Ethics, and Policy of Assisted Human Reproduction)

The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009.

Glossary – Assisted Human Reproduction, Health Canada

Service use and gaps in services for lesbian and bisexual women during donor insemination, pregnancy, and the postpartum period, L.E. Ross, L.S. Steele, & R. Epstein (academic article; focus groups with women who were themselves, or whose partners were, in the process of trying to conceive, biological parents of young children, and women who were non-biological parents of young children or whose partners were currently pregnant)

Lesbian and bisexual women’s recommendations for improving the provision of assisted reproductive technology services, L.E. Ross, L.S. Steele, & R. Epstein (academic article)

The Assisted Human Reproduction Act and LGBTQ Communities, R. Epstein and the AHRA/LGBTQ Working Group (policy position paper)

PrintLGBTQ Parenting Network (based in Toronto, the LGBTQ Parenting Network promotes the rights and well-being of lesbian, gay, bisexual, trans, and queer parents, prospective parents, and their families and children through education, research, outreach, and community organizing)

Who’s Your Daddy?: And Other Writings on Queer Parentingedited by R. Epstein (collection of essays about queer parenting by parents, prospective parents, writers, academics, lawyers, activists, health care professionals, and queer spawn, the children of LGBTQ parents)

My review of Who’s Your Daddy?: And Other Writings on Queer Parenting

Queering Motherhood: Narrative and Theoretical Perspectives, edited by M.F. Gibson (collection of essays written by a diverse range of authors, including scholars, activists, and queer parents)

Q&A with LGBTQ parenting activist Rachel Epstein (article)

Celebrating the “Other” Parent: Mental Health and Wellness of Expecting Lesbian, Bisexual, and Queer Non-Birth Parents, K.A. Abelsohn, R. Epstein, & L.E. Ross (academic article; interviews with 8 women who self-identified as a lesbian, bisexual, or queer woman, or a related term)

February 10, 2015: Weak fertility laws put potential parents on shaky ground (J. Nelson, The Globe and Mail)

February 10, 2015: Gay male couples face more hurdles on path to parenthood (B. Taylor, The Globe and Mail)

June 7, 2016: Ontario’s plan to change ‘family’ definition is positive for parents (Daily Advocate)

Book chapter available soon! Listening to LGBTQ People on Assisted Human Reproduction: Access to Reproductive Material, Services and Facilities 

More Related Research and Resources

CanadianInstitutesOfHealthResearch

Funding:

This project was funded by the Canadian Institutes of Health Research

The fact sheet and guidebook were funded by the now-defunct Assisted Human Reproduction Canada

To learn more about what is going with regard to AHR services in Canada, click here

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