What evidence is already out there?
As part of our Priority Setting Partnership, we looked to see what evidence has already been published on the 48 summary questions that LGBTQIA+ people, supporters and health professionals submitted (see more about the process here).
Short summaries of the evidence that we found are on this page, next to the question they are related to. Each summary gives a link to the published paper or report, most of which are free for anyone to read (“open access”).
To see the list of all questions, click here. You can jump back to the right section of this evidence list from each of these questions.
Our evidence check took place in spring of 2025. We will not be keeping it up to date as more evidence is published. The evidence check was not a ‘systematic review’ – there were too many questions to do exhaustive searches for each one. We may have missed some evidence.
We have not ‘appraised’ the evidence – this means trying to decide the quality of the evidence or whether it might be biased and inaccurate. Some of the evidence on this page is likely to be of low quality and may be biased. LGBTQIA+ people should discuss evidence with their health professionals before making any medical decisions
Q1. How do healthcare responses to LGBTQIA+ people’s intersectional identities affect whether they can become parents and have good perinatal care? (For example, those who may be subjected to disable-ism, fatphobia, racism or faith-based discrimination). What are the barriers to improving this?
LGBT Foundation 2022: Trans and non-binary experiences of maternity services. This is a report compiled by a charity, found here: https://lgbt.foundation/wp-content/uploads/2024/01/ITEMS20final.pdf Open Access
Summary: This project carried out a large non-systematic survey and also interviewed 4 trans and non-binary people about their experiences of ‘maternity’ services, including two people of colour. These participants described the impacts of the intersections of racism and transphobia in their perinatal experience.
Q2. What does LGBTQIA+ inclusive care look like? What models of perinatal care (for example, specialist midwives, LGBTQIA+ ‘out’ healthcare professionals, continuity of carer) work for LGBTQIA+ people?
Murdock, 2024: Midwives defining what they feel constitutes inclusive care https://doi.org/10.1111/jmwh.13557 Open Access
Summary: When defining inclusive care, midwives described the following principles: using inclusive language, changing the clinical environment, amending documents and websites, and tailoring care for each client.
LGBT Foundation 2022: Trans and non-binary experiences of maternity services. This is a report compiled by a charity, found here: https://lgbt.foundation/wp-content/uploads/2024/01/ITEMS20final.pdf Open Access
Summary: This project gathered non-systematic survey data from 121 trans and non-binary people in the UK who had ever given birth or were pregnant and also interviewed 4 people. To increase inclusive care, the report recommends that the NHS should provide targeted information for trans and non-binary pregnant and birthing people; ask people about the most appropriate language to use and then record this for implementation during care; ensure IT systems can recognise gender appropriately and routinely record gender identity; increase the visibility of a commitment to inclusive care; co-create personalised support plans; recognise the importance of trauma informed care; and implement training for perinatal staff and managers.
Riggs et al 2021: Pregnant transmasculine and non-binary people’s experiences of midwifery care. This is a chapter of a midwifery textbook available here: https://ruthpearce.net/wp-content/uploads/2024/01/men-transmasculine-and-non-binary-people-and-midwifery-care.pdf Open Access
Summary: 51 trans and non-binary people with experience of conception were interviewed from UK, US, Australia, Canada and Germany. Positive experiences with midwives included asking for consent to touch people’s bodies, ensuring correct gender markers were recorded on paper and electronically, and advocating for inclusive care from colleagues. Some participants felt supported by midwives disclosing that they had trans and non-binary family members. Some participants felt well supported by male midwives. Recommendations for inclusive care included gathering information on pronouns, names and preferred terminology, collating it and ensuring all staff were aware of it; ongoing training due to the fast moving past of literature in this area; continuity of care; avoidance of simplistic comparisons; proactively seeking to minimise any gender related distress from the perinatatal process; advocating for systemic change such as in data collection, inclusive imagery and language; understanding the limits and challenges of chestfeeding; and advocating for further research.
Hoffkling et al, 2017: Recommendations arising from the experience of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5 Open Access
Summary: 10 transgender men who had given birth were interviewed. Using the correct name and pronouns and providing increased levels of privacy were reported as being fundamental to feeling safe. Healthcare providers educating themselves rather than asking the patient to educate them, treating trans pregnancy as within the normal spectrum of care, and making joint assessments of risk in the absence of good evidence, were all perceived as good elements of care. Respecting and accepting trans people was reported to be more important than being expert in trans medical care.
Q3. What training do healthcare professionals and their educators need about how LGBTQIA+ people become parents (including family creation, perinatal care and infant feeding)?
Parker et al, 2025: An example of embedding LGBTQ+ training in midwifery training https://doi.org/10.1016/j.wombi.2024.101850 Open Access
Summary: This paper provides a context and a pedagogical approach to embedding LGBTQIA+ health equity in one school of midwifery in Aotearoa New Zealand. It describes the steps taken using a holistic whole-of-programme approach grounded in intersectionality, cultural safety and humility, and indigenous justice.
Murdock, 2024: Defining existing training and gaps https://doi.org/10.1111/jmwh.13557 Open Access
Summary: Eleven midwives were interviewed. When defining training needs for inclusive care, midwives described the following principles: using inclusive language, changing the clinical environment, amending documents and websites, and tailoring care for each client
Pezaro et al, 2022: Defining educational needs of professionals related to perinatal care for trans and nonbinary people
https://doi.org/10.1177/08912432221138086 Open Access
Summary: This paper explored the educational needs of 108 perinatal staff in the United Kingdom (97% midwives or student midwives) as related to the needs of trans and nonbinary service users. It used a self-administered internet survey. The educational needs identified included information about the practicalities of childbearing as a trans or nonbinary person, how to use inclusive language effectively, and creating policies and processes for supporting childbearing trans and nonbinary people. These caregivers’ preferences included hearing from trans and nonbinary people and sharing best practices among themselves, with open discussions about how to be inclusive
Arias et al, 2021: Midwives’ and midwifery lecturers’ views on current LGBTQ+ content in midwifery training https://doi.org/10.1016/j.midw.2021.103050 Paywall
Summary: There were 47 survey respondents and 16 focus group participants. Two themes were developed from the data analysis: Practising Open Mindedness and Cultivating Openness and four sub themes; Making Assumptions, Developing self- awareness, Challenge and Discomfort and Safe spaces. Participants proposed learning strategies that they thought would facilitate cultivating openness and open mindedness.
Hoffkling et al, 2017: Experiences of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5 Open Access
Summary: 10 transgender men who had given birth were interviewed. Aspects relevant to training needs where how to use inclusive language and promote privacy; how to collaboratively come to care decisions with minimal evidence; and the need to educate oneself rather than relying on a trans patient to do so.
Q4. How do puberty blockers and gender affirming hormones (both regulated and unregulated) affect fertility, pregnancies, the foetus, birth and postnatal healing?
No evidence found about this question
Q5. What does good perinatal mental health support look like for LGBTQIA+ people, and is this different for gestational and non-gestational parents, or for people with different genders or gender identities?
No evidence found about this question
Q6. Are perinatal outcomes different for LGBTQIA+ people, and are they affected by how someone attempted pregnancy or became pregnant?
By perinatal outcomes we mean live birth rates, stillbirths and miscarriages; pregnancy, labour and birth complications; interventions to start labour or during labour; mode of birth; gestational parent/surrogate mortality rates; birth trauma; mental health; infant feeding, health, developmental and mortality outcomes
Although many papers are included here, the question is not considered answered because only a subset of outcomes and sections of the LGBTQIA+ community are covered
Mental and physical health:
Mamrath et al, 2024: Higher anxiety in sexual minority women postnatally during the pandemic lockdown https://doi.org/10.1371/journal.pone.0297454. Open Access
Summary: 381 postnatal women (including 20 sexual minority women) completed an online survey during the first UK lockdown, including completing a psychometric test. Sexual minority women were more likely to score highly on an anxiety scale than their heterosexual counterparts. Lesbian, gay, bisexual, and pansexual participants scored highly in the ‘psychosocial adjustment to motherhood’ category.
Shenkman et al, 2023: Better mental health of lesbian mothers compared to heterosexual mothers
https://doi.org/10.1007/s13178-023-00800-8 Paywall
Summary: Seventy-two lesbian mothers by donor insemination (from 36 families) were compared with 72 heterosexual parents by assisted reproduction (without donated gametes; from 36 families) on positivity, life satisfaction, and depressive symptoms. All parents were cisgender and had at least one child born through assisted reproduction, aged 3–10 years. Lesbian mothers reported greater positivity, greater life satisfaction and less depressive symptoms
Carone, Rothblum et al, 2021: Good mental and physical health outcomes for transgender parents compared to cisgender parents https://doi.org/10.1037/fam0000776 Paywall
Summary: The study compared the quality of life and several mental health (psychological distress, life satisfaction, happiness, social wellbeing) and health (physical health, alcohol and drug use) dimensions by gender identity and parenthood status in a sample of 1,436 transgender and cisgender respondents to the U.S. Transgender Population Health Survey (TransPop study). An estimated 18.8% of transgender respondents were parents, with the majority (52.5%) being transgender women. After controlling for age, education, and relationship status, there were no significant differences between trans- and cisgender parents and their nonparent counterparts on any mental health or health dimensions.
Van Rijn-van Geldern et al, 2018: No difference in mental health and wellbeing of gay fathers through surrogacy compared to lesbian mothers and heterosexual parents using IVF https://doi.org/10.1093/humrep/dex339 Open Access
Summary: This cross-sectional study is part of an international research project involving 38 gay-father families, 61 lesbian-mother families and 41 heterosexual-parent families with 4-month-olds in the UK, the Netherlands and France. There were no differences in levels of parental wellbeing (parental stress, psychological adjustment and partner relationship satisfaction) between gay-father families with infants born through surrogacy, lesbian-mother families with infants born through donor insemination, and heterosexual-parent families with infants born through IVF.
Goldberg, Gartrell & Gates, 2014: Transition to parenthood for LGB people was similar to heterosexual people (report) https://escholarship.org/uc/item/7gr4970w. Open Access
Summary: This report addresses the research on LGB parenting, including functioning and experiences of LGB parents and their children. Relevant summary points are that, similar to heterosexual parents, LGB parents’ mental health and relationship quality decline across the transition to parenthood, although support from friends, family, and the workplace buffered all parents from the challenges of new parenthood. Studies comparing LGB and heterosexual parents in regard to mental health, parenting stress, and parenting competence have found few differences based on family structure. Conditions linked to poorer wellbeing for LGB parents include living in less supportive legal contexts, perceiving less support from family or supervisors, having higher levels of internalized homophobia, and encountering more child behaviour problems. Compared to heterosexual parents, LGB parents have not been found to differ on average, in parental warmth, emotional involvement, and quality of relationships with their children.
Borneskog et al, 2014: Higher relationship satisfaction of lesbian couples compared to heterosexual couples https://doi.org/10.1186/s12905-014-0154-1 Open Access
Summary: Three-year follow up assessment of lesbian and heterosexual couples after assisted reproduction. Participants requesting assisted reproduction at all fertility clinics performing gamete donation in Sweden were recruited consecutively 2005–2008. A total of 114 lesbian couples (57 treated women and 57 partners) and 126 heterosexual couples (63 women and 63 men) participated. Lesbian couples reported higher relationship satisfaction than heterosexual couples, however the heterosexual couples’ satisfaction with relationship quality was not low. At a follow-up after assisted reproduction with donated sperm, lesbian couples reported stable relationships and a high satisfaction with their relationships, even when treatment was unsuccessful.
General pregnancy-related:
Leonard et al, 2022: Comparison of mother-father, mother-mother and father-father birth outcomes
https://www.sciencedirect.com/science/article/abs/pii/S0002937822001727. Paywall
Summary: A population-based cohort study of all live births in hospital 2016-2019 in California. Likely sexual and/or gender minority parents were identified by a birthing parent identifying as a father (n = 498), or both parents identifying as a mother (n = 2572). The comparison group were those where the birthing parent identified as a mother and the other parent identified as a father (n = 1,483,119). Compared with mother-father partnerships, birthing parents in mother-mother partnerships were significantly more likely to have a multiple pregnancy (adjusted risk ratio, 3.9; 95% confidence interval, 3.4–4.4), induction of labour (adjusted risk ratio, 1.2; 95% confidence interval, 1.1–1.3), excessive bleeding after birth (adjusted risk ratio, 1.4; 95% confidence interval, 1.3–1.6) and severe illness/morbidity (adjusted risk ratio, 1.4; 95% confidence interval, 1.2–1.8). There was no difference in gestational diabetes, pregnancy related hypertension, caesarean birth, premature birth or low birthweight. No outcomes significantly differed between father birthing parents and birthing parents in mother-father partnerships.
Hodson, Meads and Bewley, 2017: Systematic review of likelihood of pregnancy for lesbian and bisexual women https://doi.org/10.1111/1471-0528.14449 Open Access
Summary: 30 papers (28 studies) were included. In the general population, the odds of pregnancy were nine-fold lower among lesbian women and over two-fold lower among bisexual women compared to heterosexual women (the odds ratios were 0.12 [95% CI 0.12–0.13] and 0.50 [95% CI 0.45–0.55], respectively). The odds of adolescent pregnancy were higher for lesbian adolescents and particularly for bisexual adolescentscompared to heterosexual adolescents (odds ratios of 1.37 [95% CI 1.18–1.59] and 1.98 [95% CI 1.85, 2.13]). There were inconsistent results regarding abortion rates. The odds of pregnancy after assisted reproduction were higher for lesbian women compared with heterosexual women (the odds ratio was 1.56, 95% CI 1.24–1.96). This analysis included eight papers, most of which were designed to look at outcomes other than pregnancy/birth rate. The single paper designed to look at the question of birth rate after assisted reproduction with donor sperm showed no differences between lesbian and heterosexual couples (this specific study is https://doi.org/10.1093/humrep/det445, Open Access).
Own egg versus partner egg (reciprocal IVF):
Matorras et al, 2023: Comparing the outcomes of in-vitro fertilisation in lesbians using their partner’s egg IVF versus artificial insemination https://doi.org/10.1093/humrep/dead035 Open Access
Summary: Single pregnancies after shared motherhood IVF compared to own-egg artificial insemination had similar outcomes, except for a non-significant increase in the rate of preeclampsia/hypertension after shared motherhood IVF (age-adjusted odds ratio = 1.9, 95% CI = 0.7–5.2). Twin pregnancies after shared motherhood IVF had a much higher frequency of preeclampsia/hypertension (age-adjusted odds ratio = 21.7, 95% CI = 2.8–289.4; p = 0.01).
Wrande et al, 2022: Comparing the outcomes of own egg IVF versus artificial insemination
https://pmc.ncbi.nlm.nih.gov/articles/PMC8995219/ Open Access
Summary: This is a prospective cohort study of 251 women undergoing intrauterine insemination (IUI) or in vitro fertilization, all with donor sperm, between 2017 and 2019 at one department in Sweden. This was 112 lesbian women in a relationship and 139 single women. The single women were older and more often had IVF at first treatment. There was no statistically significant difference in live birth rate after IUI between the two groups, when adjusted for age. Live birth per insemination was 19% for lesbians in a relationship compared to 14% for single people. In those using IVF, there was a higher pregnancy rate for lesbian women in relationships compared to single women (even after adjustment for age). Pregnancy per embryo transfer was 67% compared to 40% (p = 0.005, after adjustment for age) and birth per embryo transfer was 45% compared to 24% (p = 0.08 after adjustment for age).
Diego et al, 2022: Similar outcomes of in-vitro fertilisation in lesbians using their partner’s egg versus their own egg https://pmc.ncbi.nlm.nih.gov/articles/PMC9464617/ Open Access
Summary: This is a retrospective review of patients who used donor sperm at an urban, southeastern USA centre 2014-2020. Among the 374 patients, 88 (24%) were single, 188 (50%) were in a same-sex female partnership, and 98 (26%) had a male partner with a diagnosis of male factor infertility. Most patients did not have infertility (73.2%). Live birth rates per cycle were 11% in intrauterine insemination (IUI), 42% in in-vitro fertilisation (IVF), and 61% in co-IVF (where one partner’s egg is used and the other partner carries the pregnancy). Same sex partners were no less likely than opposite sex partners to have a live birth (adjusted odds ratio was 1.48, 95% confidence interval 0.92 to 2.36). Same sex partners were no more likely than opposite sex partners to have pregnancy complications (adjusted odds ratio was 0.49, 95% confidence interval 0.19 to 1.25, p = 0.1) or miscarriage (adjusted odds ratio was 0.69, 95% confidence interval 0.32 to 1.49, p = 0.3).
Brandao et al, 2022: Similar outcomes of in-vitro fertilisation in lesbians using their partner’s egg versus their own egg https://pmc.ncbi.nlm.nih.gov/articles/PMC9474973/ Open Access
Summary: Retrospective multicentre cohort study 2011-2020 in 18 fertility clinics in Spain. A total of 99 partner-egg cycles (73 couples) and 2929 own-egg cycles (2334 couples or single patients) of women younger than 38 years old with no known fertility disorder were included. Couples using partner egg were younger than those using own egg. A greater number of eggs and embryos were obtained for couples using partner egg than own egg. No differences were found between groups in outcomes, with or without adjustment for age. The total clinical pregnancy rates per embryo transfer were 57% and 50% and the live-birth rates were 46% and 41%. There was no difference in premature birth (8% vs. 12%) or birthweight (2.8 kg vs. 3.1 kg).
Nunez et al, 2021: Better outcomes of in-vitro fertilisation in lesbians using their partner’s egg versus their own egg https://pubmed.ncbi.nlm.nih.gov/34061679/ Paywall
Summary: This was a retrospective matched cohort study of couples performing a first cycle of either partner-egg (n = 60) or own-egg in-vitro fertilisation or intra-cytoplasmic sperm injection (IVF/ICSI; n = 120) 2012-2018. Pregnancy and birth rates were better with partner-egg embryo transfers: biochemical pregnancy 70% versus 48% (p = 0.004), clinical pregnancy 60% versus 40% (p = 0.01), ongoing pregnancy 60% versus 37% (p = 0.003), and live birth 57% versus 30% (p = 0.001). After adjusting for age, body mass index, and number of mature oocytes, there was still a significant improvement across all outcomes in partner egg cycles (live birth rate odds ratio 3, 95% confidence interval 1.4-6.6). Cumulative live birth rates were higher with partner eggs (66% vs. 43% [p = 0.005]).
Surrogacy:
Fuchs et al, 2018: Perinatal outcomes for surrogacy if the surrogate uses their own egg versus a donated egg https://pmc.ncbi.nlm.nih.gov/articles/PMC5962328/ Open Access
Summary: 222 women living in the United States completed a brief online survey between November 2015 and February 2016. There were 204 gestational carriers (using donated egg) and 18 traditional surrogates (using own egg). Overall, obstetric outcomes were similar. Traditional surrogates were younger, more likely to be Hispanic, more likely to be a full-time student, more likely to be on Medicaid, less likely to be a first-time carrier and more likely to have a high Depression Scale score (38% vs. 4%)
Woo et al, 2017: Perinatal outcomes for own egg pregnancy vs a donated egg surrogacy
https://www.fertstert.org/article/S0015-0282(17)31941-6/fulltext. Open Access
Summary: We identified 124 gestational surrogates who achieved a total of 494 pregnancies (312 their own spontaneous pregnancies and 182 surrogate pregnancies with donated egg). Surrogate pregnancies more likely to result in twin pregnancies than own egg pregnancies (33% compared to 1%, p<0.01). Miscarriage and ectopic rates were similar. Surrogate births had higher rates of preterm birth (10.7% vs. 3.1%), and higher rates of low birth weight (7.8% vs. 2.4%, 105 g lower birthweight on average). Surrogate births had significantly higher obstetrical complications, including gestational diabetes, hypertension, use of amniocentesis, placenta previa, antibiotic requirement during labour, and caesarean section.
Pavlovic et al, 2010: Perinatal outcomes for own egg pregnancy vs a donated egg surrogacy
https://pmc.ncbi.nlm.nih.gov/articles/PMC7183021/ Open Access
Summary: 78 donated-egg surrogacy pregnancies (with single baby) were compared to 71 own-egg pregnancies that the surrogate had previously been through for their own family building. Surrogacy cycles had worse perinatal outcomes than own pregnancies (a combination of preterm delivery, postpartum haemorrhage, preeclampsia, gestational hypertension, gestational diabetes, in utero growth restriction, oligohydramnios, abnormal placentation, placental abruption, and NICU admission; 25.6% vs. 9.9%; p = 0.02). There were no significant differences in the incidence of vaginal or caesarean birth.
Söderström-Anttila et al., 2016: Systematic review of surrogacy health outcomes for surrogate, child and family https://doi.org/10.1093/humupd/dmv046 Open Access
Summary: Most studies reporting on surrogacy have serious methodological limitations. According to these studies, most surrogacy arrangements are successfully implemented and most surrogate mothers are well-motivated and have little difficulty separating from the children born as a result of the arrangement. The perinatal outcome of the children is comparable to standard in-vitro fertilisation and egg donation and there is no evidence of harm to the children born as a result of surrogacy. There were no studies on children born after cross-border surrogacy.
Q7. How much emotional labour are LGBTQIA+ people doing when accessing (or thinking about accessing) perinatal healthcare? How can this situation be improved?
By emotional labour we mean the mental work people do in order to access services or meet someone else’s needs. It might include giving explanations of how LGBTQ+ people conceive, answering homophobic comments, dealing with your own emotions when forms or systems don’t fit your family, or thinking about any of these issues before making or going to an appointment.
Hoffkling et al, 2017: Experiences of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5 Open Access
Summary: 10 transgender men who had given birth were interviewed. Some participants avoided interacting with health professionals because of fear of transphobia and poor care. Some chose not to be ‘out’ to their providers because of fear of being denied fertility care. Most participants reported anxiety about how to identify supportive healthcare providers in advance.
Q8. How does using inclusive language throughout any treatment, pregnancy and birth, healthcare encounters, and within the first year of a baby’s life affect LGBTQIA+ families?
By emotional labour we mean the mental work people do in order to access services or meet someone else’s needs. It might include giving explanations of how LGBTQ+ people conceive, answering homophobic comments, dealing with your own emotions when forms or systems don’t fit your family, or thinking about any of these issues before making or going to an appointment.
Riggs et al 2021: Pregnant transmasculine and non-binary people’s experiences of midwifery care. This is a chapter of a midwifery textbook available here: https://ruthpearce.net/wp-content/uploads/2024/01/men-transmasculine-and-non-binary-people-and-midwifery-care.pdf Open Access
Summary: 51 trans and non-binary people with experience of conception were interviewed from UK, US, Australia, Canada and Germany. Negative experiences with midwives included dismissing the importance of preferred terminology for body parts and repeated misgendering despite correction.
Hoffkling et al, 2017: Experiences of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5 Open Access
Summary: 10 transgender men who had given birth were interviewed. Some reported that it was critical to emotional safety and wellbeing to be seen and treated as males, with the correct name and pronouns, but others were minimally bothered by misgendering. Using the correct name and pronouns was reported as being fundamental to feeling safe.
Q9. How does perinatal and reproductive loss affect LGBTQIA+ people’s mental health and decisions about trying to conceive again? What are their experiences of support during perinatal loss, and how can this be improved?
By perinatal loss we mean being unable to try to conceive (can’t find a surrogate or donor, can’t afford fertility treatment); not getting pregnant; miscarriage; stillbirth; death of a baby.
Rose and Oxlad, 2023: LGBTQ+ people’s experiences of employment leave and support following perinatal loss
https://doi.org/10.1080/13668803.2021.2020727 Paywall
Summary: 12 LGBTQ+ people were interviewed, aiming to explore their workplace leave and support experiences following pregnancy losses as gestational or non-gestational parents in the previous 6 months to 10 years. Reflexive thematic analysis generated three themes (1) Disclosure in the workplace: support, shame, and self-protection, (2) Navigating discriminatory workplace policies, leave, and entitlements and (3) Coping at work: Getting the balance right for each person. Heteronormative policies and entitlements can compound the distress of LGBTQ+ people experiencing pregnancy loss, including increasing difficulties in accessing leave, misgendering leave entitlements, failing to accommodate for high attachment to unborn babies in early gestation, and the impact of distance for parents who have engaged in surrogacy. The authors suggest that employers can assist by using inclusive language in leave policies and forms, providing people of all genders and sexualities access to parental and bereavement leave irrespective of family formation method and gestational age and allowing flexibility in hours, workload, and tasks after a pregnancy loss.
Lacombe-Duncan et al, 2022: Uses minority stress model to explain how LGBTQ+ perinatal loss might be different to cisheterosexual perinatal loss https://doi.org/10.1371/journal.pone.0271945 Open Access
Summary: Informed by minority stress theory, this qualitative study aimed to explore the experiences of multi-level stigma and resilience among LGBTQ+ people in the context of conception, pregnancy, and loss. Seventeen semi-structured interviews were conducted (2019) with a purposive sample of US LGBTQ+ people who had experienced pregnancy loss (n = 14) or in an intimate partnership in which a pregnancy was lost (n = 3) in the last two years. Participants described the profound sadness of pregnancy loss due to unique challenges of LGBTQ+ conception. Multiple types of stigma manifested at intrapersonal (e.g., anticipated sexual stigma upon disclosure), interpersonal (e.g., unsolicited advice about conception decisions), and structural levels (e.g., differential requirements to access conception compared to heterosexual/cisgender couples).
Resilience was also seen individually (e.g., purposeful disclosure of conception, pregnancy, and loss), relationally (e.g., connecting with other LGBTQ+ community members), and collectively (e.g., creating/engaging in LGBTQ+-specific conception, pregnancy, and loss online spaces).
Pyle et al, 2021: Disclosure and non-disclosure of pregnancy loss amongst LGBTQ+ people
https://doi.org/10.1145/3411764.3445331 Open Access
Summary: 17 US LGBTQ people who used social media and had recently experienced pregnancy loss were interviewed, recruited through personal contacts. Decision making about disclosure of pregnancy loss on social media is discussed. The authors argue that social media platforms can better facilitate disclosures about silenced topics by enabling selective disclosure, enabling proxy content moderation, providing education about silenced experiences, and prioritizing such disclosures in news feeds.
Riggs et al, 2020: Men, trans/masculine, and non-binary people’s experiences of pregnancy loss https://doi.org/10.1186/s12884-020-03166-6 Open Access
Summary: Interviews were undertaken with a convenience sample of 16 trans masculine and non-binary people who had undertaken at least one pregnancy and experienced pregnancy loss, living in either Australia, the United States, Canada, or the European Union (including UK). There were 10 themes: (1) pregnancy losses count as children, (2) minimizing pregnancy loss, (3) accounting for causes of pregnancy loss, (4) pregnancy loss as devastating, (5) pregnancy loss as having positive meaning, (6) fears arising from a pregnancy loss, (7) experiences of hospitals enacting inclusion, (8) lack of formal support offered, (9) lack of understanding from family, and (10) importance of friends.
Cacciatore and Raffo, 2011: Lesbians’ experiences of support following a pregnancy or baby loss https://doi.org/10.1093/sw/56.2.169 Paywall
Summary: This multiple-case study focused on child death in same-gendered-parent families. The study used in-depth interviews with six self-identified lesbian mothers who had experienced the death of a child at various ages and from various causes. Results suggest that lesbian bereaved mothers experience a type of double-disenfranchisement after their losses and that social support is often insufficient to meet their psychological needs.
Peel, 2010: Lesbian and bisexual women’s experiences of perinatal loss https://doi.org/10.1093/humrep/dep441 Open Access
Summary: This study analysed predominantly qualitative online survey data from 60 non-heterosexual, mostly lesbian, women from the UK, USA, Canada and Australia. All but one of the pregnancies was planned. Most respondents had physically experienced one early miscarriage during their first pregnancy, although a third had experienced multiple losses. The analysis highlights three themes: processes and practices for conception; amplification of loss; and health care and heterosexism. The experience of loss was amplified due to contextual factors and the investment respondents reported making in impending motherhood. Most felt that their loss(es) had made a ‘significant’/‘very significant’ impact on their lives. Many respondents experienced health care during their loss. A minority reported experiencing heterosexism from health professionals.
Q10. How does where LGBTQIA+ families are in the UK affect their access to reproductive options, and how are their decisions and experiences affected by this?
No evidence found about this question
Q11. How does the way LGBTQIA+ people got pregnant (home insemination, IUI, IVF with own egg, IVF with someone else’s egg) affect healthcare recommendations (for example, obstetric-led care and induction of labour)? How do these recommendations affect parents and babies?
No evidence found about this question
Q12. What are LGBTQIA+ people’s experiences of abortion and abortion support in the UK?
Bowler, Vallury and Sofija, 2023: Scoping review of the experiences and needs of LGBTIQA+ people when accessing abortion care https://doi.org/10.1136/bmjsrh-2022-201692 Paywall
Summary: Seven publications were included in the review that described experiences of LGBTIQA+ people accessing abortion-related care. The included studies were predominantly conducted in the USA using quantitative and qualitative research designs. Thematic analysis highlighted participants’ experiences of discrimination and exclusion in healthcare settings, healthcare avoidance, unsafe abortion, non-disclosure to providers, and poor health outcomes for LGBTIQA+ people. The authors suggest that gender-inclusive services and training for health providers is necessary to provide safe and accessible abortion care and overcome generations of mistrust held by the LGBTIQA+ community.
Q13. Where do LGBTQIA+ people and healthcare professionals look for information about reproductive choices (including success rates, health, legal, financial and employment implications)? Is the information they get accurate, and how can access to information be improved, including from NHS sources?
Greenfield, 2023: Charity commissioned report into the perinatal experiences of LGBTQ+ women https://doi.org/10.5281/zenodo.8326480 Open Access
Summary: 16 LGBTQ+ women over 18 who had either conceived a baby whilst in a relationship with another woman or conceived a baby as a solo parent were interviewed. Seven had been gestational parents only, seven had been non-gestational parents only, and two were both gestational and non-gestational parents of their children. In addition, three healthcare professionals who had provided perinatal care to LGBTQ+ women, and were LGBTQ+, were interviewed. The findings from this research showed that currently, LGBTQ+ women who are on the journey to parenthood face gaps in the information available to them in some areas. LGBTQ+ women who wish to conceive may face difficulties in obtaining accurate and appropriate information about conception options. Some healthcare professionals may have inaccurate information about Parental Responsibility for non-gestational mothers.
LGBT Foundation 2022: Trans and non-binary experiences of maternity services. This is a report compiled by a charity, found here: https://lgbt.foundation/wp-content/uploads/2024/01/ITEMS20final.pdf Open Access
Summary: This report gathered survey data from 121 trans and non-binary people in the UK who had ever given birth or were pregnant, and also interviewed 4 people. In the survey, a third did not feel that midwives provided relevant information on infant feeding antenatally; or took into account their personal circumstances when giving feeding advice postnatally. In interviews, some participants reported not being ‘out’ during pregnancy due to fear of discrimination or simply because there was no opportunity to come out, which interfered with accessing appropriate information. The report recommends that the NHS should provide targeted information for trans and non-binary pregnant and birthing people; and co-create personalised support plans.
Q14. What are the most successful methods for inducing lactation in a non-gestational parent? What are the barriers to healthcare professionals providing lactation support to a non-gestational parent and how can these be overcome?
Bertollo et al, 2024: Scoping review on inducing lactation in trans women
https://doi.org/10.1590/1413-81232024294.18232023 Open Access
Summary: The article aimed to conduct a scoping review of lactation induction for transfeminine people in the health care context. Twenty-one articles were included, published between 2018 and 2023. Among them, six are case reports and the others are publications in various formats. Lactation induction was achieved in all the case reports, with varying quantities of milk produced. Constituents of induced milk are similar to those of non-induced human milk. One included study assessed knowledge among professionals working in trans health.
Cazorla-Ortiz et al, 2020: Scoping review on inducing lactation https://doi.org/10.1177/0890334420950321 Paywall
Summary: The aim of this scoping review was to assess the different methods used to induce lactation. Twenty four articles were included. Pharmacological methods were not always used to produce milk, although breast stimulation was essential. The age of the child, interference due to bottle feeding, breast stimulation, and the support received were important factors in the induction of lactation. There were several factors that may account for the differences between developing and higher income countries in methods of induced lactation and the amount of milk that study participants produced. There was no consensus over whether previous pregnancy and/or breastfeeding experience influenced induced lactation.
Q15. When planning a pregnancy, what are the right timings to pause and restart gender affirming hormones?
Pfeffer et al, 2023: Decision making around testosterone and transgender pregnancy https://doi.org/10.1016/j.ssmqr.2023.100297 Open Access
Summary: 70 trans/non-binary people who had conceived or were considering conception and 22 healthcare providers with a focus in trans health were interviewed. In the context of uncertainty, healthcare providers tended to recommend caution and centring potential risks to the foetus/child. They often viewed any desire to use testosterone during pregnancy as selfish. Trans people felt that they were juggling competing priorities to maintain their sense of self and wellbeing, ensure continuing access to healthcare and protect their foetus/child. Most healthcare professionals and trans people defaulted to pausing testosterone before conception attempts, throughout pregnancy and until lactation was complete. Some trans people reported impaired mood and increased dysphoria during this time. A small number of healthcare providers and trans people were willing to consider the use of testosterone during pregnancy/lactation, sometimes at low dosage, feeling that the level of concern to the foetus/child was no more than for many lifestyle habits and medications that are used or taken in pregnancy/lactation.
Hoffkling et al, 2017: Experiences of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5 Open Access
Summary: 10 transgender men who had given birth were interviewed. Some participants had delayed taking testosterone to ensure fertility, others went ahead with testosterone despite uncertainty over the effect on fertility and some took testosterone while confident that it would not impair fertility (all had stopped testosterone in order to conceive). Some participants did not have any emotional impact of pausing testosterone for conception, others enjoyed the process and some had impaired mood, particularly after birth.
Q16. What increases good experiences of care and good perinatal outcomes for surrogates and LGBTQIA+ people becoming parents through surrogacy?
No evidence found about this question
Q17. How do the parental titles on birth certificates affect LGBTQIA+ parents?
Hoffkling et al, 2017: recommendations arising from the experience of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5 Open Access
Summary: 10 transgender men who had given birth were interviewed. Some participants described the impact of not being able to be listed as ‘father’ on the birth certificate as conveying a message that their identities did not matter.
Q18. How confident and competent are perinatal staff in using up to date LGBTQIA+ inclusive language, and how can this be improved?
Greenfield, 2023: Charity commissioned report into the perinatal experiences of LGBTQ+ women
https://doi.org/10.5281/zenodo.8326480. Open Access
Summary: 16 LGBTQ+ women over 18 who had either conceived a baby whilst in a relationship with another woman or conceived a baby as a solo parent were interviewed. Seven had been gestational parents only, seven had been non-gestational parents only, and two were both gestational and non-gestational parents of their children. In addition, three healthcare professionals who had provided perinatal care to LGBTQ+ women, and were LGBTQ+, were interviewed. The findings from this research include experiences of inclusive and non-inclusive language from perinatal service providers. The language currently used to describe LGBTQ+ parents is not static, and there is no agreed terminology, requiring a nuanced approach of everyone involved in providing perinatal services that centres individual parents' preferences.
Hoffkling et al, 2017: Experiences of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5 Open Access
Summary: 10 transgender men who had given birth were interviewed. Participants reported that many staff did not read intake forms where pronouns had been requested, so these were ignored. They reported frequent misgendering and use of the wrong name. Some participants had affirming healthcare providers who used inclusive language well.
Q19. What are the similarities and differences for gestational and non-gestational LGBTQIA+ parents bonding with their baby, and how can bonding be maximised?
Leter et al, 2024: Similar caregiving roles and parental affect between same-sex and different-sex parents https://doi.org/10.3389/fpsyg.2024.1332758. Open Access
Summary: 135 different-sex, same-sex male, and same-sex female couples (113 fathers and 157 mothers, comprising 147 primary and 123 secondary caregivers) who conceived through artificial reproductive techniques and lived in Netherlands, France or the UK were studied. The couples were videorecorded at home while in feeding, cleaning, and playing contexts to assess the levels of positive and negative parental affect. In addition, the couples completed questionnaires about their caregiving role, parenting stress, and the infants’ temperament. The levels of positive and negative parental affect toward the infant in all contexts were not related to parental gender, caregiving role or the interaction between parental gender and caregiving role.
Goldberg, Gartrell & Gates, 2014: Transition to parenthood for LGB people (report) https://escholarship.org/uc/item/7gr4970w. Open Access
Summary: This report addresses the research on LGB parenting, focusing on several main content areas: family building by LGB people; the transition to parenthood for LGB parents; and functioning and experiences of LGB parents and their children. They report that children’s relationships with their biological mothers appear similar in quality to their relationships with their nonbiological mothers, which researchers attribute in part to the fact that lesbian mothers tend to share coparenting.
Q20. What are LGBTQIA+ people’s experiences of taking leave from work when trying to conceive, during pregnancy or as new parents?
Rose and Oxlad, 2023: LGBTQ+ people’s experiences of employment leave and support following perinatal loss
https://doi.org/10.1080/13668803.2021.2020727. Paywall
Summary: 12 LGBTQ+ people were interviewed, aiming to explore their workplace leave and support experiences following pregnancy losses as gestational or non-gestational parents in the previous 6 months to 10 years. Reflexive thematic analysis generated three themes (1) Disclosure in the workplace: support, shame, and self-protection, (2) Navigating discriminatory workplace policies, leave, and entitlements and (3) Coping at work: Getting the balance right for each person. Heteronormative policies and entitlements can compound the distress of LGBTQ+ people experiencing pregnancy loss, including increasing difficulties in accessing leave, misgendering leave entitlements, failing to accommodate for high attachment to unborn babies in early gestation, and the impact of distance for parents who have engaged in surrogacy. The authors suggest that employers can assist by using inclusive language in leave policies and forms, providing people of all genders and sexualities access to parental and bereavement leave irrespective of family formation method and gestational age and allowing flexibility in hours, workload, and tasks after a pregnancy loss.
Greenfield, 2023: Charity commissioned report into the perinatal experiences of LGBTQ+ women
https://doi.org/10.5281/zenodo.8326480. Open Access
Summary: 16 LGBTQ+ women over 18 who had either conceived a baby whilst in a relationship with another woman or conceived a baby as a solo parent were interviewed. Seven had been gestational parents only, seven had been non-gestational parents only, and two were both gestational and non-gestational parents of their children. In addition, three healthcare professionals who had provided perinatal care to LGBTQ+ women, and were LGBTQ+, were interviewed. The findings from this research included that the uptake of Shared Parental Leave amongst LGBTQ+ women may be high.
Q21. How do transgender parents’ experiences of their gender in the perinatal period affect their relationship with their baby?
No evidence found about this question
Q22. What are non-gestational parents’ experiences of inducing lactation, and/or sharing lactation? What are the effects on the parents, and on the baby who is drinking induced milk?
Greenfield, 2023: Charity commissioned report into the perinatal experiences of LGBTQ+ women
https://doi.org/10.5281/zenodo.8326480 Open Access
Summary: 16 LGBTQ+ women over 18 who had either conceived a baby whilst in a relationship with another woman or conceived a baby as a solo parent were interviewed. Seven had been gestational parents only, seven had been non-gestational parents only, and two were both gestational and non-gestational parents of their children. In addition, three healthcare professionals who had provided perinatal care to LGBTQ+ women, and were LGBTQ+, were interviewed. The findings from this research included that non-gestational parents who wish to breast or chestfeed their babies do not have adequate support, and that the lack of knowledge about co-feeding poses a risk for newborn babies.
Juntereal & Spatz, 2019: Same-sex breastfeeding mothers https://doi.org/10.1111/birt.12470. Paywall
Summary: This study used an online survey and qualitative interviews to provide an in-depth understanding of same-sex breastfeeding mothers' experiences. Sixty-eight participants completed the online survey. Thirty-seven mothers (59%) reported breastfeeding for more than one year. Fourteen (21%) respondents reported accessing induced lactation information for the non-gestational parent from their health care practitioner. Forty-three (63%) respondents reported receiving breastfeeding and induced lactation information from other sources. Only nine (13%) non-gestational parents underwent induced lactation. Eighteen gestational mothers participated in qualitative interviews. Five themes emerged from the qualitative data: (a) committed to a year, (b) deciding “how to do it,” (c) sources of information, (d) involvement of partner, and (e) need for inclusive and educated health care practitioners.
Q23. How often is written language (for example, letters, forms and policies) used by perinatal services inclusive or exclusive of LGBTQIA+ people? How can institutions keep up to date with inclusive language?
Greenfield, 2023: Charity commissioned report into the perinatal experiences of LGBTQ+ women
https://doi.org/10.5281/zenodo.8326480. Open Access
Summary: 16 LGBTQ+ women over 18 who had either conceived a baby whilst in a relationship with another woman or conceived a baby as a solo parent were interviewed. In addition, three healthcare professionals who had provided perinatal care to LGBTQ+ women, and were LGBTQ+, were interviewed. The findings from this research showed that some, but not all, families encountered exclusive written language, including “booking” forms.
LGBT Foundation 2022: Trans and non-binary experiences of maternity services. This is a report compiled by a charity, found here: https://lgbt.foundation/wp-content/uploads/2024/01/ITEMS20final.pdf Open Access
Summary: This report gathered survey data from 121 trans and non-binary people in the UK who had ever given birth or were pregnant, and also interviewed 4 people. The report recommends that the NHS should provide targeted information for trans and non-binary pregnant and birthing people; ask people about the most appropriate language to use and then record these for implementation; and ensure IT systems can recognise gender appropriately and routinely record gender identity.
Riggs et al 2021: Pregnant transmasculine and non-binary people’s experiences of midwifery care. This is a chapter of a midwifery textbook available here: https://ruthpearce.net/wp-content/uploads/2024/01/men-transmasculine-and-non-binary-people-and-midwifery-care.pdf Open Access
Summary: 51 trans and non-binary people with experience of conception were interviewed from UK, US, Australia, Canada and Germany. Positive experiences with midwives included ensuring correct gender markers were recorded on paper and electronically. Recommendations for inclusive care included gathering information on pronouns, names and preferred terminology, collating it and ensuring all staff are aware of it; ongoing training due to the fast-moving past of literature in this area; and advocating for systemic change such as in data collection, inclusive imagery and language
Hoffkling et al, 2017: Experiences of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5 Open Access
Summary: 10 transgender men who had given birth were interviewed. Participants often felt erased by the inability of institutions to understand trans male pregnancy in written literature and images, computer systems and intake forms; even when written forms asked for pronouns they were often ignored by staff.
Q24. How can the number and range of sperm donors available to LGBTQIA+ people be increased, including those from racialised ethnic backgrounds?
No evidence found about this question
Unranked Q: What are the long-term physical, emotional and developmental outcomes for children from LGBTQIA+ families?
Same sex parents:
Cornell University (USA) reviewed 79 studies looking at the wellbeing of children of same-sex parents from 1985 to 2017: https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-wellbeing-of-children-with-gay-or-lesbian-parents/. Open Access
This review included children raised in same sex female couples, including situations where women had children in prior heterosexual relationships, and children raised in same sex male couples including by surrogacy or adoption.
Their summary was that 75 of 79 studies, some smaller longitudinal studies, and some larger cross-sectional surveys, concluded that children of gay or lesbian parents fared no worse than other children, and that “having a gay or lesbian parent does not harm children”. For the studies that followed children over many years as they grew up, many of the sample sizes were small, and some studies lacked a control group, but researchers regard these studies as providing the best available knowledge about child adjustment over the longer term.
The 4 of 79 studies that concluded that children of gay or lesbian parents faced some disadvantages were all cross-sectional surveys that could not distinguish between children who grew up solely in same sex households and those where they started in heterosexual households then one of their parents moved to a same sex household. The disruption of changing partner is known to cause problems for children, and these studies have been criticized by many scholars as unreliable assessments because of this fundamental flaw. Essentially, they needed to have compared children of family break ups where the change of partner is to a same sex household compared to a different heterosexual household, but that was not possible from the data available.
Since 2017, these additional studies have very similar conclusions to the Cornell review:
Self-esteem in children from Dutch lesbian families (Bos, Van Rijn-van Gelderen and Gartrell, 2020) https://doi.org/10.1080/10894160.2019.1625671. Open Access
Behaviour and development of children from Dutch same-sex families (Mazrekaj, De Witte and Cabus, 2020) https://doi.org/10.3390/ijerph19105922. Open Access
Wellbeing of children of UK gay fathers via adoption (McConnachie et al., 2021) https://doi.org/10.1111/cdev.13442. Open Access
Psychological wellbeing of children from USA donor conceived lesbian households (Carone, Gartrell, et al., 2021) https://doi.org/10.1016/j.fertnstert.2020.12.012. Open Access
Psychological adjustment of donor-conceived offspring of USA lesbian parents over two decades (Carone et al 2025). https://doi.org/10.1016/j.rbmo.2025.105020. Open Access
Wellbeing of children of USA gay fathers via surrogacy compared to lesbian mothers (Golombok et al., 2018) https://doi.org/10.1111/cdev.12728. Open Access
Trans parents:
A review in 2014 looked at 51 studies of trans parenting (https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Parenting-Review-Oct-2014.pdf. Open Access). They concluded that “Studies on the outcomes for children with transgender parents have found no evidence that having a transgender parent affects a child’s gender identity or sexual orientation development, nor has an impact on other developmental milestones”. Another review from 2022 which does not describe its methodology showed similar results (https://familleslgbt.org/wp-content/uploads/2022/03/Scientific-Research-to-Deconstruct-Myths-about-Trans-Parent-Families.pdf . Open Access).
Three studies since the time of the reviews also showed no evidence of harm, and that children of trans parents fare no worse than other children. Quotes include “Parents and children in trans parent families had good quality relationships and children showed good psychological adjustment.”:
Outcomes for children of donor conceived French trans men (Chiland et al., 2013) https://doi.org/10.1016/j.neurenf.2013.07.001. Paywall
Psychological outcomes for children of French transgender fathers (Condat et al., 2020) https://doi.org/10.1371/journal.pone.0241214. Open Access
Children with UK trans parents: parent–child relationship quality and psychological well-being (Imrie et al 2021) https://doi.org/10.1080/15295192.2020.1792194. Open Access
Unranked Q: How do LGBTQIA+ people make decisions about how to become parents, and how many pick each option?
Brandão and Ceschin, 2023: Systematic review of reciprocal IVF including reasons people chose it https://doi.org/10.1097/j.pbj.0000000000000202. Open Access
Summary: The main reasons for women to choose own-egg options such as artificial insemination and own-egg IVF were the cost and simplicity of the treatment (especially the former), lack of availability of more complex treatments and lack of information. Studies report that the main reason for lesbian women to quit or not pursue treatments were the costs.
The main reasons for women to choose reciprocal (partner-egg) IVF were to share biological motherhood and (less often) for medical indications (like low egg quality/number or genetic illness in the gestational parent). Studies showed that women believed partner egg IVF may strengthen their relationship with their partners. Some also said that they wanted to fulfil their partners' wishes to experience a “true shared motherhood.” This method allowed women to choose the role they wanted to play and share the burden of the reproductive treatments—at a physical, mental, and emotional level. However, some women believed that this method may paradoxically be a setback in the process of accepting nonbiological motherhood, particularly within the LGBTQ+ community.
One study included all the couples treated in a fertility clinic in Spain in a 2-year period time. Most couples had initially decided to undergo artificial insemination or own-egg IVF, and the majority of these kept their plans. However, 38% of the couples who initially wanted to do partner-egg IVF changed plans and only 11% underwent partner-egg IVF.
Van Houten et al, 2020: Parenting intentions amongst gay men and lesbians https://doi.org/10.3389/fpsyg.2020.00430. Open Access Summary: The study was based on a US cross-sectional, internet-based survey of childfree people who want to become parents in the future. The sample consisted of 58 gay men, 66 lesbian women, 164 heterosexual people (128 women and 36 men). There was no gender difference in the strength of parenting intentions. Moderate evidence was provided for gay men and lesbian women reporting a similar strength of parenting intentions compared to their heterosexual peers. Those who perceived parenthood as bringing positive life changes, especially for men, expressed stronger parenting intentions. There was no difference in this relationship by sexual orientation.
Jadva et al, 2018: Why women (mostly lesbian) source sperm donors via the internet https://doi.org/10.1080/14647273.2017.1315460. Open Access
Summary: A total of 429 women looking for a sperm donor on Pride Angel (a website that facilitates contact between donors and recipients) completed an online survey. 58% (249) saw advantages of obtaining donated sperm online with the most common advantage reported as being able to connect with and meet the donor (n = 50 (24%)). A third (n = 157 (37%)) of the participants gave disadvantages, the most common reported was encountering ‘dishonest donors’ (n = 63 (40%)). Most recipients (n = 181 (61%)) wanted the donor to be ‘just a donor’ (i.e. to provide sperm and have no further contact). Whilst it was important for recipients to know the identity of the donor, some did not see this as important for the child and thus the level of information that parents have about the donor, and that which the child has, can differ. Finding a donor online blurs the distinction between categories of ‘anonymous’, ‘known’ and ‘identity release’ donations. Whilst the survey had a large sample size, the representativeness of the sample is not known.
Tornello & Bos, 2017: Parenting intentions amongst transgender people https://doi.org/10.1089/lgbt.2016.0153. Paywall
Summary: Data were collected using an open-ended survey with 32 transgender men and transgender women regarding when and how they want to become parents in the future. They found that transgender individuals expressed specific desires for parenthood, such as biological relatedness and barriers to parenthood, such as physical limitations or lack of legal protections, which influence how transgender individuals choose to become parents in the future. For example, many participants described wanting to be biologically related to a future child and how this can be complicated by being transgender due to hormonal treatments, surgeries, or not having the biological means of become a parent using “traditional” methods.
Blake et al, 2017: Why do gay men choose surrogacy https://doi.org/10.1093/humrep/dex026. Open Access
Summary: This study used a cross-sectional design in 40 gay father surrogacy families. Multiple strategies (e.g. surrogacy agencies, social events and snowballing) were used to recruit as diverse a sample as possible. Semi-structured interviews were conducted in the family home (65%) or over Skype (35%) with 74 gay fathers (35 genetic fathers, 32 non-genetic fathers and 7 fathers who did not know or did not disclose who the genetic father was), when the children were 3–9 years old. Genetic and non-genetic fathers were just as likely to want to become parents and had similar motivations for choosing surrogacy as a path to parenthood. Most fathers (N = 55, 74%) were satisfied with surrogacy and were satisfied (N = 31. 42%) or had neutral feelings (N = 21, 28%) about their choice of who would be the genetic father. Most fathers received supportive reactions to their decision to use surrogacy from both families of origin (e.g. parents, siblings) (N = 47, 64%) and from friends (N = 63, 85%).
Unranked Q: Are LGBTQIA+ parents and their children more likely to be neurodivergent than other parents and their children, and does this effect LGBTQIA+ peoples’ experiences of perinatal care?
Children:
Sullins, 2015: Prevalence of ADHD higher in children of same-sex parents compared to others https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2558745. Paywall
Summary: US data from the U.S. National Health Interview Survey 1997-2013 was made up of children from 207,007 households, including 512 with same-sex parents. ADHD was more than twice (OR 2.4, 95% CL 1.6-3.4) as prevalent among children with same-sex parents than in the general population, after controlling for age, sex, ethnicity and parent socioeconomic status. Use of assisted reproduction was not adjusted for. ADHD risk with same-sex parents was reduced among adopted children (OR 0.54 95% CL .27-1.1).
Parents:
Bouzy et al, 2023: Systematic review showing transgender people are more likely to be autistic than cisgender people (not focusing on transgender parents specifically) https://doi.org/10.1016/j.psychres.2023.115176. Paywall
George & Stokes, 2018: Autistic people more likely to be LGB (not focusing on autistic or LGB parents specifically) https://doi.org/10.1002/aur.1892. Paywall
Abé et al., 2018: Higher proportion of ADHD adults likely to identify as bisexual than neurotypical adults (not focusing on ADHD or bisexual parents specifically) https://doi.org/10.1002/brb3.998. Open Access
Unranked Q: How do LGBTQIA+ people who have used donated gametes (eggs/sperm) and/or surrogates make decisions before, during and after pregnancy about what to tell their children about their family? What support is helpful for this?
Nordqvist, 2021: How stories about donor conception are created and told in LGBTQ+ families https://doi.org/10.1177/0038038520981860. Open Access
Summary: The articles explores reproductive storytelling as a phenomenon of sociological consequence. Donor conception used to be managed through secrecy but children are now perceived ‘to have the right’ to know about their genetic origins. The article draws on original qualitative data with families of donor conceived children to investigate the disjuncture between the value now placed on openness and storytelling, and the absence of an existing social script by which to do so. The article shows the nuanced ways in which this absence plays out on relational playing-fields, within multidimensional, intergenerational relationships.
Nordqvist, 2017: Family practices and stories about genetic and non-genetic relationships https://doi.org/10.1177/0038026117711645. Open Access
Summary: Combining a focus on family as practice with an attention to discourse, the article concentrates specifically on ‘genetic thinking’ – the process through which genetic relationships are rendered meaningful in everyday family living. The study draws on original data from a study about families formed through donor conception, and the impact of such conception on family relationships, to show that genetic thinking is a salient part of contemporary family living. The article explores the everyday, normative assumptions, nuances and understandings about genetic relationships by exploring five dimensions: having a child; everyday family living; family resemblances; traits being ‘passed on’; and family members working out accountability and responsibility within the family. Showing the significance of genetic thinking in family life, the article argues for a more sustained sociological debate about the impact of such thinking within contemporary family life.
Blake et al, 2016: Family stories and relationships between gay fathers via surrogacy and surrogates and/or egg donors http://dx.doi.org/10.1016/j.fertnstert.2016.08.013. Open Access
Summary: Parents in 40 gay father families with 3–9-year-old children born through surrogacy had a semi-structured interview. The majority of fathers were content with the level of contact they had with the surrogate, with those who were discontent wanting more contact. Fathers were more likely to maintain relationships with surrogates than egg donors, and almost all families had started the process of talking to their children about their origins, with the level of detail and children's understanding increasing with the age of the child.
Nordqvist, 2014: Legal and family story interactions in the drive for openness in donor conception https://doi.org/10.1093/lawfam/ebu010. Open Access
Summary:Openness and children’s ‘right to know’ about their genetic background have become key issues in debates about donor conception and a significant shift towards transparency has taken place in policy frameworks. But whereas openness is now supported in policy, the issue might be less of a ‘done deal’ for parents themselves; evidence suggest that many are still hesitant to disclose. This has caused concern among policymakers and campaigners, putting parents under increasing pressure to tell. In this context it is important to seek to better understand parents’ experiences, and why it is that some might feel uncertain about openness. The article explores the issue by drawing on original empirical data from a study exploring donor conception and family life, and shows that there are significant insights to be gained from looking at the impact of openness in families. The article explores four particular sets of dilemmas introduced by openness, namely decision-making and family boundaries; telling children; telling the wider family and navigating competing moral doctrines. The article argues that an important factor to consider in understanding disclosure and its difficulties is the importance and complexity of family relationships and the impact they have on parents’ decision-making process. The article argues for a change in direction in debates on openness and for the need for an increased appreciation of the vitality of relationships, suggesting that openness needs to be brought into conversation and balanced against other factors which greatly influence children’s and adult’s personal lives.
Unranked Q: What peer support do LGBTQIA+ people need when they are trying to conceive, are pregnant, or after their baby is born, and what are the barriers to meeting these needs?
Greenfield, 2023: Charity commissioned report into the perinatal experiences of LGBTQ+ women
https://doi.org/10.5281/zenodo.8326480. Open Access
Summary: 16 LGBTQ+ women over 18 who had either conceived a baby whilst in a relationship with another woman or conceived a baby as a solo parent were interviewed. Seven had been gestational parents only, seven had been non-gestational parents only, and two were both gestational and non-gestational parents of their children. In addition, three healthcare professionals who had provided perinatal care to LGBTQ+ women, and were LGBTQ+, were interviewed. The report states that currently, LGBTQ+ women who are on the journey to parenthood may face challenges to building a robust support network. There is significant room to improve the formal and informal perinatal support for LGBTQ+ women, and this report suggests ways that this work can be taken forward. The report notes that a lack of family support, combined with changes to friendship networks and difficulties in accessing parenting groups may leave some LGBTQ+ parents isolated. Experiences of parents with intersections of marginalisation were worse than others.
Manley, Goldberg & Ross, 2018: LGBTQ+ connections for new ‘plurisexual’ mothers with opposite sex partners https://doi.org/10.1037/sgd0000285. Paywall
Summary: This study investigated LGBTQ community connections among 29 plurisexual women with different-gender partners during the perinatal period. Participants completed interviews once during late pregnancy, and three times in the year after giving birth. Thematic analysis of the interview data explored how participants conceptualized community, finding that women varied in their level of and desire for engagement in both LGBTQ and parenting communities. Participants’ accounts suggested that various barriers restricted their involvement (e.g., practical barriers such as time constraints, community-level barriers such as perceived rejection from LGBTQ communities, and psychological factors such as internalized stigma). At the same time, several women identified LGBTQ others as sources of support during the transition to parenthood, and many expressed a desire for their children to be connected to LGBTQ communities. Findings have implications for how researchers conceptualize community, provide insight into the disconnection between plurisexual women and LGBTQ communities, and suggest possibilities to increase LGBTQ community accessibility during this period.
Hoffkling et al, 2017: Experiences of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5 Open Access
Summary: 10 transgender men who had given birth were interviewed. Some participants reported that pregnancy and parent support organisations for gay, lesbian and bisexual people were ill-equipped to support transgender parents.
Goldberg, Gartrell & Gates, 2014: Transition to parenthood for LGB people (report) https://escholarship.org/uc/item/7gr4970w. Open Access
Summary: This report addresses the research on LGB parenting, focusing on several main content areas: family building by LGB people; the transition to parenthood for LGB parents; and functioning and experiences of LGB parents and their children. Relevant summary points are that LGB prospective parents perceive less support from their families of origin than do heterosexual parents, but many LGB parents find that family ties strengthen after the arrival of the child. The involvement and support of the family of origin may vary depending on the LGB parent’s biological and legal ties to the child. Similar to heterosexual parents, LG parents’ mental health and relationship quality decline across the transition to parenthood, although support from friends, family, and the workplace
buffers all parents from the challenges of new parenthood.
Unranked Q: How does home insemination (including sourcing sperm informally) affect the safety and health of those involved, and would regulating informal sperm donation be possible and helpful to LGBTQIA+ people?
Jadva et al, 2018: Why women use non-regulated donors https://doi.org/10.1080/14647273.2017.1315460. Open Access
Summary: A total of 429 women looking for a sperm donor on Pride Angel (a website that facilitates contact between donors and recipients) completed an online survey. A third (n = 157 (37%)) of the participants gave disadvantages to sourcing sperm online, the most common reported was encountering ‘dishonest donors’ (n = 63, 40%). Whilst the survey had a large sample size, the representativeness of the sample is not known.
Golombok et al, 2015 (entire book): Regulation of reproductive donation https://doi.org/10.1017/CBO9781316117446. Paywall
In this multidisciplinary book, social scientists, ethicists and lawyers offer fresh perspectives on the current challenges facing the regulation of reproductive donation and suggest possible ways forward. They address questions such as: what might people want to know about the circumstances of their conception? Should we limit the number of children donors can produce? Is it wrong to pay donors or to reward them with cut-price fertility treatments? Is overseas surrogacy exploitative of women from poor communities? Combining the latest empirical research with analysis of ethics, policy and legislation, the book focuses on the regulation of gamete and embryo donation and surrogacy at a time when more people are considering assisted reproduction and when new techniques and policies are underway.
Unranked Q: What are the current experiences of LGBTQIA+ people who are thinking about and becoming parents, including experiences of cisheteronormativity? (cisheteronormativity is a systemic assumption that being cisgender and heterosexual is “normal” or “natural”)
Greenfield & Darwin, 2024: Experiences of parenthood, including some experiences of cisheteronormativity
https://doi.org/10.1111/birt.12780. Open Access
Summary: An online survey was conducted in April 2020 to provide real-time data capture of new and expectant families' experiences. It was open to those in the third trimester, or to those who had given birth since the beginning of the first UK lockdown period, and their partners. The survey asked open-ended questions about perinatal experiences. Responses were collected from 1754 participants, including 76 who self-identified as LGBTQ+. Thematic analysis identified that LGBTQ+ new and expectant parents faced similar issues to cisgendered, heterosexual expectant parents, though additional concerns were also noted relating to support and recognition. Heterocentric policies negatively affected lesbian families. Non-birthing co-mothers feared invalidation as parents. Sexual minority pregnant women were more likely than heterosexual pregnant women to consider additional birth supporters and to consider freebirthing (birth outside of the healthcare system).
Greenfield, 2023: Charity commissioned report into the perinatal experiences of LGBTQ+ women
https://doi.org/10.5281/zenodo.8326480. Open Access
Summary: 16 LGBTQ+ women over 18 who had either conceived a baby whilst in a relationship with another woman or conceived a baby as a solo parent were interviewed. In addition, three healthcare professionals who had provided perinatal care to LGBTQ+ women, and were LGBTQ+, were interviewed. The findings from this research show that LGBTQ+ women had mixed experiences of services when trying to conceive, during pregnancy and birth, and in the early postnatal period. Whilst most participants described their experiences of becoming parents as good overall, none had completely positive experiences, and the majority had some distressing experiences. The report notes that NHS perinatal services have historically been established for heterosexual couples, and may struggle to provide appropriate services for LGBTQ+ people and that heterosexism remains pervasive in these services.
LGBT Foundation 2022: Trans and non-binary experiences of maternity services. This is a report compiled by a charity, found here: https://lgbt.foundation/wp-content/uploads/2024/01/ITEMS20final.pdf Open Access.
Summary: This report gathered survey data from 121 trans and non-binary people in the UK who had ever given birth or were pregnant, and also interviewed 4 people. In the survey, a significant minority of respondents did not access healthcare after birth, and a smaller number did not access healthcare before or during birth – discomfort with NHS services were reported as contributory to this. Some respondents reported that professionals were awkward and anxious when talking to them, and that language was not inclusive. Some participants felt that their trans-ness distracted professionals from issues that had nothing to do with being trans, such as a baby having a tongue tie. A fifth of respondents said they were not spoken to in a way that respected their gender antenatally, and a quarter reported the same during the labour and birth, and postnatally. A third did not feel that midwives provided relevant information on infant feeding antenatally; nor took into account their personal circumstances when giving feeding advice postnatally. Over a third of respondents said that midwives did not appear to be aware of their medical history during postnatal care. In interviews, some participants reported not being ‘out’ during pregnancy due to fear of discrimination or simply because there was no opportunity to come out, which interfered with accessing appropriate information. Others described high levels of anxiety about quality of care and avoidance of antenatal classes or hospital birth to reduce experience of or potential for non-inclusive care. Participants from racialised ethnic backgrounds described the impacts of the intersections of racism and transphobia.
Greenfield & Darwin 2021: Scoping review on trans and non-binary pregnancy, traumatic birth and perinatal mental health. 2021 https://doi.org/10.1080/26895269.2020.1841057 Paywall
Summary: 12 papers were included in the review, from North America, Western Europe and Australia. The literature discusses the varied impact of pregnancy, birth, and the postpartum on gender dysphoria, with specific points including discontinuing testosterone therapy, changes to the chest, being socially read as pregnant, giving birth, and lactation. Dysphoria could be “physical” i.e. embodied experiences or “social” i.e. relating to anticipated or experienced reactions or treatment by others. Some participants experienced disconnection or alienation from the pregnant body, which could follow the changes to the body caused by pregnancy or could be pre-emptive, anticipating changes. Some found the bodily changes of pregnancy distressing, whilst others experienced them positively. Some found even the idea of vaginal birth traumatic, while others found a vaginal birth to be meaningful for them, transcending usual concerns about gender identity and the body. Visibility emerged as a complex issue for pregnant non-binary people and trans men to navigate. Being visible may require being permanently “out” and for some, this can be uncomfortable, or even potentially dangerous. Physical, social, and emotional isolation andexclusion were identified as common features of non-binary people and trans men’s pregnancies and some individuals’ early postpartum experiences. This isolation and exclusion was intimately linked with the experiences of either physical or social dysphoria and visibility, and could be a strategy to avoid difficulties in these areas. Feelings of social exclusion could be exacerbated by healthcare services, including lack of healthcare images and language reflecting pregnant trans men. Trans men made diverse birth choices concerning mode and place of birth; these may include more homebirths and elective caesarean births. Sometimes these choices are not initially positive, instead driven by fear of poor care and choosing the perceived least bad option in order to retain control during birth.
Riggs et al 2021: Pregnant transmasculine and non-binary people’s experiences of midwifery care. This is a chapter of a midwifery textbook available here: https://ruthpearce.net/wp-content/uploads/2024/01/men-transmasculine-and-non-binary-people-and-midwifery-care.pdf Open Access
Summary: 51 trans and non-binary people with experience of conception were interviewed from UK, US, Australia, Canada and Germany. Positive experiences with midwives included asking for consent to touch people’s bodies, ensuring correct gender markers were recorded on paper and electronically, advocating for inclusive care from colleagues. Some participants felt supported by midwives disclosing that they had trans and non-binary family members. Some participants felt well supported by male midwives. Negative experiences with midwives included dismissing the important of preferred terminology for body parts, equating trans and cisgender experiences of birth, and repeated misgendering despite correction.
Hoffkling et al, 2017: Experiences of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5 Open Access
Summary: 10 transgender men who had given birth were interviewed. Some participants preferred to pass as a pregnant woman to avoid transphobia, others preferred to pass as an overweight man to maintain gender affirmation and some preferred to be fully ‘out’ as a pregnant transgender man. All options were felt to have risks and benefits. Participants felt erased by the inability of institutions to understand trans male pregnancy in written literature and images, computer systems and intake forms, as well as structurally in terms of male and female facilities; even when written forms asked for pronouns they were often ignored by staff. Participants found it difficult to find health professionals with experience of trans pregnancy and reported that professionals were uncomfortable with providing care in the absence of evidence. They reported frequent misgendering, use of the wrong name, presumptions over anatomy from external appearance and lack of understanding of the meaning of gender identity. Some participants avoided interacting with health professionals because of fear of transphobia and poor care. Some chose not to be ‘out’ to their providers because of fear of being denied fertility care. Some participants had affirming healthcare providers. Most participants reported anxiety about how to identify supportive healthcare providers in advance.
Unranked Q: How are LGBTQIA+ people’s family relationships and existing friendships affected when they are trying to conceive, are pregnant or after their baby is born?
Simon, Tornello and Bos, 2019: Perceptions of friendship amongst child-free and new parent sexual minority women
https://doi.org/10.1080/10894160.2019.1634994. Paywall
Summary: The current study investigated the narratives of how a sample of sixty-six sexual minority women, most of whom do not yet have children but who expect to be parents in the future, perceive the changes in friendship networks following becoming parents. A thematic analysis uncovered three themes: (1) general expectations surrounding future parenthood and friendships; (2) changes in lifestyle and priorities; and (3) LGBTQ + community attachment. Further, the theme of general expectations surrounding future parenthood and friendships was largely represented among lesbian and queer women, while the theme of changes in lifestyle and priorities was predominately represented among lesbian women, and finally, the theme of LGBTQ + community attachment was shared among all sexual minority women in our sample across different sexual identities.
Goldberg, Gartrell & Gates, 2014: Transition to parenthood for LGB people (report) https://escholarship.org/uc/item/7gr4970w. Open Access
Summary: This report addresses the research on LGB parenting, focusing on several main content areas: family building by LGB people; the transition to parenthood for LGB parents; and functioning and experiences of LGB parents and their children. Relevant summary points are that LGB prospective parents perceive less support from their families of origin than do heterosexual parents, but many LGB parents find that family ties strengthen after the arrival of the child. The involvement and support of the family of origin may vary depending on the LGB parent’s biological and legal ties to the child. Similar to heterosexual parents, LG parents’ mental health and relationship quality decline across the transition to parenthood, although support from friends, family, and the workplacebuffers all parents from the challenges of new parenthood. Same-sex couples with children share childcare, housework, and paid employment more equally than different-sex couples with children. Conditions linked to poorer well-being for LG parents include perceiving less support from family.
Unranked Q: How do LGBTQIA+ families choose children’s names (for example, surnames, given names and parenting names)? What responses have they experienced, and how has this affected them?
Gabb, 2005: Parenting titles and language used in lesbian families https://doi.org/10.1177/0038038505056025. Paywall
Summary: This data comes from semi-structured interviews with 18 lesbian mothers and 13 of their children, who live across the Yorkshire region in the UK. The article examines how parental identities are negotiated in lesbian parent families. The author argues that lesbian mothers’ extraordinary maternity is not dependent on a feminist egalitarian ethic but instead comes from families’ strategic articulation of same-sex parenthood, whereby gender is done and undone in multiple and contradictory ways. Focusing attention onto the ‘other (non-biological) mother’, the author suggests that her lack of social status and (progenitor) maternal role disrupts simple readings of gendered parenthood. The author demonstrates that children’s creative familial-linguistic management of ‘family’ facilitates an inclusive conceptual framework, representing families as process.
Unranked Q: What are the options for combining gender affirming care and lactation? How do they affect each other?
Hoffkling et al, 2017: Experiences of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5 Open Access
Summary: 10 transgender men who had given birth were interviewed. Of the participants who had chest surgery prior to pregnancy, some produced sufficient milk to feed their child for over six months, some had chest swelling but no obvious lactation and some had no chest swelling or obvious lactation.
MacDonald et al, 2016: Transmasculine individuals’ experiences with lactation, chestfeeding, and gender identity
https://doi.org/10.1186/s12884-016-0907-y Open Access
Summary: This is a qualitative paper describing interviews with 22 transmasculine individuals, 16 of whom chestfed and 9 of whom had chest masculinization surgery before conception. Two participants felt that the reduction in gender dysphoria from chest masculinization surgery facilitated the choice to become pregnant. Four participants were certain they would not be able to chestfeed because of chest masculinization surgery, however some had chest changes after birth, including signs of mastitis. Five participants had delayed chest masculinization surgery in part or wholly because of their commitment to chestfeeding. Most participants with previous chest masculinization surgery had chest tissue growth during pregnancy, some minor and some significant. No participants who bound their chestprior to pregnancy did so during pregnancy, partly due to pain or lack of efficacy. Once participant bound their chest cautiously during lactation, but others found it painful or were worried about mastitis. One participant took testosterone when his child was nearly two years old and chestfeeding, under supervision of a paediatrician and with no adverse effects for milk supply or the child’s testosterone level or bodily changes.
Unranked Q: How do fertility treatments, trying to conceive, being pregnant and becoming a parent affect gender identity and dysphoria?
Hoffkling et al, 2017: Experiences of pregnant trans men https://doi.org/10.1186/s12884-017-1491-5Open Access
Summary: 10 transgender men who had given birth were interviewed. Some participants preferred to pass as a pregnant woman to avoid transphobia, others preferred to pass as an overweight man to maintain gender affirmation and some preferred to be fully ‘out’ as a pregnant transgender man. All options were felt to have risks and benefits in terms of balancing dysphoria, risk of transphobia and affirmation/support of the pregnancy.
MacDonald et al, 2016: Transmasculine individuals’ experiences with perinatal gender identity
https://doi.org/10.1186/s12884-016-0907-y Open Access
Summary: This is a qualitative paper describing interviews with 22 transmasculine individuals, 16 of whom chestfed and 9 of whom had chest masculinization surgery before conception. There were variable experiences of gender dysphoria due to physical changes of pregnancy, and/or distress due to resulting misgendering. Seven of the 16 who initiated chestfeeding reported gender dysphoria while chestfeeding. The temporary nature of pregnancy and chestfeeding, and focusing on the ability to provide nutrition for their babies, helped people to cope. Some participants had worsening dysphoria after stopping chestfeeding. Decision making on infant feeding for those who had not had chest masculinization surgery related mostly to factors unrelated to gender identity, although some felt pressure from professionals to chestfeed.
Unranked Q: How many ‘prolific sperm donors’ (donors who have contributed sperm to multiple families, resulting in a large number of biological children) donate to LGBTQIA+ people, and what is the effect of this?
Freeman et al, 2016: Demographic profile of sperm donors on one connection website https://doi.org/10.1093/humrep/dew166. Open Access
Summary: An online survey was conducted over 7 weeks with 383 men registered as sperm donors with Pride Angel, a large UK-based connection website for donors and recipients of sperm. The number of children born per donor ranged from 1 to 10 (median = 3), with 153 donor offspring reported in total. Almost 60% (57.1%, 40) of actual donors had conceived three or less children; 11.4% (8) did not know how many children had been born.
Unranked Q: What are the experiences of LGBTQIA+ people who have adopted, or who wanted to adopt babies under one year old? How can these be improved?
Kelsall-Knight & Bradbury-Jones, 2024: Scoping review on the recruitment and assessment of LGBTQ+ adoptive parents
https://doi.org/10.1155/2024/5451383. Open Access
Summary: The 16 studies identified for inclusion originated from 6 different countries, with the most prevalent being the United States (10). Adoption processes were heterocentric which created difficulty for LGBTQ + people in navigating them effectively. Examples of inclusive practice were evident in the literature. Process change and inclusion need to occur at organizational and policy levels rather than being the sole responsibility of social care practitioners.
Unranked Q: Do fertility clinics adequately inform LGBTQIA+ people and surrogates about rates of conception and of adverse events from different treatments (IUI, IVF with own egg, or IVF with someone else’s egg used in reciprocal IVF or gestational surrogacy)? How does this affect LGBTQIA+ people, their babies, surrogates and health services?
Schrijvers et al, 2020: Unmet needs in psychosocial counselling for donor insemination
https://doi.org/10.1016/j.rbmo.2020.07.025. Open Access
Summary: This quantitative study included women in a heterosexual relationship (n = 19), women in a lesbian relationship (n = 25) and single women (n = 51) who opted for donor sperm treatment (DST). Women were included if they had passed the intake procedure at a Dutch fertility clinic, were not pregnant and had no previous donor-child. Fifty-two women (55%) reported unmet counselling needs. Women in lesbian relationships (n = 10, 40%) and single women (n = 14, 27%) mostly had unmet needs on the topic of choosing a sperm donor. In general, women had good mental health, but 13 (14%) met the criteria for clinical mental health problems. Women with more unmet counselling needs also had more mental health problems.