Most aspiring parents Hope your children are genetically related to them. But for gay men, the process is complicated and expensive. Seeing through it requires working with fertility doctors, lawyers, surrogate mothers (aka surrogate mothers) and egg donors. The process takes about two years and costs about $200,000 per child — gay fathers-to-be don’t meet the eligibility criteria for most health insurance family planning benefits, though that’s starting to change.
Brent Monseur, MD, recently helped lead a study to document how gay men use assisted reproductive technology to start a family Details, including questions such as how many children they want to have and how often their efforts are successful. Monseur, who is completing postdoctoral research in reproductive endocrinology and infertility at Stanford School of Medicine, spoke with science writer Erin Digitale about the study, which was published Aug. 4 in In Fertility and Infertility Report .
How did this research come about?
Many LGBTQ people including me A phrase I heard after coming out was “You can never have a family”. Thankfully, that’s less common now, but for a long time, this comment reflects common social norms and a misconception that reproductive science isn’t good enough for LGBTQ people to become parents.
As a gay who grew up in a conservative environment, this was a challenge I thought about. I didn’t know I wanted kids, but I didn’t want someone to tell me I couldn’t. So I started researching how to start a family. As a young person, it was hard to find this information. (This was about 20 years ago; I’m 35 now.) There’s nothing in the library and very little on the internet, but I think a doctor might be involved.
In graduate school at Johns Hopkins, I worked with fertility doctors before I went to medical school . I asked them how I could start a family as gay. They explain the whole process; it’s very complicated. Then they said, “You can’t be a patient here. We don’t care for gay men…but we should.” I decided, I’m going to medical school and become a doctor who provides reproductive health care to all LGBTQ people.
Your paper provides historical context, How a shift in attitudes among LGBTQ families has changed the climate for gay men who want to become fathers. Can you summarize?
The easiest way to change sentences In other words, LGBTQ families have gone from a paradox to a possibility. We went from being condemned and pathological to being more accepted.
There is a lot of focus in the scientific literature on whether children are okay if they have gay parents. There is no data to suggest that having a gender-minority or sexually-minority parent is harmful to children. Not only are LGBTQ people now socially “ok” to have children, but there are now people who advocate for LGBTQ families. In my own field, professional organizations that develop practice guidelines for fertility doctors say that everyone should have access to fertility care. Many fertility clinics that didn’t treat everyone before—including Johns Hopkins where I was a graduate student—do now.
But there are still obstacles. Some fertility clinics in this country still don’t care for LGBTQ patients, and most health insurance plans that offer fertility benefits use a clinical definition of infertility based on heterosexual couples trying to conceive for 12 months without getting pregnant. A New York State gay couple recently filed a lawsuit, saying the standards are discriminatory.
Why are gay men reflected in the scientific literature Is the experience of seeking reproductive health care important?
Most jobs in reproductive medicine are Focuses on infertile cisgender heterosexual women. Cisgender gay men were almost never included in this study, so we as physicians know nothing about their characteristics as reproductive health patients, or even basic information about their demographics, clinical decision-making patterns, or outcomes Know.
Our paper uses data from one of the few maternity benefit companies that offers maternity insurance to gay men. This gave us an opportunity to learn about a national group of 119 cisgender men, including 5 single men and 57 gay couples, who are uniquely entitled to fertility benefits. Although the study is still relatively small, it is the largest study to date of this process on U.S. men. I often start my patient consultations by saying “there isn’t really any research on how to do this”, but now we can say “you are in the literature. Your decisions and outcomes have been studied.”
According to our data, this population has a very high rate of success in eventually having children. During the study period, approximately 70% of our study population completed egg donation and embryo transfer to a gestational carrier, resulting in an 85% live birth rate. It is important to remember that our data reflects the experiences of individuals who can afford reproductive health care because their employer-sponsored fertility benefits cover it, which is still an unusual occurrence for gay men Case.
These data are the basis for a grant application we just approved to conduct a larger population study , which will allow us to obtain information on approximately 2,000 embryos transferred annually by gay men.
What is the most of your findings important aspects?
This is a birth rate with overwhelming success group, which is unusual in fertility medicine. Many people go to a fertility doctor because they have an underlying medical problem, and gay couples often have two possible sources of sperm, a young egg donor and a surrogate who has successfully conceived. I believe that because of these medical factors, the birth rate of gay couples can serve as a modern standard for assessing the success of an IVF laboratory.
Another thing that is consistent with the findings for lesbian/bisexual women is the high rate of twin pregnancy. In our study, the rate of transferring multiple embryos into surrogate mothers did not meet the standard of care and a single embryo transfer is strongly recommended; it was much higher. We recognize that this may be because a lot of gay men ask for twins or ultimately want two, and fertility doctors may transfer two embryos to try and save money for their patients, so they only have to go through one fertility treatment course. But we need to ask: Are we exposing surrogates to unnecessary risks to twin pregnancies and gay couples to unnecessary risks of having children in NICUs? I believe better maternity health insurance for LGBTQ people would be a safer and healthier way to deal with financial stress.
I was an obstetrician before and I thought “It’s a health issue, if gay men want to Twins, we should respect their autonomy.” But once you’ve dealt with a complicated pregnancy and realized the risks, your goals will be clear, don’t rush. The goal is to have one healthy baby at a time.
Make yourself gay like you Physician scientists answer research questions about this group of parents-to-be, what does this add?
Studies have shown that when their doctor Patients do better when they are members of the same race. I suspect the same logic applies to members of the LGBTQ community. I’m a researcher now, and I have patients who come to see me specifically, not because I’m the most amazing doctor, but because I’m gay and they want a gay doctor. Also, it’s important because I’m publishing the first research in the field — sometimes, if you don’t experience it yourself, you don’t think about what people in that community do or what’s important to them. The job just wasn’t done any other way.
More information: Brent Monseur et al, Pathways to Fatherhood: Clinical Experience with Assisted Reproductive Technology for Single and Married Expectant Fathers, F&S Report
(2022). DOI: 10.1016/j.xfre.2022.07.009
Citation
: Having a baby can be complicated for gay men (16 Aug 2022) , Retrieved August 16, 2022 from https://medicalxpress.com/news/2022-08-biological-child-complicated-gay-men. html
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