Exploring the experiences of members of 2SLGBTQIA+ communities pursuing third-party reproduction

Abstract

One in six reproductive-matched (RM) couples in Canada experience infertility, as defined by the inability to conceive after 12 months of exposure to pregnancy risk, and this has been associated with significant psychological distress. However, very little is known about the experiences of 2SLGBTQIA+ individuals navigating social infertility, which refers to the inability to conceive as a result of identity or relationship status, and the ensuing reliance on third-party reproduction (TPR). An exploratory, mixed-methods study was conducted to begin this necessary investigation. The experiences of 22 2SLGBTQIA+ couples actively attempting to conceive via TPR were explored using semi-structured interviews and an online survey consisting of several self-report questionnaires measuring quality of life and distress in various domains and rates of institutional betrayal in healthcare contexts. This sample was found to report levels of distress comparable to or higher than those observed in previous RM samples and intended gestating partners were found to report more distress than their partners on average. Thematic analysis also identified patterns in participants’ responses related to specific inequities faced by this population in navigating this process, including gaps in access, information, and support. These results indicate a need for improved competence on the part of healthcare providers and the development of targeted supports for this population.