Having a Baby and Building Your Family When You Identify as LGBTQ

Building your family when you're lesbian, gay, or transgender

Two men with kid looking at book

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Whether you identify as gay, lesbian, transgender, or queer, if you want to have a baby or raise children, you have many options—possibly more options that you’ve imagined! Granted, having babies as a same-sex couple or LGBT individual can be complicated. There are logistical issues, legal hurdles, and financial obstacles that heterosexual couples rarely consider or ever need to deal with. Just like heterosexual individuals, some LGBT people will face infertility on top of "situational" infertility. Further, intersex individuals (some of whom identify with the LGBT community) may be sterile or have diminished fertility. Discrimination may also arise in your journey towards parenthood (though it should not prevent or stop you). 

All that said, where there is a will, there is a way, and lots of queer people are raising kids. According to the Williams Institute, almost 29 percent of those who identify themselves as LGBT report raising children. In the United States of America, an estimated 3 million LGBT individuals have had a child, and an estimated 6 million children have an LGBT parent.

Same-sex couples—when compared to heterosexual couples—are six times more likely to be raising foster children and four times more likely to be raising an adopted child. Also, according to statistics collected by the U.S. Census, 19 percent of same-sex households report raising children. This includes those “raising their own” kids, along with those raising adopted or foster care kids. 

At the most basic level, your options for having kids are either with the help of assisted reproductive technologies or through the adoption or foster care network.

A queer person’s options for parenting include:

  • Insemination with a sperm donor
  • Surrogacy with an egg donor
  • IVF (with or without a surrogate) with an embryo donor
  • Reciprocal IVF (for lesbian couples; one partner carries the baby, the other is the egg donor)
  • Co-parenting (a planned, platonic parenting relationship)
  • Adoption
  • Foster care

These avenues are open to you whether you are single or partnered. They are also, in most cases, open to you even if you’re HIV positive, as there are fertility procedures that significantly reduce the risk of HIV transmission to a child or surrogate mother. Lack of financial resources is the most likely barrier to some (but not all) of these paths to parenthood.

Quick Note

Because of the many legal intricacies and variations between states (and countries) when it comes to establishing parenthood for LGBT singles and couples, it’s advised that you consult with a lawyer who's familiar with local family and reproductive law as you consider your options.

Third-Party Reproduction

Unless you’re looking at adoption or foster care, some form of third-party reproduction or donor-assisted reproduction will likely be needed. Third-party reproduction refers to any fertility procedure where a “third person” is needed to provide eggs or sperm, or to be a gestational carrier for the intended parent(s).

Surrogacy arrangements are third-party reproduction because the surrogate carries the baby for the intended parent. If you use a sperm donor, egg donor, or embryo donor, those are also third-party reproduction.  

Any time third-party reproduction is being considered, there will be terms used to describe the communication relationship between the donor or carrier and the intended parent. Here are some terms you need to know.

Known Donor/Gestational Carrier

This is when the donor or gestational carrier is someone previously known to you. It may be a friend, relative, or acquaintance. The person isn’t someone you found through an agency, ad, social media, or fertility clinic.

There are many advantages and disadvantages to having someone you know be your sperm or egg donor, or act as a surrogate. The experience can improve your relationship with the person—or damage it. There may also be increased legal risks (for example, a donor or gestational carrier fighting for parental rights), and possible future disagreements over how involved the donor or carrier should be in the life of your child.

Meeting with a counselor and a lawyer familiar with the delicate nature of third-party reproduction is essential. Some fertility clinics will not work with a known donor until after psychological counseling and legal agreements have been completed.

Anonymous Donor

This has traditionally been the most common arrangement for egg and sperm donors. The donor is completely unknown to the recipient, and the intended parents also have no identifying information about the donor. While you will likely get to see a photo of your potential donor, it’ll be a baby picture or one from childhood. There’s no contact between the donor and intended parents at all.

This traditional arrangement has felt “safest” for donors and intended parents, who both may be worried about legal or emotional complications after the birth—for example, worries that the donor will try to claim parental rights or worries that an intended parent will try to extract child support from the donor.

However, many donor-conceived children wonder about their genetic origins. Intended parents may wonder about the person who helped them become a parent, and donors might wonder about the child they helped bring into the world. This has led to an increase in popularity for semi-open and open donor arrangements.

Semi-Open Donor

You’ll have more identifying information and limited contact with the donor with a semi-open arrangement. What this contact and information sharing entails can vary greatly, but typically, the communication will be through an intermediary. This could be the donor agency or a legal firm. The donor may get information like whether or not the donation led to a pregnancy. They may receive a baby photo after the birth from the intended parents. But details like personal phone numbers, addresses, and place of occupation are not shared.

Sometimes, with a semi-open arrangement, the donor-conceived child may be permitted to reach out to the donor. There may be restrictions in place, like it can only happen after the child is a legal adult.

Open Donor

With an open donor or surrogacy arrangement, contact is often direct and ongoing. The donor and intended parents may meet in person and even attend some doctor appointments together. They will likely communicate with each other directly. With some open donor situations, the donor and intended parents decide to get together once a year or every few years. There is often a relationship of some sort built between the donor, the intended parents, and the donor-conceived child.

Sperm Donor Insemination

Insemination is when specially washed semen is transferred to a woman’s cervix or uterus. Lesbian couples and single women may go this route to have a baby. The sperm donor may come from a sperm bank or may be a known donor.

Insemination can take place at a fertility clinic, or, in some cases, a midwife can conduct an insemination procedure at home. Home insemination is a possibility, but with some important cautions and caveats. There can be serious legal and medical risks with home insemination.

The cost of insemination and a sperm donor can range anywhere from several hundred dollars to several thousand dollars. It depends on how many tries you need before you achieve success and also what kind of insemination procedure is used.

At-home insemination will be less expensive, but is more likely to fail, and has legal and medical risks (especially with a known donor). When it comes to fertility clinic procedures, intracervical insemination (ICI) is less expensive than intrauterine insemination (IUI), but IUI has better success rates.

Remember that heterosexual couples having sexual intercourse may require many months to get pregnant. Taking up to a year isn’t common, but it’s not abnormal either. When you’re paying for every vial of sperm in a donor situation, the costs can add up quickly.

A big decision to be made—besides choosing the sperm donor—will be who will carry the baby. There is no wrong way to decide this, but here are some possible options:

  • Going with whoever wants to experience pregnancy and birth most (not everyone is interested in being pregnant, sometimes one partner will have already experienced pregnancy)
  • Going with whoever is most likely to have success (based on fertility history or testing)
  • Planning on insemination of both partners each month, and whoever gets pregnant, that’s the one who carries the baby (though keep in mind you could end up with “twins”!)
  • If already planning on having more than one child, making a decision to take turns (though you still need to decide who goes first)
  • Deciding to do reciprocal IVF instead of insemination as a compromise (more on this below)

Important note: Be very careful about going forward with a do-it-yourself at-home donor insemination with a known donor. Insemination that takes places outside of a fertility clinic, in many states, will automatically assign parenthood to the male sperm donor, even if no sexual intercourse took place and even if there were legal agreements set up ahead of time.

There can also be medical risks with a donor arrangement at home with a friend. Sperm donors go through rigorous screening and medical testing, but with a friend, these safeguards won’t exist.

In Vitro Fertilization

Reciprocal IVF

IVF, or in vitro fertilization, is when eggs are harvested from a woman’s ovaries and then, in a lab, put together with sperm. If all goes well, you get a few embryos, and one or two of those embryos can be transferred to a woman’s uterus. Any extra embryos can be cryopreserved for the future.

Reciprocal IVF is an option for lesbian couples that want to both have a part in the biological process of having a baby together. One partner has the egg stimulation and retrieval, while the other partner has the embryo(s) transferred to her uterus. One mother will be genetically related to the baby, while the other will have given birth to the child.

The decision of who will contribute the eggs and who will carry the child may be a personal one or a medical one. For example, if one mother is much younger or has better fertility, she would probably be the best one to contribute the eggs. Age isn’t as much of a factor when it comes to carrying the baby.

IVF is an expensive fertility treatment, and reciprocal IVF is slightly more expensive than conventional IVF. This is because the mother who will carry the baby will also need hormones and fertility drugs to prepare her uterus and control her cycle. Plus, a sperm donor will also be required, and that’s an additional cost (if it’s not a known donor).

Reciprocal IVF can range anywhere from $15,000 to 30,000. Multiple cycles may be required to achieve success. However, if there are cryopreserved embryos from an unsuccessful cycle, frozen embryo transfer cycle will cost significantly less than a full IVF cycle—usually something around $3,000 to $5,000.

Beyond IVF fees, expect to pay legal fees. Establishing parenthood may not be as straightforward as you might expect. For example, the mother who contributed her eggs may need to legally adopt the child, even though the baby is her genetic offspring.

IVF with an Embryo Donor

IVF with an embryo donor is another option for lesbian couples, single women, and men (with the help of a surrogate). When you use an embryo donor, the baby will not be genetically related to the intended parent(s). You also won’t be choosing a sperm or egg donor, since that phase of treatment is completed. Embryo donation often comes from couples who struggled to conceive, so the success odds may also be slightly lower than using an egg donor. It very much depends on the donor.

With a single woman or lesbian couple, the embryo will be transferred to the woman who plans to carry the pregnancy. With a single man or gay male couple, a surrogate will carry the embryo.

Why might you choose embryo donor IVF?

If there are fertility problems and using your own eggs isn’t an option, embryo donor IVF is a possibility. Sometimes, there will be fertility problems and neither partner can provide eggs for IVF. This may be discovered before fertility treatments begin, and sometimes it becomes apparent after failed or canceled IVF cycles.

If you can’t use your own eggs for IVF, you pretty much have two options as far as fertility treatments are concerned: you can use an egg donor, or you can consider an embryo donor.

Heterosexual couples may want the intended father to be genetically related to the baby (if possible), so using an egg donor with the intended father’s sperm makes sense. However, for lesbian couples—who may require both an egg donor and a sperm donor—using an embryo donor can be a good solution. 

Another reason is that it’s significantly cheaper than conventional IVF or IVF with an egg donor. Embryo donor IVF is so much cheaper than conventional IVF, and tremendously less expensive than IVF with an egg donor.

Conventional IVF with your own eggs is usually around $15,000 to $20,000 per cycle. IVF with an egg donor can cost anywhere from $30,000 to $40,000 per cycle. Depending on the clinic, location, and egg donor agency, costs can go even higher.

But IVF with an embryo donor is usually under $10,000. It’s not inexpensive, but it’s quite a discount compared to a full conventional IVF.

Egg/Embryo Donor Surrogacy

Surrogacy is when a woman carries a baby for an intended parent or intended parents. For single men, gay male couples, some intersex individuals, and women who can’t carry their own baby for medical reasons, surrogacy is an option for having a baby.

A surrogate may be someone the couple or person knows, or they may be found through a fertility clinic or surrogacy agency. Just like with choosing an egg or sperm donor, there are definite advantages and disadvantages to having someone you know be a surrogate. This is something to carefully consider with the help of a counselor. 

For gay male couples, they will also need to find an egg donor. You might think you can just do an insemination procedure with a surrogate, which would be less expensive. However, there are all kinds of legal and possible psychological risks when the surrogate is also the “egg donor.”

Assuming both men have good fertility, the couple will need to decide which will contribute the sperm. There are different ways to go about making this decision, including factoring in age. For example, if one father is much younger than the other, you might go with the younger man, since there are genetic risks with older dads.

In some cases, men have decided to attempt to mix the sperm of one father with half the eggs, and the sperm of the other father with the other half of eggs. High-quality embryos that are suitable for transfer to the surrogate are not guaranteed, of course, and it’s possible to end up with only embryos from one dad. But, if you’re lucky, you could get a little of both. The “extra” embryos could be cryopreserved and used to have a second child in the future, and then you might get a genetic child for each dad.

Surrogacy with an egg donor is extremely, extremely expensive, costing anywhere from $70,000 to $150,000. Costs will be lower if you can use a known surrogate or egg donor, or if you decide to use an embryo donor with a surrogate, but if you use an embryo donor, neither father will have a genetic connection to the child. No matter how you move forward, surrogacy is going to be pricey.

Having a Genetic Connection

There actually is a way for both parents in a same-sex relationship can have a genetic connection to their child. It works like this: one partner provides one gamete (egg or sperm, as the case may be). The other partner has a sibling or cousin provide the other gamete. While the second intended parent isn’t the genetic parent, they do have a genetic connection to the child.

To illustrate how this may work, let’s say we have a lesbian couple, Anne and Zoe. Let’s say Anne is the one who plans to carry the baby and get pregnant. Then, one of Zoe’s male siblings or cousins would be the sperm donor. The male sibling or cousin would not be the intended father—they are only the donor. Zoe would be the second parent, along with Anne.

To illustrate how this may work with a gay male couple, let’s say we have a couple, Alex and Zack. If Zack provides the sperm, one of Alex’s female relatives may act as the egg donor. The surrogate may be the egg donor or someone else, depending on the situation. Again, Alex’s female relative wouldn’t be the female legal parent. Alex would be the intended father, along with Zack.

As with everything, there are advantages and disadvantages to this option. For one, it requires that one partner has a sibling or cousin who is interested and willing to be an egg or sperm donor. Secondly, having an understanding that the donor will not be a parent or have any parental rights or responsibilities (even though they are a relative) can be complicated.

Both psychological and legal counseling before you make a decision is important for all parties.

Co-Parenting

Co-parenting is when two to four people decide to have a child and raise that child together, usually outside the context of marriage. Of course, only two can be the genetic parents, but in a co-parenting situation, up to four adults may parent together.

The phrase "co-parenting" is most commonly used in the context of divorce—a divorced couple that shares custody may co-parent the children together, possibly with the help of their new romantic partners. However, in the context of LBGT family building, co-parenting is planned ahead of time, before a child exists. Note that planned co-parenting is by no means exclusive to LGBT families. Heterosexual families also commit to pre-planned co-parenting arrangements.

In a co-parenting situation, assuming there are no fertility problems, the egg donor, sperm donor, and surrogate (who may also be the egg donor, in this case) are all intended parents.

A co-parenting arrangement may be made up of:

  • A single man and a single woman
  • A male couple and a single woman
  • A female couple and a single man
  • A male couple and a female couple

Co-parenting is not the same as a “known” surrogacy or donor situation. With known surrogacy and egg/sperm donors—even if an ongoing relationship takes place between the intended parents and the donor/gestational carrier—the surrogate/donor is not a parent. They take no legal, financial, or emotional responsibilities for the child. If anything, they are more like an honorary aunt or uncle. 

With co-parenting, all those involved in the arrangement are intended parents. They may or may not all decide to live together. They may not even live close to each other. But parenting responsibilities and rights are shared in some way.

Entering into a co-parenting relationship is a huge decision. You are agreeing to be connected to the child and the other parent(s) for life, at least in some way. The decision is more binding than marriage to a romantic partner in that there is always divorce after marriage—but once there is a child or children involved, maintaining some degree of ongoing communication is a must. 

Before you decide, counseling with an LGBT friendly therapist and someone familiar with the concept of co-parenting is highly suggested. 

Heterosexual or bi-sexual co-parenting arrangements may include sex for the sake of conception. However, more typically, a fertility procedure like insemination is used. For example, with a male couple and a female—three intended co-parents, in this case—one of the intended fathers provides the sperm and a fertility doctor performs an insemination procedure with that sperm to hopefully get the intended female co-parent pregnant.

The legalities of co-parenting are complex and will vary depending on where you live. Who can be on the birth certificate? Can more than two parents be named? Also, note that having your name on the birth certificate doesn’t necessarily give you parenting rights. What about legal guardianship? Will the “sperm donor” co-parent need to legally adopt the child to have legal parenting rights?

Meeting with a lawyer prior to taking steps to have a baby with a co-parent(s) is highly recommended. Informal agreements are not enough. Should your co-parenting relationship falter in the future, you don’t want any questions as to your visitation and parental rights to your child.

Transgender Unique Challenges

Transgender individuals who have been treated for gender dysphoria with hormones or surgical treatments may face additional challenges when it comes to having a genetic child. Taking hormones can negatively impact fertility for all genders. These negative repercussions can continue even if hormone treatments are discontinued or paused.

However, this doesn’t mean those who want hormonal treatments or even surgery can’t have genetic children in the future. Those assigned female at birth may even be able to carry a child after gender dysphoria treatment if they want, assuming they still have their uterus and vagina.

Ideally, future fertility options should be discussed before any gender dysphoria treatments are started. For transgender people assigned male at birth, this may mean cryopreservation of sperm. For transgender people who were assigned female at birth, this may mean egg freezing.

What happens if fertility preservation wasn’t discussed before starting hormones? Or surgery already took place? Don’t assume having a genetic child isn’t still possible.

The first step is to consult with a fertility specialist, especially one who is LGBT-friendly. They can review your medical records, do some basic fertility testing (if needed), and help you consider all your options.

Also, remember, having a child with the help of an egg donor, sperm donor, and/or gestational carrier is an option if finances allow.

Adoption and Foster Care

Adoption and foster care are popular choices for LGBT individuals and couples. Some people are under the misconception that gay and lesbian couples can’t adopt or apply to be foster parents, but this is untrue.

“Don’t be afraid to pursue adoption!” says Mark Barbagiovanni, a social worker who specializes in assisting hopeful adoptive parents. Mark and his husband have an adopted child of their own. “There is an amazing community of LGBTQ families on social media from all around the world.”

There are a variety of paths to adoption, some costing thousands of dollars and others costing very little. You may seek adoption through a private agency, through the state, or privately person-to-person, in what is known as “self-matching” adoption. It’s also possible to adopt through the foster care system.

“Adoption has so many different components, so in regard to cost and type of adoption, there are many options to build your family,” explains Barbagiovanni.

Domestic adoption is often the best option for LGBT couples, as many international adoption agencies discriminate against LGBT individuals. Depending on where you live, you may also come against discrimination and legal hurdles. But don’t let that stop you.

“Unfortunately, legislation is always changing,” says Barbagiovanni. “For those pursuing an independent adoption, they can run into people who will discriminate and be unfriendly. There are also people who are just against adoption in general.” 

“An LGBTQ person should seek out a professional that is known to work with this population. Many adoption professional will advertise that they welcome LGBTQ families,” suggests Barbagiovanni. 

In addition to going through an agency or government program, LGBT couples may want to look into what is known as self-matching adoption. This is when a private agency or individual, along with an adoption lawyer, conducts a home study. Then, you use social media, word of mouth, and print advertising to let the world know you’re interested in becoming an adoptive parent.

“There are several companies and individual adoption professionals, such as myself, who offer a marketing package for prospective adoptive parents,” says Barbagiovanni. “There are many benefits to using social media as an adoption marketing tool. It’s budget friendly and on a journey that offers very little control for waiting families, using social media lets them have some control over their matching to an expectant parent.” 

You may be concerned about adopting an older child—as opposed to a baby—that the child has already been socialized against LGBT people. Barbagiovanni explains this is only a potential problem when adopting internationally or through the foster care system. However, if you want to adopt from foster care, you shouldn’t let this fear stop you from trying.

“Hate and prejudice can start at a very early age depending on how the child has been raised thus far,” says Barbagiovanni. “In my experience, the child’s social worker will know the type of family that will be a good match for the child. There is a team of professionals that choose the family for any child in foster care. So, this shouldn’t be a problem.”

Others may be concerned that single male or gay male couples would have a harder time adopting, just because they are men, but this may not be true. “For gay male singles/couples, we have it particularly easier in the matching process, as there is no other mom 'replacing' the child’s birth mother and often get chosen quicker.”

Foster care parenting—with no intention of adoption—is another option for LGBT singles and couples to parent a child. The goal with foster care is to eventually reunite the child with their original parent(s) after they get past difficult times. Few foster care children go on to be adopted. With foster care, your relationship with the child is likely time-limited, and you will need to say goodbye eventually. Also, sometimes, the biological parents will not allow continued contact with a previous foster care parent, and this can be emotionally difficult.

All that said, foster care is a wonderful way to play an important role in a child’s life. As with adoption, looking for foster care agencies or social workers that advertise being LGBT-friendly is a good idea.

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