New definition of infertility opens doors for aspiring LGBTQ+ parents

Are you thinking of becoming a parent for the first time or expanding your family? Here are some things you may want to consider regarding fertility and your medical insurance.

Recent medical literature on the challenges facing LGBTQ+ couples and individuals on the journey to parenthood notes that “often (their) issues and needs … are conflated and then generalized.” If that’s true in a clinical setting, imagine the plights they face when applying for coverage for the medical procedures they need to have children. 

Medical insurance plans were simply not designed in consideration of same-sex couples aspiring to become parents. Even benefit packages specific to fertility coverage do not always make allowances for aspiring LGBTQ+ parents. It did not help that ASRM ― the American Society for Reproductive Medicine, which helps establish guidelines for laboratory and clinical practice, and serves as a leading resource and advocate for public policy concerning reproductive health issues ― has not historically made explicit allowances for same-sex couples in its definition of “infertility.”

That has changed. On Oct. 15, the ASRM Practice Committee redefined infertility as “a disease, condition, or status characterized by any of the following”: 

• The inability to achieve a successful pregnancy based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combination of those factors. 
• The need for medical intervention, including, but not limited to, the use of donor gametes or donor embryos in order to achieve a successful pregnancy either as an individual or with a partner. 
• In patients having regular, unprotected intercourse and without any known etiology for either partner suggestive of impaired reproductive ability, evaluation should be initiated at 12 months when the female partner is under 35 years of age and at six months when the female partner is 35 years of age or older. 

Significantly, ASRM adds, “Nothing in this definition shall be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation.”

The older definition of fertility excluded many individuals and couples from gaining fertility coverage altogether. ASRM’s new definition doesn’t mean every insurer will immediately shift their criteria on who qualifies for fertility treatment, but it is an important first step. 

Some corporations already offer infertility benefits to include single individuals, LGBTQ+ parents-to-be, and those who fall into both categories. Now, other employers could face pressure to do the same, leading to change across the country and increasing overall access to care.

This is more than a human resources issue; it’s a human rights issue. A recent report in the Review of Conceptual Business Analytics revealed that 75 percent of LGBTQ+ employees faced some form of discrimination in the workplace due to their LGBTQ identity. It concludes: “The lack of workplace policies and benefits that are inclusive of LGBTQ employees can create a hostile and challenging work environment. By implementing policies such as gender-neutral bathrooms, healthcare coverage for gender-affirming procedures, and equal parental leave benefits, workplaces can create a more supportive and inclusive environment for all employees, regardless of their gender identity or sexual orientation.”

A more inclusive definition of infertility ― at least in theory, hopefully in practice ― will break down barriers and increase healthcare equity for those in the LGBTQ+ community who aspire to grow their families.