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Modern State of LGBTQ+ Fertility 2019

space Fertility and family planning are complicated for just about everyone, but they can be disproportionately challenging for the LGBTQ+ community. Misinformation, combined with a lack of inclusive practices and affirming providers in traditional healthcare, can lead to stress and unwarranted stigma.

Welcome to the first-ever Modern State of LGBTQ+ Fertility. We teamed up with the LGBTQ+ dating and social app HER and prominent gender researcher Mere Abrams (LCSW) to survey people who identify as LGBTQ+. We asked what the respondents think and feel about fertility, and where they turn for information and support.

We believe that LGBTQ+ health is key to a healthy society. Everyone deserves access to reproductive health information and resources—no matter their background or identity.

The rise of LGBTQ+ families

More people than ever are identifying with LGBTQ+

More people than ever are identifying with LGBTQ+

Source: GLAAD, 2017

63% of LBGTQ+ millennials (ages 18-35) are considering expanding their families, mostly using assisted reproductive technologies, foster care, or adoption

63% of LBGTQ+ millennials expand their families using reproductive technologies, foster care, or adoption

Source: FamilyEquality.org, 2019

78% of respondents felt that identifying as LGBTQ+ affected how people interact with them

78% of respondents felt that identifying as LGBTQ+ affected how people interact with them

Source: Modern State of LGBTQ+ Fertility

The fertility information gap

Let’s dig into the misinformation circulating around LGBTQ+ fertility.

Of the survey respondents:

89% were not aware that age is a better indicator of fertility than overall health for people with ovaries over age 35.

89% of people with ovaries didn't know that age is a better indicator of fertility over age 35

44% were not aware that fertility declines for people with testes who are over age 45.

44% were not aware that fertility declines for people with testes who are over age 45

80% were not aware that hormone blood tests can be used to estimate egg count for a person with ovaries.

80% people with ovaries were not aware that hormone blood tests can be used to estimate egg count

46% were not aware that up to a year after initiating testosterone therapy, transgender men with ovaries may still have viable eggs.

46% of transgender men with ovaries can have viable eggs up to a year after testosterone therapy

54% were not aware that the average cost of one cycle of egg freezing is more than $5,000 USD.

54% were not aware that the average cost of one cycle of egg freezing is more than $5,000 USD
The information gap is significant, but it’s not for lack of curiosity or appetite to learn.

84%

wish they knew more about LGBTQ+ affirming reproductive healthcare

69%

wish they knew more about reproductive technologies

60%

wish they knew more about family planning options

“There’s no standard roadmap for queer people who want to have children, so we often need to write our own scripts and pave our own way.”

Jordan, Modern Fertility community member

Read Jordan's Story

The challenges with traditional healthcare

46% of all respondents do not feel comfortable talking to a healthcare provider about their fertility.

We looked at differences in comfort between heterosexual cisgender women, lesbian cisgender women, and transgender, non-binary, and gender non-conforming people.

When asked about comfort talking to healthcare providers about fertility:

18%

of heterosexual cisgender women said that they do not feel comfortable

Source: Modern State of Fertility, 2019

36%

of cisgender lesbians said that they do not feel comfortable

52%

of non-binary, transgender, and gender non-conforming people said that they do not feel comfortable

When LGBTQ+ respondents were asked about their top information sources for fertility and family planning information:

29% use general healthcare for fertility & family planning, 13% use specialist healthcare providers

Source: Modern State of Fertility 2019


A Center for American Progress study found that 29% of transgender people said a doctor or other healthcare provider refused to see them because of their actual or perceived gender identity. It’s clear that providers need to commit to supporting this community by delivering evidence-based, relevant information and a supportive environment that embraces all identities.

“I don't want to be in a situation where I'm having to educate my doctor rather than the other way around.”

Survey participant, Modern State of LGBTQ+ Fertility 2019

Enthusiasm towards home tests

While there are levels of discomfort with traditional healthcare providers, respondents were open to new ways to discover information about their bodies.

81% say a home fertility test would be useful

81% say a home fertility test would be useful

50% said they would feel more comfortable using a home fertility test than a test at a doctor's office

50% said they would feel more comfortable using a home fertility test than a test at a doctor's office

Turning to social media for fertility education

In the absence of trusted clinical resources, LGBTQ+ respondents are turning elsewhere, largely to online, non-traditional sources.

4 out of the 5 top current sources of information for fertility and family planning were free online resources:

FREE
Health-focused websites Social media LGBTQ+ focused Other Internet sources
PAID
General healthcare provider
33% listed social media as one of the top sources they turn to for fertility & family planning info

33% of LGBTQ+ respondents listed social media as one of the top sources they currently turn to for fertility and family planning info.

This number goes up to 44% for LGBTQ+ Gen Z respondents who listed social media as a top current source of information.

Yet only 4% of LGTBQ+ respondents listed social media as a preferred source for information

Yet only 4% of LGTBQ+ respondents listed social media as a preferred source for information.

11% of heterosexual cisgender women listed social media as a current source of healthcare info

For reference: 11% of heterosexual cisgender women listed social media as a current source of healthcare information.

Source: Modern State of Fertility, 2019

The top 2 preferred sources for information about fertility and family planning? General healthcare providers and specialist healthcare providers.

Interestingly, we saw a statistically significant difference in comfort depending on where people get their information. Those who use social media for fertility information typically feel less comfortable discussing fertility with a healthcare provider.

“Fertility journeys can be hard and micro-aggressions or negligence can feel even more palpable during this process, so make sure the provider and clinic is one where all involved feel respected and supported.”

Elle, Modern Fertility community

Read Elle's Story

Fertility triggers anxiety and fear — but there is hope

When asked how fertility and family planning makes them feel, here’s how those surveyed responded:
"Uncertain" and "Anxious" are two most common feelings people feel about fertility & family planning

Looking for more resources? We’ve got you

Affirming LGBTQ+ Centers and Clinics:

LA LGBT Center, Los Angeles

SF LGBT Center, San Francisco

Fenway Health, San Francisco

Mazzoni Center, Philadelphia

Callen-Lorde, New York

Queer Med, Telemedicine, pop-up locations in Florence (AL), Chattanooga (TN), Montgomery (AL)

Center on Halsted

UCSF Transgender Center of Excellence

Methodology

This research was conducted by Modern Fertility’s research team as a cross-sectional survey to discover what people who identify as LGBTQ+ currently understand about fertility and family planning. A cross-sectional survey means that we gathered the data at a single point in time and did not attempt to change or alter their beliefs in any way when gathering the data.

The data were collected from June-July 2019. A total of 207 people in the LBGTQ+ community completed the survey. The participants were recruited through the online social and dating service HER, as well as through other online communities.

So, what can — and can’t — this type of study tell us? A cross-sectional survey is a great way to learn about the number of people who hold certain beliefs and uncover the correlational relationships and subgroup differences between those beliefs. This type of study can’t tell us anything about causation.

Importantly, we wanted to make sure we conducted this study in the most accurate and scientifically sound way possible. Modern Fertility’s research team, comprised of PhD researchers and fertility and reproductive medical specialists, is committed to using the highest standards in academic research. We used reliable and validated measures and appropriate statistical analyses. The study was also approved by an Institutional Review Board (IRB), which ensures that we met the appropriate ethical standards in human research.

Demographics

Education:

Less than high school

High school graduate

Some college

2 year degree

4 year degree

Attended and/or completed graduate school

#

2

17

50

15

61

62

%

1%

8.2%

24.2%

7.2%

29.5%

30%

Racial/ethnic background:

American Indian or Alaskan

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Hispanic or Latino

Other

Prefer not to say

Note: could select more than one

#

7

10

12

1

174

17

13

3

%

3.4%

4.8%

5.8%

0.5%

84.1%

8.2%

6.3%

1.4%

Relationship status:

Single (never married)

Married

Partnered

In a relationship

Polyamorous

In a long distance relationship

Divorced

Dating

Coupled

Something else

#

74

31

20

27

8

9

4

7

10

7

%

35.7%

15%

10.6%

13%

3.9%

4.3%

1.9%

3.4%

5.3%

3.4%

Age:

Minimum: 18, Maximum: 59, M = 26.9, SD = 6.64

Gender Identities:

Cisgender lesbian - 83

Transgender - 36

Non-binary - 58

Gender non-conforming - 22

Questioning / prefer not to say - 4