The Unspoken Reality of Queer Couples Trying to Conceive

Caitlin and Jess Gray, a queer couple based in Detroit, dreamed of having a baby for as long as they can remember — someone other than their dog to shower in kisses and love.

Three years ago, following an unsuccessful IUI and an unwelcoming experience at their local fertility clinic, a close friend kindly offered to be their sperm donor. Not long after, they discovered his sperm was unusable due to a rare medical condition, and about a year after that, the Grays connected with an old friend in Colorado who agreed to donate his previously successful sperm. Caitlin got pregnant in both 2023 and 2024 but ended up experiencing two pregnancy losses.

This is just a small glimpse into what the Grays have been through over the past three years as a queer couple doing everything they can to get pregnant. The process has cost them over $25,000 thus far, alongside a significant emotional and mental strain.

The Grays are far from being the only LGBTQ+ people to face the challenges of conceiving in systems not designed for them. The number of queer people planning to have children is growing: a 2019 survey from the Family Equality Council found that 63 percent of LGBTQ+ millennials ages 18 to 35 are considering expanding their families by becoming parents for the first time or by having more children. A 2020 Census Bureau study revealed that 15 percent of the approximately 1.1 million same-sex couples in the US had at least one child under the age of 18 in their household.

Despite these rising numbers, fertility clinics, insurance policies, and anti-LGBTQ+ legislation create systemic barriers that make an already complex process even harder.

Amy Divaraniya, PhD, is a data scientist and the founder of fertility care brand Oova.

Financials are one of the most talked about aspects of queer family planning, and it makes sense: the cost of building a family is considerable. One vial of sperm can cost anywhere from $1,500-$2,000, and most of the time, clinics require a purchase minimum. Donor eggs, meanwhile, can cost anywhere from $25,000 to $40,000, and surrogates are estimated at $100,000 to $200,000.

These costs are almost always out of pocket as insurance policies that cover fertility care are slim. As of 2023, 14 states provide coverage on private insurance plans, and only three states inclusively cover LGBTQ+ people.

These are just examples of beginner starter costs — before factoring in legal fees, medical costs, counseling services, and post-birth expenses.

Queer people of color looking to build a family face even greater financial and logistical challenges due to the limited availability of diverse donors. As of February 2024, California Cryobank had 327 sperm donors, but only 14 were Black, per Illume Fertility, representing just 4 percent of the total donor pool. Similarly, according to the most recent data from the CDC in 2013, Black women experience infertility at nearly twice the rate of their white counterparts, driving even higher demand for Black egg donors.

But the monetary cost isn't always the most challenging part of the process. The emotional, mental, and psychological hurdles are often just as — if not more — demanding and exhausting.

Marea Goodman, a queer midwife and author of "Baby Making for Everybody" whose pronouns are they/them, still recalls how overwhelming it was to start their own family planning process, despite being an expert in the field. At that time, Goodman then decided to create an online virtual community, Pregnant Together, an education center to make queer parents feel less alone, as an attempt to help other families fill the isolation they experienced during their conception journey.

"Being in connection with each other helps us go through hard things. It helps us build resilience, access information, and find community. I started Pregnant Together to give queer parents visibility and open them up to other queer people going through this niche experience," they tell PS. Goodman holds these struggles close to their heart, having been through the process themselves three times.

For Caitlin Gray, the lengthy and emotional journey of trying to conceive came with an immeasurable cost, one that might not be expected on the path to parenthood. "I had to quit one of my stressful part-time jobs because I had to go for appointments every two days for IVF treatment, and the clinic's limited hours conflicted with the time I had to be at work," she shares.

Jess, Caitlin's partner and the non-carrying parent, even had their own career conflicts trying to balance being a supportive partner and maintaining client appointments as a therapist. "Having to call off for IVF treatments has professional consequences. Canceling people's appointments at the last minute is not great professional practice," they say. The stress of the process crept into almost every aspect of their life.

Similarly, Madison Andres, whose pronouns are they/she, and their partner Beryl Perron-Feller, whose pronouns are they/them, would have had a child years ago if the process were set up easier and there was greater education; no one teaches you how to conceive, so for them, figuring out how they wanted to have a child within their budget took two years of planning. From an uncomfortable trip to the sperm bank to family members constantly expressing their unwarranted opinions, trying to conceive has often tested the relationship. "This month, instead of tracking ovulation, having sex, and hoping we get pregnant, our version of trying for a baby has been calling a lawyer to set up second-parent adoption paperwork," Perron-Fellerwould says.

After having what they described as a "transactional" and "pay-to-play" experience with a sperm bank, the couple decided to source sperm elsewhere. "It felt icky to us to go to a sperm bank and say these are aspirational things we want our kid to look like or be like. The capitalistic energy did not align with our values and felt like a puzzle that wasn't necessary to play," Perron-Feller says.

The couple then realized their ideal sperm would come from a friend of a friend. "There's a beautiful ability for queer family planning to be exactly what you want it to be. With a known donor, there's an opportunity for it to be an extension of our queer family," Andres explains.

Andres and Perron-Feller contacted a few close family and friends to find a sperm donor. They initially found a friend's friend who agreed to help but then unexpectedly backed out. More recently, they found another potential donor, but his sperm count was too low to proceed. They are disappointed but committed to doing everything they can to bring a child into their lives together.

The couples PS spoke with say the process has strengthened their relationships and, if anything, made them realize just how much they want to start the family they deserve.

Even when the odds are in your favor, the current political climate, coupled with the attacks on fertility laws following the overturning of Roe v. Wade, make it hard for queer people to feel secure in their journeys to conceive. Goodman shared an example of a Pregnant Together member living in Texas who had to seek IVF treatments outside their state because they were scared of the current threat to IVF. "I have some members who are in Austin doing reciprocal IVF in Seattle because they don't want to have embryos stored in Texas," Goodman says. "Their rights are being threatened, and this upcoming election means so much for the fate of their family."

It can be hard to know where to turn, and queer people are not even sure they can trust professionals to guide them. A 2019 study by Modern Fertility found 46 percent of LGBTQ+ people don't feel comfortable talking to a healthcare provider about their fertility due to misgendering, heteronormative intake forms, and a lack of knowledge about LGBTQ+ needs. This lack of support makes communities like the one Goodman has built more important than ever.

Hidden behind somber politics and uncertainty, there is still hope.

Some recent rulings, however, have supported LGBTQ+ fertility coverage, anticipating more positive developments in the near future. In 2022, Aetna resolved a lawsuit against its policy that had mandated LGBTQ+ couples to cover fertility treatment costs themselves before qualifying for coverage. Oova founder Amy Divaraniya, PhD, tells PS, "This set a precedent for more equitable fertility treatment coverage for LGBTQ+ individuals and sparked discussions on inclusive insurance policies."

Dr. Divaraniya notes recent fertility attacks are designed to cause confusion about the state of health care, leaving people, especially LGBTQ+ people, in the dark about what kind of care they are eligible for. Her fertility company, Oova, which provides at-home hormone monitoring kits, has helped countless queer people start the family-building process in the comfort of their homes.

For mother of three, Kate Steinle, conception felt like a fun family project. Steinle is a nurse and chief clinical officer at Folx Health who came into the process with more knowledge than the average person.

Steinle and her partner used sperm from the same donor for all three of their children. She recalls that one of her biggest anxieties during her family-building process was the fear of not feeling connected to her child as the non-gestational parent, something most non-carriers can relate to.

"I don't have any genetic connection to my firstborn, and during the pregnancy, I worried what it would look like in terms of being super connected with him," she says. Jess Gray, who will also be a non-gestational parent, feels similarly, noting the difficulties of receiving support as a non-carrying parent. "Most people I know who are female-bodied are the ones carrying the baby," they say. "My emotions about the pregnancy are often dismissed, and I'm often seen as just a support system."

After having her three children, however, Steinle now realizes choosing a donor and the genetics of it all are just a small piece of the puzzle. "When that baby comes out, you've already done everything right," she notes. "That conversation you've had so many times about who it will be or what sperm choice we should have made gets completely washed away. You now have this beautiful baby."

Although Steinle and her partner live in New York, a more progressive state in terms of LGBTQ+ legislation, the couple wanted to do everything they could to protect their children and opted for a second-parent adoption, which allows for the "second" parent to have the same rights as the "first" parent. For Steinle's family, this was an estimated $3,000 expense for each child. "People assume that having two parents on the birth certificate is protective enough, but sometimes, it's not always legal confirmation," she says, adding, "Somebody could contest that."

Understanding the challenges of non-traditional family planning is essential. Accessible information should be the first step in helping people build the families they desire. Goodman is an advocate for family planning education to be prioritized at a young age. "I would love to see seminars taught in high school and colleges about this information so that people from a young age can get a sense of what will be needed if they want to become parents," they say. "There's still this sort of internalized message in the queer community that if you're queer, you can't be a parent, and that's far from the truth."

While progress is being made, the fight for equitable family planning remains marked with uncertainty. Communities like Pregnant Together and resources like Oova and Folx Health are doing their best to fight anti-LGBTQ+ legislation and make fertility more affordable to all. Plus, so many couples are leading the way, demonstrating the resilience and determination it takes to navigate this complex and often unwelcoming landscape of family planning.

The Grays admit they feel a sense of sadness over the realization that seemingly everyone around them is having children except them, but they remain hopeful and excited — hopeful for the chance to raise a family with each other, some day. "I want someone to share life's wonder and experiences with," Jess says. "I really just want to do it with my partner."

Jillian Angelini (she/her) is a sexual wellness and lifestyle journalist with words in PS, Bustle, Betches, MindBodyGreen, and more. She runs the queer advice column "The B Spot" on Betches.com and specifically enjoys writing about sex, relationships, and anything involving the queer experience.