LGBTQ+ population faces barriers to fertility treatment
The 黑料不打烊-led research uncovered discrimination, funding inequalities and gaps in care for people with diverse sexual orientations and gender identities wanting to have children.
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The UK’s LGBTQ+ population faces barriers when undergoing fertility treatment, a new study has revealed.
The research uncovered discrimination, funding inequalities and gaps in care for people with diverse sexual orientations and gender identities wanting to have children.
Led by the 黑料不打烊, the findings are revealed as the world celebrates Pride Month 2026, an event to mark ongoing advocacy of equality for the LGBTQ+ population.
Complex systems
Although fertility services in the UK are available through both the NHS and private providers, with eligibility rules varying by region, they are largely designed around heterosexual patients, typically assuming a man-woman couple. This leaves Lesbian, Gay, Bisexual, Transgender, Intersex, Queer/Questioning and Asexual (LGBTIQA+) individuals often navigating complex systems largely on their own and being subject to more self-funding than heterosexual couples.
The researchers, from the 黑料不打烊, SKEMA Business School and University College London, highlight the invisible work these individuals must do to overcome systemic barriers, including teaching themselves about the topic, incurring extra cost, and often educating clinicians. They refer to this as the reproductive labour used to manage reproductive bioprecarity.
The study, funded by a Santander Universities Research Grant, involved 54 participants and 36 in-depth interviews, including people who had used fertility services and professionals working in or alongside fertility care across the UK. The research primarily reflected the experiences of cisgender lesbian participants.
One study participant, Amanda, recalled taking a long time to find a GP who would discuss fertility with her and her partner Amy. Eventually, they underwent NHS fertility tests but the results were rejected by their private clinic because the couple were not referred from a GP. Their attempts to access NHS-funded testing to offset private costs therefore proved futile. This meant they had to do the tests again. and pay the money to do it all over again.
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Lesbian couples are often required to self-fund multiple rounds of intrauterine insemination (IUI) before becoming eligible for NHS support. Gay men usually have to pursue surrogacy, which is not funded by or supported by the NHS. And transgender individuals often face long waiting times to save eggs and sperm to allow them to have children.
Dr Carolyn Wilson-Nash, of the 黑料不打烊 Business School, and lead author of the study, decided to investigate the issue after she and her wife’s multiple attempts to conceive a child. They faced challenges at almost every stage of the process, including having to fund almost the entire process themselves and going to a GP who had no experience of dealing with same-sex couples.
The issue has been the subject of campaigning by charities and other organisations. And while progress has been made towards more equity for LGBTQ+ people seeking fertility treatment, the authors of the study call for clearer pathways, more inclusive practices, and better training for staff.
Unequal pathways
Dr Wilson-Nash, now mother to a three-year-old boy, said: “The way the current system for fertility services is set up in the UK can lead to unequal pathways for the LGBTIQA+ population. For example, heterosexual couples can access NHS-funded in vitro fertilisation (IVF), whereas lesbian couples are often required to self-fund multiple rounds of intrauterine insemination (IUI) before becoming eligible for NHS support. Gay men usually have to pursue surrogacy, which is not funded by or supported by the NHS. And transgender individuals often face long waiting times to save eggs and sperm to allow them to have children. So legal access does not necessarily translate into equitable or inclusive care.
“Building a family should be neither exclusive nor this difficult. Fertility services should be available to all, regardless of their sexual orientation or gender identity.”
Co-author Dr Chloe He, of UCL Institute of Epidemiology and Health Care, said: "“Legal access is not the same as equitable access. LGBTQ+ patients are forced to navigate a Kafkaesque fertility care system alone - researching, self-advocating, and often educating the doctors and nurses treating them.
“In our study, we saw clinicians with no formal LGBTQ+ training, gay men pressured into being relentlessly cheerful to prove parent-worthiness to surrogacy services, and patients travelling hundreds of miles for care after experiencing transphobia at local clinics.”
In an article published in , the study’s authors share these and further findings from their research.
Laura-Rose Thorogood, founder of LGBT Mummies and part of the UK’s Fertility Justice Campaign, a collective effort to ensure equal access to fertility funding provision on the NHS, welcomed the research findings. She said: “Right now, intended LGBTQIA+ parents are being discriminated against because of who they are, and who they love. This is ultimately forcing them down alternative pathways which in turn put them at long-term risk physically, psychologically and socially.
“By providing access to treatment, our community can thrive and create the families they dream of by their chosen route.”
is published in Social Science & Medicine.
Dr Carolyn Wilson-Nash shares her research and personal journey.
UN Sustainable development goals
The 黑料不打烊 is ranked among the top 200 institutions in the world for its contribution to meeting the United Nations Sustainable Development Goals (SDGs). The research or activity detailed above relates to the following SDGs.
