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Exploring 2SLGBTQIA+ Couples' Experiences of Third-Party Reproduction.

Sonia Stanger1, Ashley A Balsom1,2, Jennifer L Gordon3

  • 1Department of Psychology, University of Regina, Regina, SK, S4S 0A2, Canada.

Archives of Sexual Behavior
|March 7, 2025
PubMed
Summary
This summary is machine-generated.

Two-spirit, lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, or otherwise gender or sexually diverse (2SLGBTQIA+) couples face significant system and provider challenges during third-party reproduction. These inequities contribute to psychological distress and reduced quality of life for these individuals.

Keywords:
2SLGBTQIA+ couplesDonor spermHealthcare experiencesMental healthSexual orientationThird party reproduction

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Area of Science:

  • Reproductive Medicine
  • Sociology of Health
  • LGBTQ+ Health

Background:

  • Third-party reproduction (TPR) is a complex process for many individuals.
  • The unique needs and experiences of gender and sexually diverse (2SLGBTQIA+) couples in TPR are not well understood.
  • Existing healthcare systems may not adequately support 2SLGBTQIA+ individuals pursuing fertility treatments.

Purpose of the Study:

  • To explore the experiences of 2SLGBTQIA+ couples undergoing third-party reproduction.
  • To identify challenges and inequities faced by 2SLGBTQIA+ individuals in the TPR process.
  • To inform recommendations for improved fertility care and support for the 2SLGBTQIA+ community.

Main Methods:

  • Online recruitment of 31 2SLGBTQIA+ couples (n=62) from the USA and Canada.
  • Semi-structured interviews to gather qualitative data on experiences.
  • Online surveys assessing fertility quality of life, anxiety, depression, and institutional betrayal.
  • Descriptive statistics and thematic analysis of collected data.

Main Results:

  • Thematic analysis revealed system-level issues (e.g., lack of information) and provider-level issues (e.g., heteronormative assumptions).
  • 34% of participants scored in the clinical range for anxiety and depression.
  • Intended gestating partners reported lower quality of life compared to non-gestating partners.

Conclusions:

  • 2SLGBTQIA+ couples experience significant psychological distress and reduced quality of life during TPR.
  • Systemic and provider-level inequities negatively impact fertility care for 2SLGBTQIA+ individuals.
  • Recommendations include staff training, inclusive practices, anti-discrimination policies, and targeted support development.