Gay men children
For gay men, having a biological child can be complicated
Most people hoping to become parents envision having children who are genetically related to them. But for gay men, this process is complicated and expensive. Seeing it through involves collaboration with a fertility doctor, a lawyer, a gestational carrier (a.k.a. surrogate mother) and an egg donor. The process takes about two years and costs around $200,000 per child - and prospective gay fathers don't meet eligibility criteria for most health insurance plans' fertility benefits, although this is beginning to change.
Brent Monseur, MD, recently helped lead a study to document details of how gay men use assisted reproductive technology to build their families, including questions such as how many children they wish to have and how often their efforts succeed. Monseur, who is completing his postdoctoral fellowship at Stanford Medicine in reproductive endocrinology and infertility, spoke with me about the research, which appeared Aug. 4 in Fertility & Sterility Reports.
A refrain that many LGBTQ people, including myself, heard after coming out, was, "You'll never be able to have a family." Thankfully this is less common now, but for a long time this comment reflected prevailing social norms and a misconception that reproductive science wasn't advanced enough for LGBTQ people to become parents.
As a gay person growing up in a conservative environment, this was a challenge I thought about. I don't know that I want to have children, but I didn't want someone to tell me I couldn't. So I went looking into how I might build a family. As a young person, it was really hard to find that information. (This was around 20 years ago; I'm 35 now.) There was nothing at the library and very little on the internet, but I figured it probably would involve a doctor.
In graduate school at Johns Hopkins, before I went to medical school, I worked with fertility doctors.
I asked them how I could start a family as a gay man. They explained the whole process; it was super complicated. Then they said, "You wouldn't be able to be a patient here. We don't take care of gay men ... but we should." I decided, "I'm going to go to medical school and be a doctor who does provide reproductive care to all LGBTQ people."
The simplest way to put it is that LGBTQ families have shifted from being a paradox to a possibility. We went from being criminalized and pathologized to more accepted.
There has been a lot of focus in the scientific literature on whether children turn out OK if they have gay parents. There's no data to suggest anything detrimental to children about having gender- or sexual-minority parents. Not only is it now socially OK for LGBTQ people to have children but there are also people now advocating for LGBTQ families.
In my own field, the professional organization that sets practice guidelines for fertility doctors says everyone should have access to fertility care. Many institutions whose fertility clinics didn't previously treat everyone -- including Johns Hopkins, where I went to grad school -- now do so.
But there are still barriers. Some fertility clinics in this country still won't take care of LGBTQ patients, and most health insurance plans that offer fertility benefits use a clinical definition of infertility based on a heterosexual couple trying to conceive for 12 months with no pregnancy. A gay couple in New York State recently sued, saying those criteria are discriminatory.
Why is it important for the experiences of gay men seeking fertility care to be reflected in the scientific literature?Most work in reproductive medicine has focused on infertile, cisgender heterosexual women. Cisgender gay men are almost never included in this research, so as physicians we don't know anything about their characteristics as reproductive health patients, even basic information such as their demographics, clinical decision-making patterns or outcomes.
Our paper used data from one of the very few fertility benefit companies that does offer fertility coverage to gay men. That gave us a window into a national group of 119 cisgender men, including five single men and 57 gay couples, who uniquely had fertility benefits. Even though this study is still relatively small, it's the largest study of U.S. men going through this process to date. I have often started my patient consultations by saying, "There's not really any research on how to do this," but now we'll be able to say, "You are in the literature. Your decision-making and outcomes have been studied."
Based on our data, the success rates for ultimately having a child are really high for this population. At the time of the study, about 70% of the people in our study population had completed both egg donation and embryo transfer to a gestational carrier, with a live birth rate of 85%. It's important to keep in mind that our data reflect the experiences of individuals who can afford reproductive medical care because their employer-sponsored fertility benefits cover it, and that is still an unusual situation for gay men.
This data served as the foundation for a grant application we've just had approved to conduct a much larger population study that will give us access to information on about 2,000 embryo transfers annually in gay men.
What are the most important aspects of your findings?This is a group that has overwhelmingly successful birth rates, and in fertility medicine, that is unusual. A lot of people see a fertility doctor because they have an underlying medical issue, whereas gay male couples usually have two possible sperm sources, a young egg donor and a gestational carrier who has already had successful pregnancies. I think that, because of these medical factors, birth rates for gay couples could serve as a modern standard for evaluating the success of IVF labs.
The other thing, which aligns with findings in lesbian/bisexual women, is that there is a high rate of twin pregnancies. In our study, the rate of transferring more than one embryo to the gestational carrier was not in line with the standard of care, which strongly recommends transferring a single embryo; it was much higher.
We recognize that this may be because a lot of gay men request twins or may ultimately want two children, and fertility doctors may be transferring two embryos to try to save their patients money so they only have to go through the fertility treatment process once. But we need to ask: Are we putting gestational carriers at unnecessary risk from twin pregnancies, and putting gay couples at unnecessary risk of having babies in the NICU? I believe better insurance coverage for fertility care for LGBTQ people would be a safer, healthier way to address the financial pressure.
Before I was an OB/GYN, I thought, "This is a health access issue, and if gay men want twins we should respect their autonomy." But once you take care of complicated pregnancies and realize the risks, it becomes clear that your goal is not to hurry. The goal is one healthy baby at a time.
What does it add to have physician-scientists like you, who are gay, answering research questions about this population of prospective parents?There is research to show that patients do better when their physician is a member of the same race.
I suspect that same logic applies for members of the LGBTQ community. I'm currently a fellow, and I have patients coming specifically to see me, not because I'm the most amazing doctor but because I'm gay, and they want a gay doctor.
Also, it's important because I'm publishing the first study in this area -- sometimes, if you don't have the lived experience, you don't consider what people in that community do or what's important to them. The work just isn't being done otherwise.
Photo by Davide Zanin
Gay Men: How to Have a Biological Child
Becoming a Parent Through SurrogacyGay men face more challenges in becoming parents than any other group, both biological and financial. The good news is that there are ways to overcome many of these barriers.
According to a report from the UCLA School of Law’s Williams Institute, estimates that there are 28,000 same-sex male couples in the U.
S. who are raising children, biological or adopted. Here are some basics to help gay men understand how they can have a biological child through surrogacy.
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In order to have a biological child, a gay man needs a female surrogate who will carry the baby. In traditional surrogacy, the surrogate is inseminated with the man’s sperm and is the biological mother of the child. In gestational surrogacy, donor eggs from another female are fertilized with the man’s sperm in the embryology lab. The resulting embryos are then transferred to the surrogate’s uterus. This process is called in vitro fertilization, or IVF, treatment. If one or more embryos implant, she will become pregnant and will carry the baby to term. Both the egg donor and the gestational surrogate have to be prepared with fertility drugs for treatment. The gestational surrogate is not biologically related to the child she carries.
Laws about surrogacy vary greatly from state to state. Surrogacy is not allowed in some states, so you would have to go out of state to find a surrogate if you live in one of those. Some states mandate that the egg donor and the surrogate must be different women. Many fertility centers have relationships with egg donors and surrogacy agencies. WIN Specialty Services supports those who pursue surrogacy, referring prospective parents to one of several experienced and credentialed surrogacy agencies in our network.
It’s important to consult an attorney who is experienced in reproductive law to find out about this and about the legal definition of “parent” in your state. Does the surrogate have any rights in the child? Is your partner legally a parent if you are married, but he is not biologically related to the child? Do you need to have legal agreements with the surrogate and the egg donor? It’s good to sort out these issues before you pursue being a biological parent. RESOLVE, the National Infertility Association, has a number of resources on surrogacy and the legal issues involved, which are available on their website.
WIN helps intended parents navigate these legal questions by providing access to legal counsel specializing in third-party reproduction, as well as social workers and counselors for additional support.
Any man who plans to participate in insemination or IVF has to undergo FDA-mandated screening in an andrology laboratory to make sure his sperm are healthy and that he isn’t infected with any STDs. The sperm test will also help determine the quality and quantity of his sperm and whether additional procedures like intracellular sperm injection (ICSI) will be needed to fertilize the egg.
What if both of you want to contribute to your children’s genes? Some labs will allow each of you to provide sperm and will use your sperm to fertilize separate batches of eggs from the donor. That way, if twins are born, they will be biological half-siblings. In this scenario DNA testing may be necessary to determine which partner is the biological parent if a single child is born.
Or a gay couple may decide to have their first child with one partner’s sperm and use the same egg donor and the other partner’s sperm for a second child at a later time.
The costs of having a child with a surrogate include the surrogate’s fee, the cost of fertility drugs and IVF treatment for the surrogate, the donor’s compensation, fertility drugs and treatment. The cost of medical care for the surrogate through pregnancy and delivery may not be covered by your insurance, in which case you will need to purchase coverage for the surrogate. That’s another area to investigate as you make your plans. The total cost of surrogacy may range from $100,000-$200,000. Despite these expenses, growing numbers of gay men are investing to have a biological child.
Some people find surrogates in another country through medical tourism in an attempt to lower the cost. There are many dangers to this, including legal issues with surrogacy in some countries and with the quality of medical care.
India, which was a major hub for surrogacy, has banned commercial surrogacy (paying a woman to bear your child) for foreign visitors, on the grounds that the practice exploited poor, illiterate women. Thailand has also banned it for foreign visitors, and China has banned it entirely. The war in the Ukraine has put many commercial surrogates and the children they are carrying in danger. If you are considering medical tourism for surrogacy, do your homework carefully. If something looks too good to be true, it probably is.
WINFertility’s surrogacy program offers same sex couples, as well as patients who cannot conceive or carry a pregnancy, the opportunity to build their family through surrogacy. Our specialty care associates can direct intended parents to one of the several credentialed surrogacy agencies in our network.
Children of homosexual Dutch couples were more successful than their peers
Dutch children raised by homosexual couples study better than their peers raised by heterosexual couples.
This conclusion was reached by scientists from the Catholic University of Leuven, who analyzed the estimates of more than 1.2 million 12-year-old children, of which 2.9 thousand were brought up by same-sex couples. The reason for this connection, according to researchers, is the better socioeconomic conditions that homosexual parents provide for their children. Article published in journal American Sociological Review .
Citizens who oppose adoption by same-sex couples or simply do not support it exist in all countries, regardless of policies regarding sexual minorities. Therefore, same-sex families with children remain stigmatized, largely due to the belief that children growing up without a father or mother may be inferior to their peers in development or mental health (although researchers have shown many times that this is not the case).
Deni Mazrekaj from KU Leuven and colleagues decided to take a closer look at the development of children in same-sex couples and their peers from heterosexual families.
Scholars have focused on the Netherlands, which on April 1, 2001 became the first country to officially allow same-sex marriage; at the same time, homosexual couples of the country were officially allowed to adopt children. In 2017, Dutch citizens are also the most relaxed of all Europeans about adopting children in same-sex relationships: of all citizens surveyed, 86 percent partially or fully support the right of sexual minorities to adopt.
The researchers collected data on just over 1.2 million Dutch children born between 1998 and 2007, of which 0.25 percent (2,971 children) were raised by a same-sex couple. For each child, performance data was available: the researchers used the results of standardized school tests taken at 12 years of age. In the analysis, the researchers also took into account the annual income, education and age of the parents, as well as whether they are married and how many children were in the family.
It turned out that at 12 years of age, the scores of children raised by homosexual couples were 0.
139 standard deviations higher than their peers (p < 0.001). Adjusted for socioeconomic status, the difference became smaller (children from same-sex families scored higher by 0.054 standard deviations), but remained statistically significant (p < 0.01). Differences also persisted when taking into account whether the children lived with their parents from birth (although estimates for such children were higher), whether homosexual parents were married, and whether the child was adopted from another country.
In addition, the researchers also assessed the relationship between having children raised by same-sex parents and children receiving secondary education diplomas: it turned out that children from gay families were 4.8 percent more likely to receive a diploma than their peers.
Thus, Dutch children raised by same-sex couples actually learn better than their peers from heterosexual families. According to the authors, the most likely explanation is socioeconomic factors.
In order for a same-sex couple to adopt a child or use the services of a surrogate mother, a certain income is needed, and the child’s education directly depends on income. However, even after taking into account socioeconomic factors, children from same-sex families still score higher.
And homosexual couples themselves are about as happy in a relationship as heterosexual couples - at least, this was shown by the results of a survey conducted in the UK and Australia three years ago.
Elizaveta Ivtushok
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Russian LGBT children told about their painful experiences in a book
A book has been published that tells about "non-existent" people - LGBT children. The author of the book, a journalist from Nizhny Tagil, Elena Klimova, explains that the authorities do not officially recognize the existence of children who have felt their “otherness”, which means that their protection is out of the question.
In fact, the book has become a detailed study of how Russian teenagers survive with their homosexuality.
White hardcover, black ink illustration, solid table of contents and over 300 pages, nearly every page with children's stories of unbearable despair, self-hatred, beatings from parents and classmates, and the desire to commit suicide. The book by Elena Klimova, a journalist from Nizhny Tagil, tells about children who become aware of their homosexuality in kindergarten and elementary school.
The title of the book is “Children-404. LGBT Teenagers in the Walls of Silence" hints at a web browser response that says the page you're looking for doesn't exist.
Understanding the law on the promotion of homosexuality in Russia, adopted to protect children, Klimova wondered, who protects LGBT children? She tried to find studies on gay teenagers in our country, but it turned out that there was nothing of the kind. Then Elena decided to search through social networks for children who felt their “otherness”, and instead of five or six answers, she received dozens, and then hundreds of letters with stories one another heavier.
“Problems and worries turned out to be not childish. Misunderstanding of parents, bullying at school, thoughts of suicide and attempts to commit suicide, lack of information about who they are, what happens to them and how to live with it, ”the author wrote in the book. She began to publish children's stories on the Internet, thus the project "Children-404" was born, over a year of work Elena received more than 1.5 thousand letters. In especially difficult cases, psychologists provide assistance to adolescents - 15 specialists cooperate with the project. And if the parents kicked the children out of the house, then volunteers in different cities of Russia help them find a temporary home.
Actually, these letters form the basis of the book. Unique material for researchers.
Gay threat comes from children
The law on gay propaganda has started to work against minors. In the Bryansk region, a schoolgirl was put on...
03 February 14:07
The stories of teenagers reveal when they felt their difference from other children, how they accepted this discovery, to whom they decided to tell about themselves and what was the reaction.
How many children were beaten by classmates and friends, whom they tried to rape, and who was raped with a bottle, whose parents took their children to church and then imprisoned them in mental hospitals, how many teenagers ended up swallowing pills, cut their veins and stood on the windowsill, looking down.
“There are no official statistics on how many LGBT teenagers try to commit suicide, how many succeed. In March-June 2013, I interviewed 292 teenagers. And even the modest data that I received make the hair on my head move, ”says the author of the book. Of the respondents, 104 people thought about suicide because of homophobia. 50 people made a suicide attempt, of which 16 people tried to commit suicide several times.
“It seemed that my life was over, I am strange, not like everyone else. I considered myself wrong, sick, I could not understand myself. I kept hoping that it would pass, I would become normal, ”says 16-year-old Sophia from St. Petersburg. “I opened up to my family.
For all of them, I became sick and vile, because of this I had suicide attempts. I became closed off to everyone except my online friends,” says 16-year-old L. “I first felt same-sex attraction when I was 13. I couldn't take it, for a whole year I had self-denial. I stubbornly believed that I was “not like that”, I thought that this age would pass. Then I began to think that it can be cured, but in search of a means of "curing" I found out that I was born this way and always will be. Now I no longer consider myself a degenerate,” says 14-year-old N. from Chelyabinsk.
“Your orientation is very difficult to hide, no matter what anyone says. You have to constantly control yourself. But sooner or later people notice and throw a lot of dirt on you,” says 15-year-old Dasha from Orsk. “On the fifth day (of bullying by my parents), an ambulance took me and my girlfriend. Tablets. We did it because my mother called my girlfriend the day before and threatened her with prison. When I was discharged and I returned home, my mother said: “I thought everyone would be happy that you survived?” - says 18-year-old Sveta.
“Girls from a parallel class entered the English room. They beat me without even explaining anything. Then I was in the hospital with a concussion. They hit my head on the desk. I now have a crooked nose and a displaced cervical vertebra,” says 14-year-old Lyuba from Khabarovsk.
“I was severely beaten a couple of days ago. They broke three fingers on my hand, and there were cigarette burns on my body and face,” says 17-year-old Roma.
But among the letters of despair there are stories with a happy ending - about parents who accepted their children as they are, about support from friends and teachers, about moving to another city and being freed from fears. “The biggest fear was before my father. I tried my best to hide my “secret life”. However, I don't know how he knew. Once he simply called me to his place, and it turned out that it didn’t matter to him with whom and what I was doing, the main thing was that I was happy, ”says 17-year-old Dasha from Moscow. “My mother is the most beautiful woman in my life.
She accepted me, asking only one thing: “You understand that it will be hard for you? Our society is too uncouth,” writes 18-year-old Lis.
Among the statistics there are the words of psychologists, including psychological emergency departments, who explain how a teenager who finds himself in alienation feels, where children can find help and support, how parents should properly respond to a child's confessions. There are also letters from parents urging them to love their children for who they are.
14 pages are reserved for appeals of teenagers to the deputies who came up with and adopted a law banning gay propaganda.
Do not flog children for gay propaganda
In the Bryansk region, officials lifted sanctions against a schoolgirl suspected of gay propaganda. About this...
Feb 06 18:04
Klimova usually draws attention to accusations of propaganda of homosexuality, that teenagers' stories about painful experiences can hardly be called propaganda.
“It is unlikely that information about how hard and difficult it is to be gay, how these teenagers who have nowhere to turn suffer, can lead someone to the idea that being gay is good.
Many people say that they were not happy when they realized their homosexuality, they tried to get cured, went to church, met girls, watched porn, but came to the conclusion that they could not change themselves. At the same time, they suffered a lot, and I don’t see gay propaganda in this,” says Klimova. Vitaly Milonov, deputy of the Legislative Assembly of St. Petersburg, tried to bring her to justice. But at the end of February of this year, the Dzerzhinsky District Court of Nizhny Tagil confirmed that the Children-404 project was not propaganda of homosexuality. Administrative proceedings against Klimova were closed.
The book "Children-404" also officially does not exist. “There is no information about the printing house in the imprint,” Klimova draws the attention of Gazeta.
Ru.
- Initially, I planned to print it with us, the printing house agreed, but when they saw the contents of the book, they immediately refused. I didn't argue with them. Apparently, they are afraid of accusations of propaganda. As a result, I found a printing house in Moscow, which printed the circulation without any questions.
The book does not have an ISBN number, a unique code required for book distribution in retail chains. It is distributed free of charge. The book was printed with the support of Russian-speaking LGBT people in Germany, according to the last page.
“Thinking about the circulation, I imagined 100–200, maximum 500 copies,” says Klimova. She asked her friends on social networks who needed such a book, and as a result, the circulation turned out to be 1200 copies, and that was not enough for many. The electronic version of the book can be downloaded on the Internet and read, and paper versions were sent to everyone who made an order in advance.
