Barriers for lesbian women and gay men who desire children: data from a mixed qualitative and quantitative study in Brazil
Main Article Content
Abstract
Introduction: Non-heteronormative families, despite structural similarities to traditional models, face unique challenges such as discrimination and inadequate medical care. In assisted reproduction, barriers include limited access to inclusive clinics, insufficient provider training, and lack of insurance coverage for procedures. Objective: To explore the barriers faced by lesbian women and gay men in Brazil who wish to have children through assisted reproductive technology (ART). Methods: This cross-sectional, mixed-methods study was conducted through an anonymous online survey in 2022. A total of 178 participants met the inclusion criteria. Quantitative data were analyzed descriptively, while qualitative responses were categorized into six themes: compliments, difficulties, positive experiences, societal prejudice, healthcare professional prejudice, and other personal accounts. Results: Financial difficulties were the most frequently reported barrier (36.5%), followed by societal prejudice (23.0%). Discrimination from healthcare professionals was noted by 5.6% of respondents. Despite these challenges, 15.1% shared positive ART experiences. Notably, male participants were more likely to express positive feedback than female participants (p=0.035). Conclusion: LGBT individuals in Brazil face significant barriers to ART, including financial constraints, misinformation, and discrimination. Addressing these obstacles is essential to ensuring equitable reproductive rights for this population.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY) that allows others to share and adapt the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.References
1. Instituto Brasileiro de Geografia e Estatística (IBGE). Agência de Notícias IBGE. Available from: https://agenciadenoticias.ibge.gov.br
2. National Center for Health Statistics (NCHS). Years Survey Included Sexual and Gender Minority (SGM)-related Questions 2013 – Present: Survey Description. Available from: https://www.cms.gov/about-cms/agency-information/omh/downloads/sgm-clearinghouse-nhis.pdf
3. Ard KL, Makadon HJ. Addressing the needs of LGBT patients and families. Med Clin North Am. 2012;96(6):1019-35. https://doi.org/10.1016/j.mcna.2012.08.011
4. Dow K. Looking into the Test Tube: The Birth of IVF on British Television. Med Hist. 2019;63(2):189-208. https://doi.org/10.1017/mdh.2019.6
5. Conselho Federal de Medicina (CFM). Resolução nº 2.013/13. Adota as normas éticas para a utilização das técnicas de reprodução assistida. Available from: https://portal.cfm.org.br/images/PDF/resoluocfm%202013.2013.pdf
6. Conselho Federal de Medicina (CFM). Resolução nº 2.121/2015. Adota as normas éticas para a utilização das técnicas de reprodução assistida. Available from: https://sistemas.cfm.org.br/normas/arquivos/resolucoes/BR/2015/2121_2015.pdf
7. Conselho Federal de Medicina (CFM). Resolução nº 2.320/2022. Adota normas éticas para a utilização de técnicas de reprodução assistida. Available from: https://sistemas.cfm.org.br/normas/arquivos/resolucoes/BR/2022/2320_2022.pdf
8. Defreyne J, Van Schuylenbergh J, Motmans J, Tilleman KL, T’Sjoen GGR. Parental desire and fertility preservation in assigned female at birth transgender people living in Belgium. Fertil Steril. 2020;113(1):149-57.e2. https://doi.org/10.1016/j.fertnstert.2019.09.002
9. Casare R, Chrisostomo K, Sandrin N, Chrisostomo H, Nisihara R. Do LGTB people desire to have children? A Brazilian cross-sectional survey. JBRA Assist Reprod. 2025;29(1):81-93. https://doi.org/10.5935/1518-0557.20240094
10. Wu HY, Yin O, Monseur B, Selter J, Collins LJ, Lau BD, et al. Lesbian, gay, bisexual, transgender content on reproductive endocrinology and infertility clinic websites. Fertil Steril. 2017;108(1):183-91. https://doi.org/10.1016/j.fertnstert.2017.05.011
11. Buchmueller T, Carpenter CS. Disparities in health insurance coverage, access, and outcomes for individuals in same-sex versus different-sex relationships, 2000-2007. Am J Public Health. 2010;100(3):489-95. https://doi.org/10.2105/AJPH.2009.160804
12. Raja NS, Russell CB, Moravek MB. Assisted reproductive technology: considerations for the nonheterosexual population and single parents. Fertil Steril. 2022;118(1):47-53. https://doi.org/10.1016/j.fertnstert.2022.04.012
13. Ethics Committee of the American Society for Reproductive Medicine. Disparities in access to effective treatment for infertility in the United States: An Ethics Committee opinion. Fertil Steril. 2021;116(1):54-63. https://doi.org/10.1016/j.fertnstert.2021.04.039
14. Tate DP, Patterson CJ. Desire for parenthood in context of other life aspirations among lesbian, gay, and heterosexual young adults. Front Psychol. 2019;10:2679. https://doi.org/10.3389/fpsyg.2019.02679