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Discussion Summary: Feb. 5, 2023

LGBTQ+ Family Formation

LGBTQ+ family formation options are expanding, from surrogacy to IVF to adoption and more, but LGBTQ+ people still face many challenges. In February, Eidos brought together experts from academia, research, and business to discuss the landscape of family wellness and the work that still needs to be done. We were honored to host Emma Schwartz, Patrina Sexton Topper, and Bianca Wilson for a conversation with our own Jessica Halem about LGBTQ+ family formation. Resources documenting their conversation are available below.

Conversation recorded February 2023.

About the Panelists:

  • Emma Schwartz, founder, Y’all
  • Patrina Sexton-Topper, PhD, BSN, MS, research consultant, University of Pennsylvania School of Nursing
  • Bianca Wilson, PhD, the Rabbi Zacky Senior Scholar of Public Policy, Williams Institute

Conversation Summary:

  • Approximately 20% of Gen Z identifies as LGBTQ+, with Gallup data showing this rate is stable
  • An estimated 2–3.7 million children in the U.S. have LGBTQ+ parents, though definitive studies are lacking.
  • Key research gaps include:
    • Lack of accessible information for prospective LGBTQ+ parents
    • Financial barriers to assisted reproductive care
    • Need for more inclusive and tailored healthcare
    • Insufficient data on intervention usage, success rates, and quality of care
  • A family expansion business was introduced to address accessibility, highlighting:
    • Wealth disparities as a barrier
    • Gen Z’s expectations for access to assisted reproduction and adoption
  • Current realities show:
    • 80% of children with LGBTQ+ parents come from previous heterosexual relationships
    • Structural challenges such as criminalization, incarceration, and poverty disproportionately affect LGBTQ+ people of color and trans individuals
  • Legal and biological complexities include:
    • Issues with surrogacy and sperm donation (e.g., custody and legal recognition)
    • State-by-state variation in same-sex custody laws, making legal recognition costly and time-consuming

Key Takeaways:

  • All people have the right:
    • To have children
    • To NOT have children
    • To parent free from threats of harm
  • The market landscape for assisted reproductive technologies is growing. The issue is the marketing and promise of inclusive care without the actual delivery of that care.
  • Lack of research around LGBTQ+ families causes challenges for policy and business growth around LGBTQ+ family formation due to lack of data to justify need.
  • As the LGBTQ+ community grows in younger generations, family formation infrastructure isn’t growing as rapidly and may not be prepared to meet the growing demand from the community.
  • Medical system support and accessibility is important for queer family formation, but we also need non-medicalized options available to queer families in the same way heterosexual families have fertility tracking and other natural methods to be more in control and holistic in the process of family formation.

Questions for Panelists:

What do we know about economic barriers to family expansion for LGBTQ+ parents? 

    • Patrina reported that many of the people she spoke to in her research struggled with costs of family expansion. However, public health mandates that we work towards the optimal health of the community. Honoring the desires of LGBTQ+ people to expand their families plays an important role in health for the individual and society.
    • Bianca pointed out part of this health is destigmatizing how children come into a family, whether they be from a previous relationship or any other method. Emma brought up that most children in LGBTQ+ families come from bisexual relationships when a partner leaves and remarries. This form of family expansion is also likely to grow in Gen Z.
    • Emma talked about increased economic barriers for LGBTQ+ parents who are Black. She’s worked with xHood, the largest Black Queer parenting group online.
    • Bianca reminded us that it’s important to remember many assisted reproductive technologies are financially out of reach for queer families struggling with poverty. Additionally, foster and adoption systems can be rooted in systemic inequalities that largely disadvantage poor, Black, brown, transgender, and immigrant queer people.

What future direction does LGBT+ family formation work need to go?

    • Patrina spoke about the challenge of obtaining funding for LGBTQ+ research despite its massive importance. She plugged the Lesbian Health Fund, an organization that helps fund this reproductive research to assist LGBTQ+ families.
    • Emma spoke about the challenges surrounding sperm, or gamete, donation. The current process and industry surrounding sperm donation is often very stigmatized and closed-off, causing unethical circumstances for children in which they don’t have access to necessary genetic or medical family information.
    • Bianca spoke about the need for large level changes on a governmental, democratic level to ensure a country where we can build the kind of communities and families we want with the support we need.

Further Reading:

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