So how did you do it? When my partner was pregnant with our now-five-year-old, that’s a question we got alarmingly often from well-meaning (straight) friends. Sometimes, in a particularly benefit-of-the-doubt kind of mood, we’d answer truthfully: we inseminated at home with a known donor, a friend. Other times, out of righteous queer anger (did the asker ever think about the fact that no one had ever asked how they had managed to get knocked up?) we’d take a snarkier approach: Well, you know, we had a little too much to drink one night and one thing led to another… So hilarious, wasn’t it, to imagine us getting pregnant by accident?
It’s not just the biological impossibility that injected this response with irony. For queers who want to be parents, the road is stacked with decision upon decision, carefully mapped route upon route—anything but accidental. In a 2004 article in Family Relations, the family and child education scholars Jennifer M. Chabot and Barbara D. Ames interviewed lesbians transitioning to parenthood about their decision-making process, covering decisions around adoption vs. pregnancy, who would become pregnant, who to choose as a donor, where and how to access support and information, and whether to become parents at all. While all this decision-making means that LGBTQ people often enter the parenting process with a good deal of clarity and intention, it is also exhausting.
My partner and I were incredibly lucky to conceive our first child “turkey baster” style after only two tries—a remarkably quick, trauma-free, and inexpensive process. When we decided, four years later, to try for a second child, we assumed—naturally, stupidly—that we’d have it just as easy. Two and one half years later, we’re still trying. We began again with home insemination, moved on to intra-uterine insemination (IUI) at home, then IUI at a medical facility, and are now pursuing in-vitro fertilization (IVF). In moving into the realm of fertility biomedicine and assisted reproduction technologies (ART) as queer parents, we’re far from alone.
In her essay “Queering the Fertility Clinic,” the public health scholar Laura Mamo writes:
LGBT reproduction has almost fully moved from a do-it-yourself alternative practice to complex engagements with, and consumption of, a panoply of biomedical services that rely on third and fourth parties.
In the marketplace of “Fertility, Inc.,” being LGBTQ has itself become figured as a fertility “risk factor” requiring biomedical intervention. Not only does shifting from DIY conception efforts to Fertility, Inc. bring about a host of new decisions to be made (including how to pay for it all), but this shift also entails a loss particular to queer-identified people—a shift from a process that can feel quite “culturally queer,” to one that feels anything but.
In their essay “Queer Parenting and the Revelation of Twins,” the gender scholars Leslie Robertson and Kathryn Trevenen describe the “intensely communal, queer, and playful nature” of their early attempts at conception with a donor-friend. Their insemination sessions involved dinner parties, dancing, and travel to far-flung locales. While I don’t know that dancing was ever involved, the communal, playful quality rang true for us: I remember one session, about six months in, when our house was full with our queer donor, his queer friend he’d brought along, our queer midwife who was helping out with home IUI, and her teenage son—all of whom were alternately called on to entertain our young kid, who, if he wondered what all these people were doing in his house, didn’t ask. Not only did that attempt feel like a community effort—it also affirmed the expansive vision of family that mattered as much to us as the biological one we were working to establish.
When we decided it was time to move on to a more medicalized approach, our next step was to pursue IUI in a medical setting, which would allow for a higher-tech and more closely monitored insemination, as well as additional testing to try to get the root of our difficulty. It was clear, immediately, that we had left the queer commune vibes behind. Our donor would come in and make his deposit, head out to work, and an hour later my partner would lay on an exam table while kind or brusque doctors and nurse practitioners inserted our donor’s semen into her uterus. I was in the waiting room, rendered, for the moment, useless. Infertility necessarily entails a kind of narrowing down—an increased focus on the reproductive body parts and their functioning, to try to get to the root of the issue, with little regard for the broader context that informs each person or couple’s reproductive journey. While I’m sure that straight couples dealing with infertility confront a version of this, for queer people invested in a more communal vision of family-making, the contrast is all the more stark.
Sitting in the hard-backed clinic chair, waiting for my partner to text me and tell me all had gone well, I tried to tell myself there was something subversive about “infiltrating” Fertility, Inc., as queers. Yet in her essay “Failing Infertility: A Case to Queer the Rhetoric of Infertility,” the feminist scholar Maria Novotny reminds us of Judith Butler’s caveat that “failure to approximate the norm… is not the same as the subversion of the norm…there is no promise that subversion will follow from the reiteration of a constitutive norm.” One could argue that this goes for the decision to reproduce, more generally, too; it is undeniable that queer family formation replicates certain aspects of heteronormative domesticity, even while populating the conventional roles with differently gendered or bodied actors. This tension is inherent in nearly every aspect of the biomedicalized process—for example, when a couple uses one partner’s egg and the other’s uterus (known as “reciprocal IVF”), is this a middle finger or a capitulation to the biological imperative?
These tensions come into even greater relief at the IVF clinic—which is where my partner and I headed after we hit the ceiling of the interventions our regular provider offered. This also meant, in our case, a shift to paying for services out of pocket. Because of the expense (from $15,000 to $25,000 for one cycle, typically) many insurance plans don’t cover IVF, and those wishing to pursue it have been known to take such major steps as moving to a state that mandates coverage, or getting a job somewhere like Starbucks, which has comprehensive infertility coverage, in order to reduce the financial burden—or going into significant debt. The financial inaccessibility in itself positions IVF as indicative of “stratified reproduction”—implicitly placing greater value on the “reproductive futures” of those who can afford to pay for it. The fact that my partner and I had the financial resources to afford IVF (and that we are white and cisgender) not only meant that we could access services—it meant that, apart from our queerness, we could come close to occupying the role of the client whose needs the fertility clinic is structured around serving: a cisgender, heterosexual, white, financially secure couple.
Yet even queers who come “close enough” to occupying the role of the ideal IVF client must contend with a system that, despite breaking conception down to its most pragmatic elements, is replete with cisgender and heteronormative assumptions. The questions should be straightforward: where is the sperm coming from? The egg? The uterus? And who will be assuming responsibility for the projected baby-to-be? Yet byzantine chains of liability continue to produce paperwork that inaccurately labels a trans woman sperm donor as “father,” say, or asks a lesbian providing the egg for reciprocal IVF to waive her parental rights. As the sociologist Epstein puts it, the clinic is set up to reassure heterosexual couples that they are “natural parents” of the child, while for queers “parents become non-parents.” Robertson and Trevenen recall bristling when their donor’s semen had to go under a mandatory six-month quarantine—the same semen they’d comfortably inseminated with at home was now being treated as, the authors write, “an unknown and potentially threatening substance.” (As of this writing, some clinics in the U.S. and Canada are beginning to relax the quarantine for “known donor” sperm.)
And then, of course, there’s the vulnerability of queer and trans bodies during gynecological exams, egg retrieval, and embryo transfer procedures that are uncomfortable and invasive, at best. Many LGBTQ people are already used to battling cisgender and heternormative assumptions, biases, and misreadings in a medical context, and the fertility clinic is no exception. Epstein describes the ordeal of a trans man who, when undergoing an invasive test to assess the state of his fallopian tubes, was made to contend with the doctor’s banter about the TV celebrity of “this trans guy in the States who’s pregnant”—presumably his only other reference point for trans pregnancy. At this moment of intense bodily vulnerability—the doctor was attempting, painfully, to access the patient’s cervix—he focused on the patient’s “otherness” in the context of the clinic, rather than on helping him comfortably gain access to important information about his body. Ironically, this patient had also frequently been misgendered at the clinic; yet in the midst of a presumably straightforward medical procedure, his transness was what the doctor focused on.
My partner and I went to an IVF clinic in Portland, OR, that frequently serves LGBTQ clients. Although dealing with infertility continues to be a challenging and often alienating process, given our “close enough,” privileged status described above, we have not, for the most part, felt alienated at the clinic. But we have no illusions that our having gained access to the fertility clinic makes the clinic or its systems and structures any more queer. The biomedical model in which the clinic is entrenched exists “within a landscape of expanded structural inequalities marked by interlocking systems of power, privilege, and vulnerability,” as Laura Mamo and Eli Alston-Stepnitz argue in their article “Queer Intimacies and Structural Inequalities: New Directions in Stratified Reproduction.”
The contemporary reproductive landscape replicates and reinforces global power imbalances that go beyond who does or doesn’t have access to particular services. Fertility clinics also typically facilitate surrogacy and egg donation, for example, which often depend on affluent clients from wealthy countries purchasing the services of women from “low resources and high gender unequal regions.” Mamo and Stepnitz argue for an approach to reproductive equity that not only calls for expanded LGBTQ access to “an unequal system of ARTs,” but for a more nuanced and intersectional approach to how power and inequality operate in healthcare overall.
And thus, a return to the paradox alluded to above: Fertility, Inc. reinforces normativity and entrenched power imbalances—while also affording LGBTQ people the possibility of queering notions of kinship, family, and reproduction itself. At the end of the day, if my partner conceives through IVF, the baby will come home to the house that hosted that multi-generational, super queer gathering, and is sure to host more like it (minus the insemination). Our five-year-old has been growing up with a sense of family that easily includes those who do and don’t share his genetic material. He’s known that our donor “helped make him” since before he could speak. Robertson and Trevenen discovered, after giving birth to twins conceived via IVF, that parenting twins enhanced their sense of queerness: they both breastfed, for example, and they found themselves called into being a huge extended family, blending both bio and chosen members, early on. They write: “Despite the normalizing and disciplining impacts of engaging with ‘the fertility industry,’ it was the support and enthusiasm from our community that sustained many of our reproductive efforts.” For the authors, this deliberate and expansive network does not merely serve a role of as-needed support; it is integral to their evolving self-definition of what family is and can be.
For those of us who resist homonormativity and yet wish to have children, part of our desire is to queer what family and parenting can look like. In “Raising Queerlings: Parenting with a Queer Art of Failure,” Michelle Walks applies to queer parenting J. Halberstam’s notion of failure as “the unsuccessful maintenance or contribution to the neoliberal, patriarchal, heteronormative status quo.” When queer parents deliberately raise their children as culturally queer, building expansive notions of family, eschewing conventional gender roles for children and parents alike, instilling a value of criticality around norms and conventions, we do not automatically bring down the oppressive systems we both replicate and resist, yet we create something necessary and vital: possibility.