“<i>Doctors asked if we are sisters or friends</i>”: Experiences of 2S/LGBTQIA+ couples in the context of medically assisted reproduction

Although 20% of couples who seek medically assisted reproduction (MAR) identify as 2S/LGBTQIA+, MAR services are primarily based on a medical/cisgender definition of infertility, failing to account for 2S/LGBTQIA+ individuals’ experience of social infertility—that is, their inability to conceive due to their relationship status. Whereas the consequences of the MAR process on various aspects of mixed-gender/sex couples have been demonstrated (e.g., emotional, relationship, sexuality, social life), the generalization of this knowledge to the 2S/LGBTQIA+ community remains unexplored. This qualitative study aimed to explore the specific impacts of MAR on different aspects of 58 Canadian 2S/LGBTQIA+ couples’ lives. While participants were asked about the impact of their MAR journey on the various spheres of their lives, the thematic analysis revealed that what proved most central to their experience were the barriers they encountered to access sensitive and inclusive care, echoing themes from existing literature such as heteronormativity and cisnormativity, a lack of tailored services, psychological distress triggered by the MAR process, and experiences of stigma and discrimination. Other themes outside the healthcare context were also identified: financial burden, a lack of social models and support systems, the emotional toll of repeatedly coming out, and microaggressions from family members. These findings underscore the urgent need for targeted research and reforms in reproductive healthcare to better serve 2S/LGBTQIA+ couples and address the systemic barriers they face.