More than a medical condition: a theoretical exploration of infertility’s hidden burden

BACKGROUND: Beyond its biological aspects, infertility interacts with systemic injustices, social stigma, and psychosocial pressures. To critically examine how infertility is experienced, mediated by gendered norms, structural barriers, and identity conflicts, this study draws on theoretical perspective of infertility as a socially entrenched issue by combining various concepts. METHODS: This narrative review explores the psychological aspect of infertility with the synthesis of peer-reviewed articles. Literatures are critically analyzed using three theoretical frameworks (Stress and Coping Theory, stigma theory, and intersectionality theory) to form three themes namely, psychological distress and coping, stigma and gendered identity, and intersectional injustices. Theoretical frameworks allowed for a conceptually rich interpretation of findings, stressing how cultural norms, power dynamics, and institutional exclusion impacts infertility. RESULTS: The review reveals that infertility is commonly appraised as a threat to one's identity, relationships, and future aspirations, often leading to intense emotional turmoil. First, stress and coping theory shed light on gender differences in coping and widespread psychological suffering. Peer support and counseling were examples of adaptive methods meanwhile; avoidance and denial were the maladaptive responses. Second, the stigma theory demonstrated how infertility diminishes gendered identities, with men associating infertility with emasculation and women as "failures." Stigma was made worse by medical prejudices, such as racial preconceptions. Third, intersectionality theory brought to light structural injustices. CONCLUSION: To eliminate racist and gendered hierarchies in reproductive healthcare, future interventions must place a priority on culturally appropriate mental health assistance, policy changes (e.g., subsidized IVF), and anti-stigma campaigns.