Counseling Issues for Gay Men and Lesbians Seeking Assisted Reproductive Technologies (ART)

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Download a PDF of this fact sheet here

How are gay men and lesbians having children? 

They are having children through heterosexual marriage, adoption, artificial insemination with donor sperm, and surrogacy and egg donation. Issues may arise medically, legally, socially and emotionally. Counseling prior to embarking on the path to parenthood, during the process, and after a family is formed is recommended.

Are parenting concerns of heterosexual couples different than those of gay or lesbian couples? 

All potential parents share concerns about their ability to be good parents, the affordability of parenting, questions about the suitability of bringing children into a world like the one in which we live, and about how a child changes a person’s/couple’s life. Couples using ART may also share concerns about the biological connection to the child; conceiving with a third party; societal attitudes towards ART; educating family, friends, and the general public; and disclosure to the child and family. In addition, there are unique issues for gay and lesbian couples.

What unique issues are present for gay and lesbian couples? 

These issues include internalized homophobia and societal homophobia. Internalized homophobia is a term used to represent the negative and distressing thoughts and feelings experienced by lesbians and gay men about their sexuality which are attributed to experiences of cultural heterosexism and victimization. Find a clinician who displays sensitivity and awareness of lesbian and gay clients’ unique issues. 

What questions need to be addressed by gay and lesbian couples?

Before conception:

The first question many same-sex couples ask is whether or not it is OK to have a child. These couples may wonder if friends and family will support their choice and whether their children will suffer from having same-sex parents instead of having a mother and father. Confronting internalized homophobia, accepting oneself completely, and addressing unexamined feelings must also be addressed by the would-be parents.

During the fertility work-up:

ART options require decisions such as whose sperm or eggs to use and who will carry the child. Furthermore, the partner whose uterus, sperm or eggs were not used may question their status as a full and equal parent.

After a successful cycle:

The couple should decide what last name to use and what their children will call them. The couple should discuss how to talk to their children about their family. Parents are encouraged to tell age-appropriate truth and avoid lying or deceit. The couple may wonder how much to tell others about the details of their children’s conception (e.g., who was the sperm donor, etc.). It is suggested that parents share with others what feels comfortable and appropriate.

© 2012 The American Society for Reproductive Medicine • ASRM grants permission to photocopy this fact sheet and distribute it to patients.  

Revised 2012  

Counseling Issues for Gay Men and Lesbians Seeking Assisted Reproductive Technologies (ART)-pdf

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