Modern State of LGBTQ+ Fertility 2019
Fertility and family planning are complicated for just about everyone, but they can be disproportionately challenging for the LGBTQ+ community. Misinformation, combined with a lack of inclusive practices and affirming providers in traditional healthcare, can lead to stress and unwarranted stigma.
Welcome to the first-ever Modern State of LGBTQ+ Fertility. We teamed up with the LGBTQ+ dating and social app HER and prominent gender researcher Mere Abrams (LCSW) to survey people who identify as LGBTQ+. We asked what the respondents think and feel about fertility, and where they turn for information and support.
We believe that LGBTQ+ health is key to a healthy society. Everyone deserves access to reproductive health information and resources—no matter their background or identity.
The rise of LGBTQ+ families
More people than ever are identifying with LGBTQ+
63% of LBGTQ+ millennials (ages 18-35) are considering expanding their families, mostly using assisted reproductive technologies, foster care, or adoption
Source: FamilyEquality.org, 2019
78% of respondents felt that identifying as LGBTQ+ affected how people interact with them
Source: Modern State of LGBTQ+ Fertility
The fertility information gap
Let’s dig into the misinformation circulating around LGBTQ+ fertility.
Of the survey respondents:
89% were not aware that age is a better indicator of fertility than overall health for people with ovaries over age 35.
44% were not aware that fertility declines for people with testes who are over age 45.
80% were not aware that hormone blood tests can be used to estimate egg count for a person with ovaries.
46% were not aware that up to a year after initiating testosterone therapy, transgender men with ovaries may still have viable eggs.
54% were not aware that the average cost of one cycle of egg freezing is more than $5,000 USD.
The information gap is significant, but it’s not for lack of curiosity or appetite to learn.
wish they knew more about LGBTQ+ affirming reproductive healthcare
wish they knew more about reproductive technologies
wish they knew more about family planning options
“There’s no standard roadmap for queer people who want to have children, so we often need to write our own scripts and pave our own way.”
Jordan, Modern Fertility community member
The challenges with traditional healthcare
46% of all respondents do not feel comfortable talking to a healthcare provider about their fertility.
We looked at differences in comfort between heterosexual cisgender women, lesbian cisgender women, and transgender, non-binary, and gender non-conforming people.
When asked about comfort talking to healthcare providers about fertility:
of heterosexual cisgender women said that they do not feel comfortable
Source: Modern State of Fertility, 2019
of cisgender lesbians said that they do not feel comfortable
of non-binary, transgender, and gender non-conforming people said that they do not feel comfortable
When LGBTQ+ respondents were asked about their top information sources for fertility and family planning information:
A Center for American Progress study found that 29% of transgender people said a doctor or other healthcare provider refused to see them because of their actual or perceived gender identity. It’s clear that providers need to commit to supporting this community by delivering evidence-based, relevant information and a supportive environment that embraces all identities.
“I don't want to be in a situation where I'm having to educate my doctor rather than the other way around.”
Survey participant, Modern State of LGBTQ+ Fertility 2019
Enthusiasm towards home tests
While there are levels of discomfort with traditional healthcare providers, respondents were open to new ways to discover information about their bodies.
81% say a home fertility test would be useful
50% said they would feel more comfortable using a home fertility test than a test at a doctor's office
Turning to social media for fertility education
In the absence of trusted clinical resources, LGBTQ+ respondents are turning elsewhere, largely to online, non-traditional sources.
4 out of the 5 top current sources of information for fertility and family planning were free online resources:
Health-focused websites Social media LGBTQ+ focused Other Internet sources
General healthcare provider
33% of LGBTQ+ respondents listed social media as one of the top sources they currently turn to for fertility and family planning info.
This number goes up to 44% for LGBTQ+ Gen Z respondents who listed social media as a top current source of information.
Yet only 4% of LGTBQ+ respondents listed social media as a preferred source for information.
For reference: 11% of heterosexual cisgender women listed social media as a current source of healthcare information.
Source: Modern State of Fertility, 2019
The top 2 preferred sources for information about fertility and family planning? General healthcare providers and specialist healthcare providers.
Interestingly, we saw a statistically significant difference in comfort depending on where people get their information. Those who use social media for fertility information typically feel less comfortable discussing fertility with a healthcare provider.
“Fertility journeys can be hard and micro-aggressions or negligence can feel even more palpable during this process, so make sure the provider and clinic is one where all involved feel respected and supported.”
Elle, Modern Fertility community
Fertility triggers anxiety and fear — but there is hope
When asked how fertility and family planning makes them feel, here’s how those surveyed responded:
Looking for more resources? We’ve got you
Mental Health & Counseling:
National Center for Transgender Equality
Reproductive Health Information:
Affirming LGBTQ+ Centers and Clinics:
LA LGBT Center, Los Angeles
SF LGBT Center, San Francisco
Fenway Health, San Francisco
Mazzoni Center, Philadelphia
Callen-Lorde, New York
Queer Med, Telemedicine, pop-up locations in Florence (AL), Chattanooga (TN), Montgomery (AL)
UCSF Transgender Center of Excellence
This research was conducted by Modern Fertility’s research team as a cross-sectional survey to discover what people who identify as LGBTQ+ currently understand about fertility and family planning. A cross-sectional survey means that we gathered the data at a single point in time and did not attempt to change or alter their beliefs in any way when gathering the data.
The data were collected from June-July 2019. A total of 207 people in the LBGTQ+ community completed the survey. The participants were recruited through the online social and dating service HER, as well as through other online communities.
So, what can — and can’t — this type of study tell us? A cross-sectional survey is a great way to learn about the number of people who hold certain beliefs and uncover the correlational relationships and subgroup differences between those beliefs. This type of study can’t tell us anything about causation.
Importantly, we wanted to make sure we conducted this study in the most accurate and scientifically sound way possible. Modern Fertility’s research team, comprised of PhD researchers and fertility and reproductive medical specialists, is committed to using the highest standards in academic research. We used reliable and validated measures and appropriate statistical analyses. The study was also approved by an Institutional Review Board (IRB), which ensures that we met the appropriate ethical standards in human research.
Less than high school
High school graduate
2 year degree
4 year degree
Attended and/or completed graduate school
American Indian or Alaskan
Black or African American
Native Hawaiian or Other Pacific Islander
Hispanic or Latino
Prefer not to say
Note: could select more than one
Single (never married)
In a relationship
In a long distance relationship
Minimum: 18, Maximum: 59, M = 26.9, SD = 6.64
Cisgender lesbian - 83
Transgender - 36
Non-binary - 58
Gender non-conforming - 22
Questioning / prefer not to say - 4