Inequity and Inequality in Family Building

Fertility Toolkit

Fertility and Family Building Education: Inequity and Inequality in Family Building

The traditional definition of infertility excludes many individuals and couples who face barriers to care and need access to fertility treatment to build their families. According to a recent survey, approximately 3.8 million LGBTQ millennials aged 18-35 are considering expanding their families; 63% of these individuals are looking towards options like adoption, assisted reproductive technology (ART) and foster care to build their families. Fertility and family building benefits offered through traditional health plans often have restrictive designs that require an infertility diagnosis, which discriminates against LGBTQ+ individuals and parents who are single by choice, and/or require that patients use less effective fertility treatments first (often called step therapy) before they can pursue the treatment they need.

Inequality comes in many forms, but race-related disparities in fertility and maternal health, especially among Black women, have persisted for decades. Black, Indigenous and People of Color (BIPOC) continue to have higher rates of infertility. They also have a higher risk of maternal mortality. Despite these higher rates of infertility, Black women are less likely to access treatment when compared to white women and if they do, may wait twice as long before seeking help.