Peppy HealthOctober 14, 20229 min read

LGBTQ+ and Fertility - How to offer inclusive support

At Peppy, we believe that everybody’s health journey matters. Every fertility journey matters regardless of your sexual orientation, gender identity, or how you choose to grow your family. However, choosing non-traditional methods of family building may lead to some issues traditional workplace support for parents may not cover. The panel featured Peppy’s Director of Fertility Services, Francesca Steyn and Michael Johnson Ellis, a gay father and the founder of Two Dads UK, set up to support LGBTQ+ families through surrogacy. Jae Sloan, of Proud Science Alliance, a collective of science and healthcare sectors dedicated to improving LGBTQ+ awareness in these areas and GSK employee, was also in attendance.

Fertility journeys in the UK

“The fertility journey is a hard one,” says Francesca. "It’s all-consuming and it affects both physical and emotional aspects.” There are multiple complications to navigate when it comes to surrogacy in the UK. Francesca warns a lot of planning is needed when considering fertility treatment. Access to fertility treatment funding continues to be rife with inequality. “It’s a postcode lottery, and mainly for heterosexual couples,” she says. “We’re seeing that same sex couples or people from the LGBTQ+ community aren’t getting access to treatment funding. NHS England funding is different all over, and every Clinical Commissioning Group has different criteria for different groups of people.” “People will have to pay generally thousands of pounds if they want to have a family. This is due to the financial ethics they have to navigate.” Parents must consider paying for donor eggs, sperm and embryos, along with finding a surrogate or considering adoption. On top of this, there’s navigating a clinic that is inclusive of participants and also has experience with LGBTQ+ clients.” There are not only financial aspects hopeful LGBTQ+ parents have to deal with, but also legal and medical obstacles, along with a reduced access to these kinds of healthcare in the first place.

Michael’s surrogacy journey

Michael Johnson Ellis has experienced the process of having children via surrogacy first hand: “For us, surrogacy was always our preferred route to parenthood. We started exploring, and it can be a minefield, which is one of the reasons why we do what we do now.” says Michael. Michael and his husband’s surrogacy journey had to be an independent one. “The non-profits that are available in the UK weren’t allowing any more intended parents to become members,” he explains, “But threw me into a world of people and networks, which is how I met Francesca. We began networking with new people to start building a web of support.” Michael wanted to use his sperm to create their first child. Reproductive medicine was the better option for them. It meant they could freeze more embryos and revisit them later if they decided to have more than one child. “We had to educate my employer about the type of leave I would be taking, which was an absolute disaster,” shares Michael. “But it also meant that I quickly became engrossed in the fertility world. I could start to support everybody else, and more importantly, understand that everybody’s journey wouldn’t be like mine.”

Lack of psychological safety

He also goes on to express the lack of psychological safety he felt in the workplace regarding his choice to begin his fertility journey. “When I announced that I wanted children and would be having time off for tests, I was asked by someone fairly senior in my organization if I was sure. They said any time that I would need to take off was a ‘lifestyle choice’ and I had to take this as annual leave. In the beginning of fertility treatments, there are so many appointments, particularly with surrogacy. You're classed as a donor, so you have to undergo a lot of tests. I was at the clinic a lot.” “I couldn’t talk about this at work, and felt really alienated,” reveals Michael. “Though I hadn’t had a child yet, but I immediately felt the pressure that women have been feeling for decades; of not feeling safe to tell my employer that I’m thinking of starting a family. I instantly felt a complete switch towards me, and what my future could look like in that organisation.”

Gender identity in the workplace

Jae Sloan, who works in increasing the inclusivity of LGBTQ+ families in the workplace shares Michael’s concerns of poor receptions of fertility treatment by employers. They call to make workplaces more inclusive in general. “Even if a company has a policy, if it still doesn’t feel safe to talk about it with your line managers or your colleagues, it's still a barrier. Organisations should not just consider pre-existing policies offered, but fundamentally, what does it feel like to show up in that workplace?”

Improving inclusivity

Jae stresses the importance of employers asking people who are open about their gender identity and sexual orientation how to help make the work environment more accepting, as has been done in GSK. “We can do more about creating visibility about these discussions, and frankly, having this kind of event within an organisation would be super helpful.” Jae is hopeful for the future of improving inclusivity and support for LGBTQ+ families in work networks. They were struck at how inclusive and open the fertility treatment policy at GSK was, but was also surprised to find that it was only due to the pioneering experience of a LGBTQ+ colleague before them. They stressed the importance of being brave enough to stand up for what is important for you in the workplace.

Psychological safety

Francesca says: “The fertility journey involves a lot of appointments, and workplaces need to be flexible. People have asked me to write doctor’s notes or sick letters because they’re scared to tell their employer the procedures they’re having done. You shouldn’t have to be doing that, but we do, because there’s no other option. That’s why we know these conversations need to be had. During the adoption process, time off should also be given for court attendings and also for any mental health issues related to fertility treatments.

Talking is key...

Jae says, “Look internally, see if there’s a strong employee resource group. When you’re doing pioneering work, it's super important to have supportive people around us. Don't be ashamed or afraid. You have to be brave to reach out and ask, and make that first step.” Francesca says, “Anyone who is going through a fertility journey should speak about their experience. The chances are, if you speak to someone, they’re going to have been in a similar situation or they know someone who might have been. By sharing, you can create your own support group. This can include people of different walks of life or in different stages of their fertility journey. Talking is key.”

Making inclusive spaces

Jae says, “My advice to trans and non-binary people in the workplace is, normalise that part of yourself. Introduce yourself and your pronouns. It's also about being open and saying, ‘I’m uncomfortable.’ This allows for authenticity and really open conversations. We’re all on this journey together and it’s essentially about intention.” Peppy believes it's so important to start and continue to normalise these conversations. We must continue the positive change that has been seen in the past few years.

Meeting the gaps in healthcare...

"As a member of the LGBTQ+ community, you may have to find your own path because you don’t fit NHS criteria,” Fran explains. “Now, there is more and more being done to make sure that gap is being met. People are being given advice about other options.” At Peppy, we look after people at all stages of their fertility journey, even those who just want to know their options. Fertility Network UK is working with other organisations for the Fertility Education Initiative to educate about starting a family. Teenagers, young people and people from the LGBTQ+ community have shown rising interest in learning about fertility.

Educating...

“Information and support is continuing to grow. People are coming forward from all sorts of backgrounds for fertility advice,” says Fran. “But there still needs to be more done to make sure people know where and what info is available. Even just text chatting with someone for five minutes can change a life.” Michael agrees that educating young people in general about fertility is deeply important. This is especially since the recent UK lockdown, which spurred many people to consider how important starting a family was to them. “As a generation, all we’ve been told is how not to get pregnant. Now, we need to know how you can get pregnant.” “There’s nearly 500 children born each year through surrogacy. More and more people are coming forward to be egg and sperm donors. We’re definitely seeing more people explore family building through reproductive medicine, not just LGBTQ+ people, but also younger generations. These workforces are coming through now, and will need workplace support, someone to talk to and an inclusive policy.”

Growing willingness to talk

There’s a growing need, and willingness, to talk about alternative parenthood in the workplace. It’s intersectional and will reach across different sectors and all kinds of work environments. Regardless of whether you are part of the LGBTQ+ community, many people are deciding to start a non-traditional fertility journey and it's becoming an increasingly important issue. However, it can be difficult to navigate completely inclusive spaces when it comes to the intersection of religion and the LGBTQ+ community. The panel stressed the importance of creating safe spaces to have these conversations in. “The best thing an organisation can do is create an environment where it's okay to show up as yourself and talk about yourself, and to partner up with a company like Peppy, who are offering support on all of these issues.” says Jae. “The Fertility Network UK did a study that showed, in a group of people undertaking a fertility journey, 90% reported feeling depressed,” explained Francesca. “The process is gruelling. It’s so important to get that conversation going and support people who are anxious and stressed about what they’re going through.” She also recommends signposting employees to the British Fertility Society website, which breaks down concepts like ovulation and IVF for people who may not know.

Final thoughts...

Jae also stressed the need for employee networks in large organisations, particularly for LGBTQ+ people, but also women and disabled employees and to create intersectional internal events where pathways for such conversations could be facilitated. “Listen to your employees,” Michael finishes. “That’s the best way to keep yourself educated about LGBTQ+ culture and remain inclusive. You’ll learn more about what we have to go through and where we’re going. Don’t be afraid to ask, and if something makes you uncomfortable, just say it. We can talk about it - that’s the best way. To just start talking and educating.” Being LGBTQ+ in the workplace and the details of fertility journeys and reproductive medicine are topics that aren’t discussed enough. There’s a requirement for more broader awareness than just the people they affect directly, because the reality is, they affect us all. Whether it's a friend, a colleague, line manager or even a director in the workplace, we can all stand to learn more about LGBTQ+ fertility. Resources:

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