Fertility – the Extra Challenges Faced by the LGBTQ+ Community

September 11, 2021

Forward thinking companies looking to attract and keep their talent are offering fertility support as part of their benefits package.

Magic Circle law firm Clifford Chance recently became the first UK law firm to include fertility investigations and treatment in employees’ private medical insurance. This was following the popularity of fertility support on the Peppy app.

In the case of LGBTQ+ staff, it pays for employers to understand the extra challenges they are up against when starting or increasing their family. Especially, as this is becoming more common. In the past five years, the number of same-sex families has grown by over 50%. LGBTQ+ staff have a much higher chance of needing support when starting or growing a family.

Francesca says…

Francesca Steyn, Peppy’s Director of Fertility Services and Chair of the Royal College of Nursing Fertility Nurses’ Forum says: “As conception often involves fertility treatments which may include donor sperm, donor eggs or surrogacy, it can be a long and complex journey in terms of mental and physical challenges. It’s also tricky to find the right information”.

Sixty-three percent of LGBTQ+ Millennials aged 18-35 are considering expanding their families by becoming parents for the first time, or by having more children. Yet support is not always readily available.

According to a study by Reproductive Biomedicine and Society 2018, out of 547 fertility websites reviewed, 62% did not directly advertise to or welcome gay men as patients. Ignorance and prejudice can overshadow everything. From being a single parent, to being an unmarried couple with children, to being “allowed” to adopt or start a family. Attitudes may be changing but they still have a long way to go.

Says Francesca: “The IVF process is hard enough, but people from the LGBTQ+ community really have a lot of other things often thrown into the mix. For one thing, they may not have yet come out to their employers. But if they’re talking about having a family through surrogacy or adoption it may potentially ‘out’ them to the rest of the organisation”.

Finding employers who will support their family plans has become a priority for your potential staff. 72% of LGBTQ+ people and allies say that they’re more likely to accept a job at a company that’s supportive of LGBTQ+ employees.

So, it really pays to be aware of the challenges they face, as well as offering relevant support.

What the IVF process entails

“If you’re a gay man you may choose  the surrogacy route to parenthood. This can be a very long and expensive process. And then there are the legalities around the whole process of surrogacy to think about.” says Fran.

“Appointments don’t just stop at the fertility clinic. Surrogates will also require ante-natal care and Intended parents will want to be at those appointments to support their surrogate and be involved in the care of their child.

Same sex female couples will use a sperm donor to help them on their path to parenthood. There are a lot of decisions that need to take place, including where they will source their donor sperm. They then may have to navigate the fertility treatment journey at a clinic.”

There’s a great deal of stress and worry involved in trying to conceive. 85% of people feel fertility treatment has had a negative impact on their work and 19% have needed to reduce hours or leave the workplace altogether.

The legal aspect

After finding a surrogate, which could take up to 2 years in the UK, then its recommended that Intended parents and surrogates seek legal advice as part of the arrangement. Currently you can only apply to the courts to be the legal parent of your child after they are born.

Says Fran “Your surrogate carries your child but you’re not legally the parents straightaway in the UK. You have to apply for a parental order and wait for this to be granted by the court in order to become the legal parents of your child born through surrogacy.”. This potentially can create a lot more stress and may mean there may be absences or time off from the workplace.

The financial aspect

There are huge inequalities over NHS funding as most of the LGBT+ community will not qualify for NHS funding for fertility investigations or treatment. Standard IVF treatment costs between £6,000 and £10,000 per cycle (HEFA). Says Francesca ““People often need to pay thousands of pounds if they want to consider having a family. The cost of fertility treatment for the LGBTQ+ community is often much higher as they will need to factor in costs such as donor sperm, eggs or surrogacy and additional testing for certain types of treatment .”

Says Fran “They may have grown up with discrimination. To then find there’s no equality in the NHS when it comes to fertility treatment can be crushing”.

Some companies are extending financial help to their LGBTQ+ workforce. For example, JP Morgan has expanded company benefits to help LBGTQ+ employees pay for fertility treatments and surrogacy services. Samsara offers financial support to LBGTQ+ employees going through commercial surrogacy – but as this form of surrogacy is banned in the UK, this is of no help to UK employees.

Going through adoption

Same-sex couples and single LGBTQ+ adopters have had the legal right to adopt since 2005. Plus, the number of children adopted by same-sex parents is growing every year. 1 in 6 adoptions in England in 2020 were to same-sex couples, and adoption agencies and local authorities have a legal duty not to discriminate on the basis of sexual orientation or gender identity.

However, as with any adoption, the process can be longwinded. It involves time off work to attend adoption appointments and to deal with the legal issues. Additionally, leave must be taken when the adoption takes place. Statutory Adoption Leave is the same as maternity leave – 52 weeks.

It’s important to offer equal benefits to all employees, regardless of their sexual orientation, including adoption leave.

Not being ‘out’ at work

For staff members who have kept their sexuality to themselves, becoming parents can present extra challenges. Says Francesca: “If you’re not ‘out’ it adds a whole other layer of anxiety around fertility treatments. You may not want colleagues to know you’re trying for a family. There’s the risk of being judged for it as well as for your sexuality. Sadly, we see people getting vilified for this all the time”.

Alongside the need for an inclusive and flexible fertility policy is the need for confidentiality due to potential judgement from others.


Having to access so many different services means that flexibility is an absolute must for your LGBTQ+ staff. Offering company support can really make a difference. In fact, 96% of employees said they would feel more positive about their employer if they were offered specialist fertility support, following a pilot of Peppy Fertility support (2020). Says Francesca: “Peppy provides an opportunity to support people on a fertility journey. We will guide them on their path to parenthood with correct and evidence-based information.”.

Peppy Tips

  • The journey to parenthood is more complicated for your LGBTQ+ staff, so make sure they know that support is available.
  • Confidentiality is a must, to avoid the chance of discrimination and judgement.
  • Point your LGBTQ+ staff in the direction of specialist services where they can get relevant support.






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