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Guelph Sexuality Conference: LGBTQ Family Planning 101 for Service Providers
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Guelph Sexuality Conference: LGBTQ Family Planning 101 for Service Providers

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This workshop is intended to provide an opportunity for service providers to develop and deepen their knowledge of the legal, social, and practical aspects of LGBTQ family planning, and become......

This workshop is intended to provide an opportunity for service providers to develop and deepen their knowledge of the legal, social, and practical aspects of LGBTQ family planning, and become aware of information and resources available to prospective parents. Multiple pathways to parenthood for LGBTQ prospective parents including adoption, sperm, egg, and embryo donation, co-parenting, and surrogacy will be examined. The goal of the workshop is to help service providers gain knowledge to use to assist LGBTQ clients in visioning, accessing information and resources in anticipation that our clients are now considering parenthood or may consider parenthood in the future.

Originally presented: Guelph Sexuality Conference, June 19, 2014 Guelph, ON, Canada

Andy Inkster, MA is the Health Promoter for the LGBTQ Parenting Network, Sherbourne Health Centre. In his work, Andy creates resources and develops educational and community-building opportunities for LGBTQ parents and prospective parents. He is one of the co-facilitators of Queer & Trans Family Planning(s), a family planning course developed in partnership between The 519 Church Street Community Centre and the LGBTQ Parenting Network. A queer and trans parent himself, Andy has been involved in queer and trans family planning work since 2005 as a member of the Trans Fathers 2B working group.

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  • Andy Inkster, MA is the Health Promoter for the LGBTQ Parenting Network, Sherbourne Health Centre. In his work, Andy creates resources and develops educational and community-building opportunities for LGBTQ parents and prospective parents. He is one of the co-facilitators of Queer & Trans Family Planning(s), a family planning course developed in partnership between The 519 Church Street Community Centre and the LGBTQ Parenting Network. A queer and trans parent himself, Andy has been involved in queer and trans family planning work since 2005 as a member of the Trans Fathers 2B working group.
  • This workshop is intended to provide an opportunity for service providers to develop and deepen their knowledge of the legal, social, and practical aspects of LGBTQ family planning, and become aware of information and resources available to prospective parents. Multiple pathways to parenthood for LGBTQ prospective parents including adoption, sperm, egg, and embryo donation, co-parenting, and surrogacy will be examined. The goal of the workshop is to help service providers gain knowledge to use to assist LGBTQ clients in visioning, accessing information and resources in anticipation that our clients are now considering parenthood or may consider parenthood in the future. <br /> <br /> Why are you here? Think about that for a minute, and we’ll go around the room in a few minutes to give a quick introduction and to talk about why each of you is here and what you want to get out of this workshop.
  • Other ideas?
  • I want to acknowledge that Chris Veldhoven, one of the conference co-chairs, and someone I have had the pleasure of working with for nearly 20 years originally developed these slides for the Queer & Trans Family Plannings Course, which is a joint program between Queer Parenting Programs at The 519 and the LGBTQ Parenting Network at Sherbourne Health Centre. <br /> <br /> I have since redesigned and changed the slides a bit, and adapted them a bit to this presentation, but the original concept and much of the language is his.
  • Queer & Trans Families start from a variety of places <br /> Single parents by choice *may* be more common in our community – we don’t have hard data <br /> The nuclear family is a western, modern cultural construct – for newcomer, immigrant, and non-western cultures may be a source of tension, may involve navigating a broader network of relations than two partners. <br /> <br /> It’s important to note that we don’t all start from the same place – some families may include children already, and some include partners while some do not. <br /> <br /> It’s also important to note that LGBTQ people are writing their own scripts – but due to increasing acceptance and “scripting” – conventional norms affect us as well. We may find ourselves waiting until after marriage, but we may not.
  • We will go over each pathway in some depth, but here is the rough overview. It’s important to remember that remaining child-free is an option – for those “considering” in a partnership, it’s not uncommon to have one partner who is more invested in parenting than another. <br /> Sometimes people start out along one pathway, discover it’s not working for them, and switch. People may also have stronger feelings toward one pathway than another – it’s not uncommon for someone to know that adoption is part of their future, for example, or for other people to not ever consider it because the genetic connection to their child is important to them. <br /> Finally, it’s not all about what individuals want – logistics, finances, and medical considerations are all part of the decision-making process. We have separated out have a uterus from need a uterus to pull issues of donor conception away from issues related to surrogacy. <br /> In a lot of the infertility conversations, donor gametes and surrogacy occupy some of the same decision making space, but for LGBTQ people, it makes sense to separate them a bit.
  • Adoption is at once the most understood, and most common pathway to parenthood, but also has the most myths around it.
  • There are, broadly speaking, four types of adoption: <br /> <br /> Most adoptions completed by LGBTQ people in Toronto are PUBLIC adoptions – through CAS <br /> Kinship and fostering are not necessarily part of this list in quite the same way, but generally involve the same process <br /> Private adoptions are less common, but still completed quite frequently, in fact, some adoption agencies report more demand for gay men from birth families than there are profiles available <br /> International adoption is generally not an option for most LGBTQ families – there are exceptions, such as bi-identified heterosexual couples, some trans families – but in general, most LGBTQ families cannot realistically consider international adoption.
  • The adoption process in Ontario has been harmonized, so that private and public adoption workers do the same homestudy with Ontario families. <br /> <br /> PRIDE training has nothing to do with LGBTQ pride, it stands for Parent Resources for Information Development and Education <br /> One way to speed up an adoption process is to pursue a private homestudy and private PRIDE training, and then a public adoption <br />
  • Adoptions are generally finalized six months after a permanent placement is made. This can be extended in cases where termination of parental rights has not happened. <br /> The adoption process involved a lot of dealing with institutions and bureaucracy – while the intended parent(s) may be focused on themselves, and their desire to become parents, the process of public adoption is focused on the well-being of a child. <br /> <br /> In private adoption, the process is weighted in favour of the birth mother (or birth family) quite heavily, until finalization. <br /> This fundamental mismatch can make this process challenging for hopeful parents. <br />
  • The reality of adoption is that there are many more children in need of permanent families than there are suitable permanent families. However, the match is crucial, rather than the quantity. Because racial matching is prioritized, there is a particular need for latin@ families <br /> <br />
  • I’ve pulled trans folks out here because the reality is that we just don’t know that much about how trans people fare in adoption – I have anecdotal reports from transmasculine people who have adopted in Toronto and across the US. In some cases, they have been matched with Gender Independent or trans youth and children. <br /> Questions about adoption? <br />
  • I have separated out issues of donor conception and surrogacy – while some of the infertility community and some of the literature around surrogacy mixes the two issues, in LGBTQ family planning, they are generally considered distinctly. We will first look at donor conception, when there is a uterus available “in house.” <br /> <br /> Secondly “Have a Uterus” means not just having a uterus, but being willing and able to use it. And it could mean there are two uterii in the family
  • What makes a baby? Sperm, eggs, uterus <br /> LGBTQ families who include a trans partner may have all their gametes lined up and ready to go – for example, for a lesbian family that includes a trans woman and cis woman. <br /> Many families only have one set of gametes in-house, for example two women may have only eggs <br /> The question of using sperm from a known or unknown donor can be very difficult or it can be quite simple <br /> The somewhat unique issue of “double donor” – where a queer family needs donor sperm, but due to infertility discovers they also need donor eggs – is somewhat specific to LGBTQ families. We will return to talk about donor conception in some depth.
  • Ways to introduce the sperm to the egg <br /> IUI – insemination <br /> IVF – in vitro fertilization <br />
  • Need a uterus might include a single or gay male couple (or more), a transwoman partnered to a man (cis or trans), or two trans men partnered to each other.
  • Importantly, some of these decision will be different: <br /> <br /> Gestational carrier – a person who carries an embryo/fetus they are not genetically connected to, the egg comes from either a parent or a known or anonymous egg donor <br /> <br /> Traditional carrier – a person who carries an embryo/fetus they are also genetically connected to <br /> <br /> For example, while a cis woman and her transman partner might do home insemination, if a woman is carrying her partner’s egg, they would have to do IVF. Traditional surrogacy can be done with insemination, but surrogacy with donor egg requires IVF. People make choices for other reasons, too – for example, the non-gestational partner may feel strongly that she wants inseminations to take place in a clinic setting, to further remove the donor from the equation. <br /> <br /> Other people may feel more comfortable if their partner has sex with another person in an anonymous encounter. <br /> <br /> <br />
  • We will return to some of these quandaries at the end, I just want to flag them now as points to bring up <br /> “Third Party Reproduction” is the term the fertility industry uses to talk about egg, sperm, and embryo donation, as well as surrogacy. <br /> The term really showcases the couple-centric nature of the fertility industry, which we will address in a moment.
  • Parenting in community – what does this mean? - Parenting with several parents <br /> Being involved in a child’s life as a parent
  • Co-parenting in a group, i.e. a gay couple and a lesbian couple, or two single people parenting “just as friends” <br />
  • Step-parenting and blended families are common – this is a good example of one of the ways in which you don’t always get a choice.
  • Parenting in community can mean deliberately resisting the norms of the nuclear family
  • Some LGBTQ people may be drawn to mentoring whether as a parenting activity or not
  • While not every mentoring relationship needs to be foster parenting, there is a need for foster homes that are equipped for teenagers, and LGBTQ teenagers in particular may have difficulty finding suitable foster placements. Often when a child in care comes out, the foster family’s worker has to work very hard to find a suitable placement. LGBTQ adults may consider fostering LGBTQ teens as a pathway to parenthood where they have particular expertise. <br /> However, because Fostering is tied to the Children’s Aid Society, homestudy, training, system, it makes sense in our model to keep fostering in the yellow path. But, I wanted to add this roundabout pathway to fostering, because fostering can also happen informally – for example the queer teenager who spends most of her time with her friend’s family because her own isn’t supportive. <br /> <br /> I specifically tied Fostering to Parenting in Community to capture those informal arrangements, and to co-parenting because for many foster parents, fostering is about co-parenting with the child’s worker and the agency that has formal decision making power, as well as the child’s parents to the extent they are able, if reunification is the goal for that family. <br /> <br /> Questions about parenting in community? <br />
  • What does it mean to be child free? <br /> Child Free by choice or child free by circumstance – many people may choose to be child free <br /> Many people who are Child Free may delight in spending time with other people’s kids, while still not desiring to have one or more of their own. <br /> In our final diagram, we positioned Child Free near “community” – and point out that many of these choices are still an option for people who consider themselves “child free.” <br /> <br /> I want to also point out that “Child Free” invokes the idea of volition, or choice – childfree is not the same as “Child Less” – childlessness implies a lack. <br /> <br /> Child free can be a place of choice, or it can be a place of acceptance after having moved through child lessness. Choosing to be child free is likely to be an emergent issue for LGBTQ people as parenting becomes more normalized for LGBTQ people. <br /> <br /> Questions about being Child Free?
  • Handout – decision making at each stage <br /> <br /> Basically, every box represents a decision. There are decisions to be made at each stage. <br /> <br /> Decisions are built into the PRIDE training and SAFE home study process – however, that reflection is coercive and not entirely free – most people in the process of adoption report managing their worker’s impression of them to one degree or another. <br /> <br /> In fertility and pregnancy, there are decisions as well, but a less reflective process – unlike adoption, where the legislation, regulations, interests of the worker, and the process are weighted toward the child and the birth family, in the fertility system, it’s an industry, and a commercial marketplace. <br /> <br /> Decisions are required, but not as much of a space is created for them to take place.
  • T
  • Remember – while some hormonal treatments may cause sterilization, not all do <br /> Some surgical procedures may cause sterility, but not all do <br /> For trans men, banking eggs is VERY invasive and expensive <br /> For trans women, sperm banking is much cheaper, but still expensive
  • Youth who are transitioning may not be ready to think about parenting, but if genetic connection is important to them, they may need to make decisions.
  • Some definitions of family are move valued – monogamous, partnered – coupled <br /> Challenges of using known donors <br />
  • Some definitions of family are move valued – monogamous, partnered – coupled <br /> Challenges of using known donors <br />
  • Infertility – talk about that in a minute <br /> Being LGBTQ may put people at higher risk of some complications, such as postpartum depression – a history of depression makes postpartum depression more likely. We know that bi-identified people are at particularly high risk of depression due to social pressures, and trans people also have higher rates of depression – for these families, seeking support for PPD may be more difficult than for straight, cis people <br /> Gestational carriers – PPD is in part a hormonal and chemical reaction – gestational carriers may not feel well supported and may experience a sense of loss as the attention turns from them to the baby <br /> Pregnancy loss – especially if the pregnancy is in someone else’s body, how is that experienced? How does a gestational carrier experience pregnancy loss? <br /> Prenatal diagnosis – this one is very tricky, there may be a period of mourning and loss, or a decision may be made to terminate a much-wanted pregnancy. <br /> Intended parents and gestational carriers <br /> Infant loss – is always, obviously, very hard for parents, families, and communities – LGBTQ people may experience loss or grieving differently – we don’t know. <br /> Adoption disruption – more prevalent is uncertainty and stress. Because of how parental leave is structured, many parents may experience reentry into the workplace at the same time as finalization, and the stress associated with this time can be very difficult. If the birth family is still attempting to pursue reunification, finalization can be delayed. Even in the best possible cases, this can be a time of uncertainty and the unknown, and most people feel a sense of relief once the adoption is finalized. Parents may also feel a sense of loss and grief – for the times they weren’t with their child before their child came into their lives, or sympathy for and empathy with the birth parent or family <br />
  • We may not think that LGBTQ people can have surprise pregnancies or end up with children without planning – but it happens
  • This is for a variety of complicated reasons, including: - Trans youth may not think of their sexual behaviour as putting them at risk of pregnancy <br /> Lesbian or queer women who have sex with men may be less likely to use oral contraception or Nuvaring or similar <br /> Gay/bi/queer male youth may be under pressure to prove their heterosexuality <br /> Finally, heterosexual sexual behaviour may be about proving they aren’t LGBTQ
  • Who would let someone like me become a parent? <br /> <br /> Internalized homophobia and transphobia <br /> <br /> Entitlement as a resilience strategy <br />
  • This workshop is intended to provide an opportunity for service providers to develop and deepen their knowledge of the legal, social, and practical aspects of LGBTQ family planning, and become aware of information and resources available to prospective parents. Multiple pathways to parenthood for LGBTQ prospective parents including adoption, sperm, egg, and embryo donation, co-parenting, and surrogacy will be examined. The goal of the workshop is to help service providers gain knowledge to use to assist LGBTQ clients in visioning, accessing information and resources in anticipation that our clients are now considering parenthood or may consider parenthood in the future. <br /> <br /> Why are you here? Think about that for a minute, and we’ll go around the room in a few minutes to give a quick introduction and to talk about why each of you is here and what you want to get out of this workshop.

Transcript

  • 1. LGBTQ Family Planning for Service Providers Guelph Sexuality Conference • June 19 2014 Andy Inkster, MA Health Promoter, LGBTQ Parenting Network Sherbourne Health Centre, Toronto 333 Sherbourne Street, Toronto, Ontario M5A 2S5 • (416) 324-4100 ext. 5276 • ainkster@sherbourne.on.ca 1
  • 2. Learning Objectives  Understand the various pathways to parenthood  Decision making processes, considerations at each stage  How & when to bring up future parenting plans or ideas with clients  Gain knowledge to assist LGBTQ clients in visioning, accessing information and resources  Knowledge of challenges  Why are you here? 2
  • 3. Why this matters:  Normalizing & modeling parenthood for LGBTQ people  Visioning for LGBTQ people is an important resilience strategy  Medical decisions that people who are transitioning make can impact their future fertility  In a context of societal homophobia, parenting is one of the flashpoints or triggers for homophobia 3
  • 4. Introductions Why are you here?  What sort of work do you do with LGBTQ people?  Do you think of your clients as prospective or future LGBTQ parents?  Why or why not?  What do you hope to get out of this session?  What brought you here? 4
  • 5. Adapted from slides developed by Chris Veldhoven Queer Parenting Programs Coordinator for the Queer & Trans Family Plannings course Pathways to Parenthood Options for consideration
  • 6. Where are you starting from? Single? Partnered? Poly? Extended Family? Friends? Exes? Divorce-extended family? Married? Modern family? Post-modern family? Who’s in your family?
  • 7. You/Your Current Family Child Free Adoption Fertility, pregnancy, birth Community
  • 8. You/Your Current Family Adoption
  • 9. You/Your Current Family Adoption Public Private International Kinship Fostering
  • 10. You/Your Current Family Adoption Public Private International Kinship Fostering SAFE Home Study PRIDE Training SAFE – Ontario Homestudy Structured Analysis Family Evaluation PRIDE Parent Resources for Information Development and Education
  • 11. You/Your Current Family Adoption Public Private International Kinship Fostering SAFE Home Study PRIDE Training Matching Finalization
  • 12. Adoption  Hopeful parents often feel they are competing against each other and societal norms  Lesbian, gay, bi people are often perceived as having particular strengths by workers  Advocacy skills & having experienced challenges  Come to adoption as a first choice  May be particularly suited to kids who are gender independent, trans, or LGBTQ identified  Trans people may have particular concerns about disclosure 12
  • 13. Adoption – for trans folks  Trans people may have particular concerns about disclosure  Strategically disclose to the worker during the homestudy & backround check process – if it comes up later, it will be perceived as dishonest  Trans people have adopted and do foster in Ontario  CAS workers often emphasize two years of “stability” – this may or may not influence their assessment of trans individuals 13
  • 14. You/Your Current Family Have a Uterus
  • 15. You/Your Current Family Have a Uterus Sperm/Egg/Embryo Have Them Known Donor(s) Unknown Donor(s) Co-parenting
  • 16. You/Your Current Family Have a Uterus Sperm/Egg/Embryo Have Them Known Donor(s) Unknown Donor(s) Co-parenting Having Sex Home Insemination Assisted Human Reproduction: IUI, IVF
  • 17. You/Your Current Family Have a Uterus Sperm/Egg/Embryo Have Them Known Donor(s) Unknown Donor(s) Co-parenting Having Sex Home Insemination Assisted Human Reproduction: IUI, IVF Need a Uterus
  • 18. You/Your Current Family Have a Uterus Need a Uterus Sperm/Egg/Embryo Have Them Known Donor(s) Unknown Donor(s) Co-parenting Having Sex Home Insemination Assisted Human Reproduction: IUI, IVF Co-parenting Traditional Carrier Gestational Carrier
  • 19. “3rd Party” Reproduction  Known or unknown egg, sperm, and embryo donors  Gestational carriers  Non-genetic parenting  Complications & considerations for LGBTQ people in fertility clinics 19
  • 20. You/Your Current Family
  • 21. You/Your Current Family Community
  • 22. You/Your Current Family Community Co-parenting
  • 23. You/Your Current Family Community Co-parenting Step-parenting
  • 24. You/Your Current Family Community Co-parenting Step-parenting Parenting in Community
  • 25. You/Your Current Family Community Co-parenting Step-parenting Parenting in Community Mentoring
  • 26. You/Your Current Family Community Co-parenting Step-parenting Parenting in Community Mentoring Fostering
  • 27. You/Your Current Family Child Free
  • 28. Child Free Adoption Have a Uterus Need a Uterus Community Public Private International Kinship Fostering SAFE Home Study PRIDE Training Matching Finalization Sperm/Egg/Embryo Have Them Known Donor(s) Unknown Donor(s) Co-parenting Having Sex Home Insemination Assisted Human Reproduction: IUI, IVF Co-parenting Traditional Carrier Gestational Carrier Co-parenting Step-parenting Parenting in Community Mentoring Fostering Pathways to Parenthood Developed by Chris Veldhoven, Queer Parenting Programs Coordinator, The 519 Church Street Community Centre
  • 29. Objective 1  Understand the various pathways to parenthood Questions? 29
  • 30. Objective 2  Have a sense of decision making processes, considerations at each stage 30
  • 31. Child Free Adoption Have a Uterus Need a Uterus Community Public Private International Kinship Fostering SAFE Home Study PRIDE Training Matching Finalization Sperm/Egg/Embryo Have Them Known Donor(s) Unknown Donor(s) Co-parenting Having Sex Home Insemination Assisted Human Reproduction: IUI, IVF Co-parenting Traditional Carrier Gestational Carrier Co-parenting Step-parenting Parenting in Community Mentoring Fostering Pathways to Parenthood
  • 32. Decision to become a parent  Parent? Or not?  Many people will be in this place for a long time  Timing  Mismatch between biology and social expectations for people with eggs – fertility decreases starting in mid-20s  People with sperm have more options with timing  With surrogacy, finding a gestational carrier  Pressure for “perfect” timing – may be greater for LGBTQ people than straight and cisgender peers 32
  • 33. Decisions in Adoption  Open adoption  Questions around what degree of openness  Legal questions – is openness enforceable?  Openness in adoption is generally preferred, to the extent that it is desired, and is safe and healthy for children, parents, and birth parents 33
  • 34. Decisions in Adoption  “Special Needs”  What are you prepared to handle?  Interestingly – nobody asks that about giving birth, and perhaps we should  Age of a child  How many – sibling sets 34
  • 35. Decisions in Pregnancy  Who goes first?  If there are two moms who are capable of being pregnant this decision could be easy, or it could be hard  What if it doesn’t work?  How long to keep trying?  What interventions to pursue? 35
  • 36. Decisions – Eggs? Sperm?  Does one partner wish to carry the other partner’s egg?  Costly, invasive  Inseminate with sperm from both intended fathers?  With gestational carrier surrogacy, it is possible to implant eggs fertilized by sperm from two different people  Egg freezing: typically half eggs and half embryos are frozen, and that means choosing a source of sperm now – whether a donor or partner. 36
  • 37. Decisions – Donors  Known or unknown egg and sperm donors?  Both are possible  Sperm banks provide a third option “Identity Release”  Sometimes one partner feels strongly about a known donor, while another feel strongly about having an unknown donor Why might a nongestational mother or a trans father feel strongly about having an anonymous donor? 37
  • 38. Decisions – Embryo Donation  Receiving embryos  Embryo donations are often made in a process that resembles adoption – people who have embryos choose from profiles of hopeful recipients  Embryo donation may also be possible between friends  Donating Embryos  Families may be unsure of what to do with “leftover” embryos once their families are complete  LGBT families may be more likely to explore embryo donation because of the acceptance of donors 38
  • 39. Decisions – Uterus  “Traditional” or gestational carrier?  Gestational carrier is generally more accepted in a fertility clinic, but it’s possible to do at-home traditional surrogacy  In Canada? – Unclear legalities  In the US? – Very expensive  Abroad? – Unclear visa regulations, ethical concerns  Finding a gestational carrier is the hardest part of the eggs + sperm + uterus = baby equation 39
  • 40. Objective 2  Have a sense of decision making processes, considerations at each stage  Questions? 40
  • 41. Objective 3  How & when to bring up future parenting plans or ideas with clients 41
  • 42. How & When Brainstorm What are some moments when potential parenthood could be discussed? Moments when potential parenthood should be discussed? Moments when potential parenthood must be discussed? 42
  • 43. How & When Key Moments for trans people - Pre-hormones - Pre-surgery Resource: Reproductive options for trans people Fact Sheet from Rainbow Health Ontario 43
  • 44. Trans Youth Puberty blocking drugs – prior to Tanner Stage II (early puberty) may cause permanent sterility. (Many unknowns) Youth may not be well positioned to make fertility preservation decisions  Sperm freezing is non-invasive, cost-effective, and technologically sound  Freezing eggs is invasive, costly, and technologically complex – requires choosing a source of sperm (typically anonymous donor) 44
  • 45. How & When Relationship Counselling  Joint reproductive decisions can be a source of conflict for many partners  Jealousy – What if one partner gets a genetic connection, and one does not?  Insecurity – the non-gestational partner may feel a sense of being displaced as a mother 45
  • 46. Resources Brochures, booklets, & info sheets from LGBTQ Parenting Network:  LGBT Adoption in Ontario (booklet)  Assisted Human Reproduction Guidebook  Brochures:  Parenting options for GBQ Men  Choosing a sperm donor: Known or Unknown?  Insemination procedures  Co-parenting 46
  • 47. Resources LGBTQ Parenting Network website: lgbtqpn.ca/resources  Features resources from LGBTQ PN and other organizations 47
  • 48. 48 Joint programs of Queer Parenting Programs at The 519 Church Street Community Centre and the LGBTQ Parenting Network at Sherbourne Health Centre. Dykes Planning Tykes This course emphasizes donor insemination, adoption, and co-parenting for lesbian, bi, and queer-identified women. 12 week & Weekend Intensive Daddies & Papas 2B Emphasizes adoption, surrogacy, and co-parenting for gay, bi, and queer-identified men. 12 week Queer & Trans Family Planning(s) Depends on participant interest and need. Weekend Family Planning Courses
  • 49. Objective 4  Gain knowledge to assist LGBTQ clients in visioning, accessing information and resources 49
  • 50. Objective 5  Challenges facing LGBTQ intended parents 50
  • 51. Financial Barriers Assisted human reproduction can be very expensive:  Anonymous donor sperm $900+/cycle  Surrogacy with anonymous donor egg, IVF, & gestational carrier $50,000+ Adoption has a wide range:  Adoption – private $20K+  Public adoption – free or close to it  PRIDE training $750/person 51
  • 52. Challenges in AHR Assisted human reproduction Square peg in a round hole Fertility clinics are set up for heterosexual cis people who are infertile. “Any pregnancies since I last saw you?” 52
  • 53. Challenges in Adoption  Myths around adoption  From other LGBTQ parents  From extended family and community  Internalized myths  Fitting into expected models of family 53
  • 54. When Plans go Awry  Infertility & “Still Trying”  Pregnancy loss / miscarriage  Prenatal diagnosis  Abortion  Infant loss  Adoption uncertainty, stress, and disruption  Relationship breakdown (partners, co-parents, and community)  Postpartum & Postadoption depression 54
  • 55. Long Pathways - Roadblocks Fertility & Infertility - LGBTQ people often inhabit a grey zone – neither infertile, nor fertile - Infertility is very stressful - (in)fertility support groups and resources tend to be heterocentric and cisnormative 55
  • 56. Surprise!  LGBTQ people have sex  Sexual behaviour doesn’t always match identity  Bi people  Testosterone is not a contraceptive & it only takes one  Your adopted child’s future siblings  A child in your community  Planning for one – getting multiples 56
  • 57. LGBTQ Youth & Pregnancy Involvement Pregnancy involvement rates are higher among LGBTQ youth than among straight cisgender youth 57
  • 58. Entitlement In order to advocate for themselves with medical providers, or with adoption workers, LGBTQ people must feel entitled to receive the level of care they need. 58
  • 59. Learning Objectives  Understand the various pathways to parenthood  Decision making processes, considerations at each stage  How & when to bring up future parenting plans or ideas with clients  Gain knowledge to assist LGBTQ clients in visioning, accessing information and resources  Knowledge of challenges  What did you get out of today? 59
  • 60. Further Training 60 Rachel Epstein Coordinator LGBTQ Parenting Network Sherbourne Health Centre 333 Sherbourne Street Toronto, ON M5A 2S5 (416) 324-4100 ext. 5219 repstein@sherbourne.on.ca
  • 61. Andy Inkster Health Promoter LGBTQ Parenting Network Sherbourne Health Centre 333 Sherbourne Street Toronto, ON M5A 2S5 www.LGBTQParentingNetwork.ca 61 (416) 324-4100 ext. 5276 ainkster@sherbourne.on.ca /LGBTQPN @LGBTQPN