It’s a palpable longing, the one for a house full of kids and all the trappings of parenthood. It’s powerful. Perhaps the desire is one you’ve had ever since you were a kid. Maybe the family pangs are of recent vintage, snagging you when your friends, siblings, neighbors or third cousins once removed started having broods of their own.
It was pretty easy for them. Their family building is happily anticipated, a given that’s enshrined in our culture. But it’s not the same for you. Your sexual orientation sent your dream of 2.4 kids and a dog off to the aptly named Never Never Land.
Whatever your path to coming out, it may have meant channeling your parent imperative into aunt, uncle or godparent status. Because any scenario but the usual—a straight couple and baby makes three—seemed out of reach. There didn’t appear to be a whole lot of soccer dads or Nascar moms.
Well, it’s a whole new world. Not simple, but ripe with possibilities.
More and more gay men and lesbians are having kids. Some choose the adoption route. Others are having their own genetically-linked offspring through medical intervention—from intrauterine insemination to sophisticated Assisted Reproductive Technologies. They’re using surrogates, egg and sperm donors (donor gametes). They’re forging new ways of having the children that many heterosexual couples take for granted. This fact sheet is dedicated to helping you through the thicket of issues that you’ll confront as a gay man or lesbian if you do choose to make a baby with you own gametes. It’s a primer that lays out the questions about making the first choice—between biological and adoptive family building—and some of the criteria and consequences of your reproductive possibilities. A second fact sheet is dedicated to the adoption option.
Precisely because it is new and the political and cultural climates are volatile, you need to be prepared with all the information you can harvest before you take the first baby step toward making your own baby. There’s a lot of it. For example, each state has a distinct—and rapidly changing—legal terrain. Medicine offers a variety of options. Trying to choose which of you will get pregnant and whose egg or whose sperm to use is more complicated and potentially volatile than you might think. And whichever route you choose, it’s guaranteed to come with an assortment of financial costs ranging from modest to exorbitant.
It’s a pretty tangled skein, so take out your knitting needles.
A IS FOR ... ADOPTION OR ASSISTED REPRODUCTION OR ...?
The first major decision you and your partner have to make is: Do you want your child to have a genetic or biological relationship to either or both of you? For women, the primary medical considerations involve sperm banks (or a friend to donate) and the assisted reproduction technologies that are used to treat fertility problems (artificial insemination and in vitro fertilization). For men to have a genetic relationship with their children involves working with ovum donors and, the more complex part, surrogates. (Lesbians sometimes, though rarely, work with a surrogate, when both moms-to-be shouldn’t, can’t, or don’t want to carry a child.) There are two kinds of surrogates. The gestational surrogate is a woman who offers her uterus to carry the embryo created from another woman’s egg and the prospective dad’s or dads’ sperm and delivers the resulting baby. She has no genetic relationship to the child. The traditional surrogate is a woman who carries a child conceived with her own egg. Gestational surrogates are more common precisely because they have no genetic connection to the fetus.
Kimberly Robinson and Jeanne LoCicero decided on pregnancy because “I wanted the experience of a pregnancy if that was possible,” Kimberly says. “Adoption was not a starting point for us. We started with me because I’m a bit older.” As women age their fertility decreases, especially after they hit 35. So the age of the mom whose egg will be used has to be taken into account. For both moms to have a biological connection, one partner will be the gestational carrier, the one who controls fetal environment, and the other will contribute her ovum—her genetic material.
In the future, Kimberly says, she and Jeanne haven’t ruled out adoption or a pregnancy for Jeanne. Not an uncommon scenario, says Andrea Braverman, director of psychological services at Reproductive Medicine Associates of New Jersey. She has talked to couples about whether both partners want to experience pregnancy. They’ll have to sort out where they are in their respective careers and when does it make sense for one partner to carry. “I have had some couples who want to be pregnant at the same time.”
In addition to the visceral emotions of wanting the biological tie, couples should consider “how important is it to have a child of the same ethnicity or race,” says John Weltman, who runs Circle Surrogacy in Massachusetts, an agency that helps match surrogates and egg donors with parents-to-be. “It’s easier to control with a surrogate than with adoption. How important is it to know the parents and the genetic makeup of your child?”
Kimberly, who recently gave birth to Vivian, says she and Jeanne “tried to find a sperm donor with characteristics that were like Jeanne’s and an ethnic heritage like Jeanne’s. I think that in a lot of ways, deciding on a donor was similar to the way a lot of straight couples choose. They need to find someone who looks like the person they consider the father.
“We wanted to solidify in other people’s minds that the child was born to both of us,” she says.
“I always felt I’d be a parent,” says Len Johnson. Len and his partner, Scott Tyler, worked with a gestational carrier. (These are not their real names; they’ve asked for pseudonyms to protect their privacy.) “The reason we ruled out adoption,” Len said, “was the genetic connection. That was a little more important to me than to Scott.
“In fact, when we first started doing this, we talked about all the options, adoption and surrogacy. We had female friends—one who would consider carrying, one who said she’d consider donating. Even a family member, from Scott’s side, talked about egg donation. I contacted an IVF doctor, and his office called me back to say they didn’t work with male couples. I even contacted an attorney to find out about legal recourse.”
This kind of discrimination is not uncommon, according to Dr. Vick Sahakian of Pacific Fertility Center Los Angeles, who has been working with gay men and lesbians for over a decade. “So many places refuse to treat lesbian and gay patients because of a religious or ethical bias,” he says. Some, he observes, refuse because they worry about the psychological ramifications of kids growing up with two mothers or two fathers. This, despite studies showing that adopted kids with same-sex parents do just fine. “Others refuse because doctors often fear the retribution of other patients.” Dr. Sahakian explains that infertile heterosexual couples may feel unease or outright hostility about facilitating gay and lesbian parenthood precisely because it isn’t usually about infertility and doctors worry “their infertile patients will have a strong negative response. In two or three years we’re going to laugh that we had this conversation. It’s changing so fast.”
Despite the discrimination, Braverman says she’s witnessed a “geometric growth in the number of couples pursuing this and the number of clinics willing to help same-sex couples. In the last 20 years we’ve gone from barely finding a physician to do this, and now it’s everywhere. It is true that most physicians seem to feel more comfortable with lesbian couples.”
“Regardless of how you do this,” says Stuart Miller, CEO of Growing Generations, a surrogacy and egg donor agency in California, “as a gay person, this is planned. You spend time planning because gay people don’t get pregnant in the back seat of a car.”
B IS FOR ... BECOMING PREGNANT
After the IVF center snubbed Len and Scott, “the hassle seemed more than it was worth,” says Len. Then, by sheer serendipity, he learned of an agency that brings surrogates and egg donors together with prospective parents (there are several throughout the country). From there, it seemed like “kismet,” he says. “They explained the procedures and paperwork. They facilitated everything, introducing us to lawyers and doctors.
“The surrogates are asked a ton of questions and we are too, including moral questions about abortion, if there’s something wrong with the embryo, or selective reduction [aborting one fetus when there is a multiple pregnancy, a procedure sometimes necessary to protect the health of the woman and the remaining fetus or fetuses]. Both sides have to be on the same moral page. The agency is looking at ethnicity, personality, relationship. They asked questions about our backgrounds, religious and demographic.”
“Most people feel that a surrogate should have had children already,” says Patricia Mendell, MSW, a New York therapist, “or at least a child. Many only want a surrogate who has done it before. There’s a lot of evaluation of the surrogate that has to get done, the psychological and the medical.”
“I’ve worked with gay men,” says Mendell, “where the eggs have been split, one donor and one surrogate, both partners contribute gametes. That gives you an equal chance.”
“But,” says Braverman, “what do you then say when the pediatrician wants to take a health history? Which one do you give? How do you protect the child? They need to think of it from the child’s point of view, the implications for the child as he or she gets older.”
Minneapolis-based attorney, Judith Vincent, who works with same sex couples, urges gays and lesbians working with a surrogate to get legal counsel and check out the attorney thoroughly. “Ask a lot of questions about what the attorney has done in the field. Is this someone who has had several years of experience at least or someone who has recently started taking these cases? Ask how many cases they handle. Be aware that in this area of the law, there aren’t that many cases at all. In Minnesota we’re going to see maybe 20 surrogacy cases. So if you talk to an attorney who says he or she has done seven, that’s a pretty good number.”
Check with the American Academy of Adoption Attorneys, advises Vincent. “As members of that organization we’ve found ourselves getting lots of surrogacy. In fact, a lot of members list a specialty and if they list assisted reproduction as a specialty they’ve met some standards beyond those they’ve met just to get into the Academy.”
Once you’ve got a name, consider calling the state bar associations to see if there have been complaints and proceedings against that attorney. Be advised that a lawyer could get sued and the suit could be frivolous, or that it could be settled with the proviso that no one talk about it. “I would go to surrogacy.com to see if the attorney is listed there and try to get into a chat room and ask if anyone has worked with that lawyer.”
If you’re going to work with a surrogacy agency, Vincent again suggests going through the American Academy of Adoption Attorneys. “If someone calls me with a question about an agency, I can go to that whole membership and ask if any has had experience—good or bad—with these people.” Contact the Better Business Bureau. But the truth, admits Vincent, is “It’s just really hard because with the Internet these things spring up overnight and disappear. Some have been around for years and everybody knows them; they have a reputation.”
Once again, she advises logging on to surrogacy.com, getting into a chat room, putting out the word that you need information on X or Y agency, and throwing your query into the ether ring. It is often the best source of information in these matters.
“We always represent just the parent or parents to be,” Miller says, adding that every surrogate must have her own attorney. “We can answer the surrogate’s questions, but we never represent both sides.” Agencies have lists and profiles of people willing to be surrogates or donors that are used for the matchmaking process.
Then there’s money.
And it’s the guys who are stuck with very expensive protocols, because they need an ovum donor and a surrogate. Len says, “It cost us over $100,000 just to have our baby born. We probably got away cheaply. We didn’t have any miscellaneous stuff.
“When we first met with the agency they gave us a sheet of costs. There are a lot of things on there: if she’s pregnant with multiples it’s more expensive; there’s bed rest; we’d have to cover medical expenses and lost wages. So a lot of things that could have come up didn’t.”
Women catch a break. Usually. Unless there’s a fertility problem, lesbians can use their own eggs and bodies to carry the pregnancy. According to Sahakian, it costs about $1,000 a month for insemination—approximately $350 per try for the sperm and between $600 and $700 for the doctor to do the insemination.
Dr. Michael Doyle of Connecticut Fertility Associates adds that insurance will cover a lot of the costs associated with insemination. “Sperm is the most expensive aspect.”
How successful it is all depends on the woman’s age and the condition of her eggs, according to Sahakian. “Under 30, I would say about 80% of the women get pregnant within four to six months. Between 30 and 35, it takes them a little longer. Over 35, it’s always a struggle and it might not happen.”
When a woman does face age-related or other infertility, she would move to In Vitro Fertilization. Sahakian estimates it costs between $12,000 and $15,000 per IVF cycle, with women under 40 averaging about a 35-40% success rate per try, depending on the underlying nature of the problem.
But there still might be emotional costs for women embedded in the finances, says Braverman. “If one provides eggs and the other carries, what does that do to the budget? One partner might feel, I would love you to carry the baby, but I can do insemination for a couple of hundred dollars or we could do IVF for $10,000. I think that’s a conversation couples have not infrequently. There’s a lot of disappointment there.”
While there’s no right or wrong approach, there are strong feelings about known and anonymous carriers. And if they are known, should that relationship continues after the child is born. On one side is John Weltman who feels very strongly that surrogates and donors should be known. “People too often do it anonymously, but it’s hugely important to kids ten years down the road. A lot of them ask questions, and I think it dispels a lot of mystery for kids if the donor is known.
“I think this is something that should be a lifelong commitment,” says Weltman. “It’s great for kids to know who helped their parents have a baby. It’s a wonderful thing these women are doing. Our program encourages continued involvement. Different people want different levels of involvement. Some people just send Christmas cards, other people have daily contact. I don’t think we have any couples that don’t have any contact at all.”
Kimberly and Jeanne felt just as strongly but in the opposite direction. They used an anonymous donor. “Jeanne’s a lawyer,” Kimberly says. “From a safety perspective, the legal issues are different. You have to have them sign away their rights of parentage. With a known donor, you always run the risk of the donor wanting to be more involved than you intended or conceived of.”
“Not that this would have been a problem if we’d known someone,” she says, “but I imagine it would be awkward. You don’t want someone stepping in and saying, I don’t want them raised in that religion or going to that school. We wanted to raise a family in a traditional way and in a legally safe way for our child.”
Dr. Doyle has many donors who prefer anonymity. “If the donor needs to feel safe in the arrangement, as many of them do—many of our egg donors want to be anonymous, the vast majority of our sperm donors do—it has to be understood that that’s going to be all the way through. Many people wouldn’t be egg or sperm donors if they knew their privacy would be violated.”
Len and Scott developed a warm relationship with their surrogate and her family, but the ovum donor was anonymous (though they have a lot of information to share later on, if need be). The bottom line to becoming pregnant: Make sure it’s all spelled out, and that you, your agency or clinic, and your surrogate and donor are in agreement on all details.
C IS FOR ... CONSULT A LAWYER
The legal issues may be the most consuming and confusing—and daunting—aspects of having your child. Where the child is going to be born is the overriding issue. Will Halm, a California attorney specializing in assisted reproduction and family formation law, says, “The laws you follow are determined by the state the child’s born in. Many times the laws are even determined somewhat by the county regulations, the judge, and the court. Sometimes it matters, sometimes it doesn’t. The intended parents should contact a local family law attorney in the county where the baby will be born.”
“What happens,” says Miller, “is if people don’t have the right information when they start, they could wind up with one parent not able to establish parental rights. Even if that parent is able to establish guardianship he or she has limited rights compared to parents. In the event that the biological parent—father or mother—dies, that guardianship can be contested.”
For male couples choosing surrogacy over adoption, Halm says, there are three big issues: “First, find out what the state laws are on parentage, whether or how to terminate a surrogate’s rights.” He strongly recommends having legal contracts with the surrogate and egg donor or the sperm donor.
“Second, if the surrogate is married, find out what the husband’s rights are.
“Third, gay males want to know how to ‘perfect’ the rights of the biological father and whether he can go on the birth certificate at the hospital or has to go through the judicial process.”
For the non-biological parent it’s more difficult to get on the birth certificate. “Most states are fine on surrogacy,” says Weltman, “but lots are not fine on second-parent adoption,” where the non-biological parent adopts the child after birth.
However, Judith Vincent, reports, “in my experience in the Midwest, second-parent adoption is pretty standard provided you’ve got a state that allows same-sex adoption. In the upper Midwest, I don’t know of any real problems although in Minnesota it’s judge by judge. I’ve worked with a lot of gay and lesbian couples and it’s a pretty normal process.”
Some states do require separate termination of parental rights by the surrogate, who then signs rights consenting to adoption.
Halm says, “Adoption can happen at any point in the process if state law allows gay people to adopt,” but that it’s “important to secure parentage rights formally through a judicial adoption process for both members of the couple. There have been many cases where someone has raised a child, they break up, and the other partner who did not secure parentage rights was denied visitation or parentage rights.”
The variations from state to state are so marked, says Halm, that for example in California you can get a judgment before the birth of the child declaring both members of a gay couple as parents (with both on the birth certificate); in other states, if the surrogate is married, her husband has to be listed on the birth certificate as the father. “In many states there are a lot of gray areas in surrogacy and parentage,” he says. “The same laws on adoption apply to gay individuals or gay couples as to straight ones so long as there are no laws specifically curtailing the rights of gay people to adopt.”
Kimberly and Jeanne also faced the issue of pre-birth orders versus second parent-adoption rights, and they won the right for both of them to be on a New Jersey birth certificate in May 2005. “Jeanne would have had to adopt,” says Kimberly, “if the court had not ruled in our favor. Even though we have a will it would have been more difficult for her to remain in Jeanne’s care.” They began the court case at the end of her first trimester.
Their families had been supportive throughout the process, including around the court case. “We don’t have as many family issues as other families,” Kimberly says, “where the biological families would have fought for custody. A lot of states rule for the biological families, so you have the situation where the intended parent who has loved this child has no rights to the child. So it was important that we establish a relationship between me and Jeanne [they married in Canada], and we each establish a relationship to the child we were bringing into the world. We were both involved in the process in the beginning.”
In states where this is not yet allowed, Halm, points out that you may need a “judgment declaring her the legal parent. If the sperm donor is unknown, there will be no father listed on the birth certificate. If the donor is known and you don’t want the donor to have any parentage rights, you have to go through the judicial process to terminate their rights.”
Then there’s the question of interstate recognition: What if you move? Will the state you move to legally recognize your relationship to your child? “Adoptions or parental judgments given in one state should be recognized in any state,” says Miller, “because of the ‘full faith and credit clause’ in the Constitution. However, Oklahoma passed a law last year  in which they said they wouldn’t recognize out-of-state judgments or adoptions for same-sex couples. That is being contested now in courts in Oklahoma, and because this is a constitutional issue between states it will wind up in the Supreme Court. Oklahoma is the only state with such a law on the books. It’s an important test case.”
D IS FOR ... DEALING WITH EMOTIONS
Emotional issues will likely arise at all stages for both partners, during the planning, research, and conception, during the pregnancy—and throughout the child’s life. Many of the questions gay partners should talk about are the same ones that heterosexuals discuss—are we ready, where to live, where are the good schools, what kind of community do we want. But there are added dimensions because you’re a same-sex couple.
“What couple is ever at the same stage?” says Braverman. “It can be more stress on top of the things they already have to navigate. They already feel intruded upon by having to seek medical help. Of course, same-sex couples know beforehand that they’re going to need assistance, but that doesn’t mean we’re rational and that we don’t resent being intruded upon by the medical system. It’d be so much easier if we didn’t have feelings.”
“How will one guy feel if one is a successful genetic father and the other is not?” asks Mendell. “How will one woman feel if her eggs aren’t viable and her partner’s are?”
“Who’s going to parent first?” asks Braverman.
They have to “create a strong foundation from the beginning,” says Dr. Kim Bergman, a psychologist with Growing Generations. “It’s about intentionality. Get clear that you’re comfortable with yourself and your sexuality, and then you impart that to your children.
“That is something you have to be real clear about: It’s not okay to be a gay parent in the closet. You have to deal with your own homophobia before you have kids.”
As with heterosexual couples, prospective gay parents need to “think about their relationship,” before they have a child, says Ellen Speyer, a psychologist in southern California. They need to think about “the strength of their relationship, their commitment. What about their parenting styles? Is someone very strict, someone loosey goosey? Some issues are very concrete. Who’s going to stay home? What about day care?”
But, she says, “when gay couples come to me, the number one issue is disclosure: How do they help their child with the issues of not having a daddy or a mommy in the home? They discuss if they have common ideas about it: does one want to keep it a secret about who the donor/surrogate is? Will the other spill the beans?”
Speyer firmly believes that the parents have to be in agreement on when and how they’ll disclose their child’s origins, and be prepared with as much information as they decide is necessary. “As a rule,” she says, “I typically say that the more information the child has the easier it is. That the disclosure of the child’s genetic background is important to the child’s sense of self, and it needs to be developmentally appropriate.”
But, she says, the children need to be prepared. “How will we help our child when other kids tease when they go to school? Some will be mean, as are parents; some make jokes. It’s always hard to answer in advance.
“What I usually help them do is extend their own support system. The severity or difficulty of the issues is directly related to the quality of the support system.”
“I think a lot of people hope they’re going to get support from their families,” says Corey Plank, communications director of Family Pride, a nationwide group focused on equality for lesbian, gay, bisexual and transgender (LGBT) parents and their families. “For some people, there’s a mix; some have tremendous support; for other it’s still a challenge. It does happen that parents of a gay child, who struggled with their child being gay, change once there’s a grandchild. There are varying levels of homophobia, but once there’s a child, it tends to soften. Grandparents want to be good grandparents and want to be with their grandchildren. It often helps them become more accepting of their gay/lesbian children.”
“If people aren’t going to be supportive,” says Braverman, “how are you going to handle that? You can tell them after you’re pregnant, because who needs all that [negative] chatter. They need to discuss how they’re going to share the news.”
“We’re really fortunate living in the tri-state area [New Jersey, New York, Connecticut],” says Kimberly.
“New Jersey tends to be a good place to live for gay and lesbian people in general. Even when the state is discussing a policy that affects gay and lesbian people, they’re very respectful unlike other states.
“Because Jeanne’s family is from New Jersey, it was a place for us. We have friends here in the area. Fortunately we are both out to our families and have been for years, and I’ve always been out at work as has she. For us, we’re not fighting an internal struggle. The question is: how do you want to be to strangers?”
When gay parents have children, “you’re sort of coming out over and over again,” says Bergman. “A person in a grocery store says, when a gay dad is in line getting Pampers, ‘You’re such a great parent, your wife must be so pleased.’ If you’re alone you can be quiet; if you have a five-year-old with you, you can’t be.”
Kimberly and Jeanne knew that filing the court case would make them and their family more than extraordinarily public. “It was a little frightening,” she says, “to put your picture out there, but it was important to say, ‘Here’s what a lesbian family looks like, and here are some of the issues that come up for gay and lesbian parents that aren’t on the radar.’ We had to explain to our families.”
What about religion? “Our church is outstanding,” says Kimberly. “They’ve been very supportive.”
“If you are of different religions,” says Braverman, “how are we going to raise the child? Is the religion overtly anti-homosexual? How do we deal with that? I was working with a couple with a kid in Catholic school. Everything was going okay, and everyone in the community was being very tolerant, until the kids started sleeping over each other’s houses. Then it wasn’t okay.
“Ultimately they moved to an area where there are a lot of gay people. They moved to a community where they’ll be embraced.”
GOING ON THE JOURNEY
“The thing with gay and lesbian parents,” says Plank, “in most cases, when they are having children it is not a fast process. It is a process and a journey and people really have to think about the path they want to take to parenthood.”
The American Fertility Association is here to help you along that path, so contact us at 888-917-3777 or http://www.TheAFA.org.
This fact sheet was funded by an unrestricted educational grant from Dr. Vick Sahakian, Pacific Fertility Center Los Angeles (http://www.pfcla.com), and Growing Generations (http://www.growinggenerations.com), a surrogacy and egg donation firm dedicated to serving the gay and lesbian community.