Understanding Social Infertility: An Evolving Term in Reproductive Health

Engaging in allyship with the LGBTQIA+ community entails, among other things, educating ourselves about the unique challenges they face. One significant issue is the often complicated journey to parenthood for those who choose that path. Social infertility is a new and evolving term describing this process.

In recent years, infertility has gained awareness, resulting in reduced stigma and greater access to support for those experiencing it. For instance, nineteen states now require insurance companies to cover some fertility treatments for individuals facing infertility. Traditionally, medical definitions of infertility require heterosexual sex and are defined in physiological terms. This means people can’t get an infertility diagnosis unless there’s something “wrong” with their reproductive system. Consequently, a significant group of people struggling to become parents are excluded from insurance coverage and other meaningful support, often being left out of conversations about infertility.

Due to this inequity, bioethicists, medical providers, and activists have advocated for a broader definition of infertility that doesn’t exclude patients based on sexual orientation or relational circumstances. Social infertility is a newer term used to describe situations where people want to become parents but are not biologically able due to social or relational circumstances. This includes factors like sexual orientation, relationship status, and life circumstances, which might necessitate fertility treatments. In support of this movement, in the fall of 2023, the American Society for Reproductive Medicine (ASRM) updated their definition of infertility to include “anyone needing medical interventions to achieve a successful pregnancy either as an individual or with a partner” (ASRM 2023). Additionally, in 2022, Illinois updated its legal language around infertility to be more inclusive of the LGBTQIA community and single people, recognizing one of the definitions of infertility as “a person’s inability to reproduce either as a single individual or with a partner without medical intervention” (Illinois General Assembly 2022). This change mandates many (though not all) insurance plans within Illinois to cover fertility treatments for people experiencing social infertility.

While these changes have expanded access to reproductive care for many communities, particularly the LGBTQIA community, some bioethicists have voiced concerns about the implications of medicalizing or pathologizing LGBTQIA relationships. This is an ongoing and evolving topic, and we at Wildflower are committed to continuing to learn, grow, and provide education on this issue. See the resources below if you are interested in learning more!

At Wildflower, we offer a comprehensive range of infertility supports tailored to meet the unique needs of individuals and couples. Our services include individual and couples counseling, designed to help you navigate the emotional challenges of infertility. We also provide support groups where you can connect with others who share similar experiences, fostering a sense of community and understanding. Additionally, we offer consultations with experts in reproductive mental health to guide you through the complexities of fertility treatments and provide personalized support. Our team is dedicated to offering compassionate care and evidence-based interventions to support you on your journey to parenthood.

Sources

Howard, Jacqueline.  Infertility gets a new, expanded definition to address ‘the reality of all’ seeking care, medical group says.  CNN. (2023, October 23). https://www.cnn.com/2023/10/23/health/reproductive-medicine-group-updates-its-definition-of-infertility-to-address-the-reality-of-all-seeking-care/index.html.  

ASRM publishes a new, more inclusive definition of “Infertility.”  ASRM. (2023, October 15).  https://asrmcongress.org/asrm-publishes-a-new-more-inclusive-definition-of-infertility/?c

Campo-Engelstein, Lisa and Lo, Weei.  Expanding the Clinical Definition of Infertility to Include Socially Infertile Individuals and Couples. Reproductive Ethics II.  (2018, August 21).  https://link.springer.com/chapter/10.1007/978-3-319-89429-4_6

Illinois General Assembly Public Act 102-0170. Illinois General Assembly – Full Text of Public Act 102-0170. (1 January 2022). https://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=102-0170

Insurance Coverage by State: Resolve: The National Infertility Association. RESOLVE. (2024, January 18). https://resolve.org/learn/financial-resources-for-family-building/insurance-coverage/insurance-coverage-by-state/

Roldan, E. (2022, February 15). Guide to Navigating Infertility Treatment Coverage in Illinois – 2022. Howard Brown Health. https://howardbrown.org/navigating-infertility-treatment-coverage-illinois-2022/

Sussman, A. L. (2019, June 18). The case for redefining infertility. The New Yorker. Retrieved from https://www.newyorker.com/culture/annals-of-inquiry/the-case-for-social-infertility.

What the definition of infertility means for LGBTQ+ people. FOLX HEALTH. (n.d.). https://www.folxhealth.com/library/what-the-definition-of-infertility-means-for-lgbtq-people