{"id":4578,"date":"2023-04-21T15:18:49","date_gmt":"2023-04-21T15:18:49","guid":{"rendered":"https:\/\/blog.geneticsupportfoundation.org\/?p=4578"},"modified":"2023-04-21T15:26:24","modified_gmt":"2023-04-21T15:26:24","slug":"series-2-nod-towards-cisgender-heterosexual-couples","status":"publish","type":"post","link":"https:\/\/blog.geneticsupportfoundation.org\/index.php\/2023\/04\/21\/series-2-nod-towards-cisgender-heterosexual-couples\/","title":{"rendered":"LGBTQIA+ Discrimination and Eugenics in the American Society for Reproductive Medicine (ASRM) Guidelines for Gamete and Embryo Donation: Series 2: Nod towards Cisgender, Heterosexual couples"},"content":{"rendered":"\n<p><em>By Devin Shuman, MS, CGC and Jenny Rietzler, MS, CGC<\/em><\/p>\n\n\n\n<p>Hopefully after reading part one of our new series, <a href=\"https:\/\/blog.geneticsupportfoundation.org\/index.php\/2023\/02\/20\/lgbtqia-discrimination-and-eugenics-in-the-american-society-for-reproductive-medicine-asrm-guidelines-for-gamete-and-embryo-donation-a-series\/\">LQBTQIA+ Discrimination and Eugenics in the American Society for Reproductive Medicine (ASRM) Guidelines for Gamete and Embryo Donation<\/a>, you\u2019ve reviewed the <a href=\"https:\/\/www.asrm.org\/globalassets\/asrm\/asrm-content\/news-and-publications\/practice-guidelines\/for-non-members\/recs_for_gamete_and_embryo_donation.pdf\">ASRM recommendations<\/a> and realized that their failure at inclusivity extends far beyond their discriminatory practices towards gay sperm donors. In part two, we focus on how ASRM imposes their own value system of \u201cprenatal optimization\u201d onto patients regarding who is \u201cqualified\u201d to contribute to this future family, centering cisgender, heterosexual, sexually intimate partners as the default unit.&nbsp;<\/p>\n\n\n\n<p>The guidelines start with noble intentions: \u201cThe availability of donor gametes [egg\/sperm] provides individuals and couples who otherwise may not be able to conceive with an opportunity to build a family.\u201d And it appears that ASRM is trying to sound inclusive towards all family structures. If you\u2019re a single parent wanting to use a donor &#8211; awesome! If you are a same sex couple wanting to use a donor &#8211; good for you! But what about reciprocal donation? In other words, female partners where one carries the pregnancy, while the egg of their partner was \u201cdonated\u201d or used for the conception. Per the guidelines, \u201cDonors are defined as individuals who are not sexually intimate partners of the recipients.\u201d That sentence appears inclusive of reciprocal donation, assuming the female partners participating in reciprocal donation are sexually intimate. However, a stipulation emerges. Later on there is clarification as to why lesbian couples are included in the donor guidelines: \u201cIn this setting, the partner does not donate her oocytes [eggs]. The oocytes should be considered shared between sexually intimate partners <strong>because sperm is shared between heterosexual couples, presumed to be sexually intimate<\/strong>.\u201d . . . Come again? So because heterosexual couples can do it, I suppose we will let it count for lesbians too? They had the opportunity to frame it around being in a committed relationship, but focused on sperm instead. *<em>Insert face palm emoji<\/em>*<\/p>\n\n\n\n<p>Further, when discussing embryo donation and exceptions to sperm\/egg donor requirements, ASRM consistently frames the default\/norm to be \u201csexually intimate couples\u201d, as already mentioned above. So if you\u2019re an asexual couple or want to create a family with a platonic partner &#8211; you don\u2019t have a place in these guidelines? On this same thread, ASRM has a second relevant position statement on <a href=\"https:\/\/www.asrm.org\/globalassets\/asrm\/asrm-content\/news-and-publications\/ethics-committee-opinions\/access_to_fertility_treatment_by_gays_lesbians_and_unmarried_persons-pdfmembers.pdf\">access to fertility treatment &#8220;irrespective of material status&#8221;<\/a> which starts on shaky ground with the statement that \u201cmost diverse sexuality and gender (DSG) individuals and couples cannot biologically reproduce on their own.\u201d This is a pretty big leap to assume the vast majority of couples with gender-queer, non-binary, or trans individuals will require assistance with reproduction. This just furthers the narrative of othering the LGBTQ+ community as \u201cdeviations from the norm\u201d.<\/p>\n\n\n\n<p>While this position statement at least states the obvious that \u201cinfertility clinics should treat persons equally, regardless of sexual orientation or gender identity, the fact that ASRM even frames this as an \u201cethical debate\u201d is absurd; framing&nbsp; \u201cwelfare concerns\u201d and \u201creligious beliefs\u201d as excuses for discrimination should never be validated. In our research, we\u2019ve also learned fertility insurance guidelines have not caught up. Many insurance policies require a medical diagnosis of infertility that is defined in heterosexual terms, or proof that the individual\/couple is unable to conceive children through intercourse. Forcing a couple to have unprotected sex for 6-12 months to \u201cprove infertility\u201d when they don\u2019t even have the organs necessary to create a pregnancy together is an unnecessary barrier to the point of being discriminatory. Cathy Sakimura, director of family law at the <a href=\"https:\/\/www.nclrights.org\/\">National Center for Lesbian Rights<\/a>, was quoted in a <a href=\"https:\/\/www.washingtonpost.com\/business\/2022\/04\/13\/gay-couple-ivf-benefits-discrimination-complaint\/\"><em>Washington Post<\/em> article<\/a> from April of 2022: \u201cLGBTQ people are not being thought of, and you could say were actively excluded, in the creation of fertility insurance generally and the statutes that address fertility insurance.\u201d<\/p>\n\n\n\n<p>OK, back to the original ASRM guidelines. When discussing donor psychoeducational counseling the recommendations state that \u201cpartners should be included in the clinical interview\u201d. This once again assumes being in a relationship is the default. It also flashes us back to the 1950s housewife needing their husband\u2019s permission for a medical procedure or a bank account. This theme also came up in their <a href=\"https:\/\/www.asrm.org\/globalassets\/asrm\/asrm-content\/news-and-publications\/ethics-committee-opinions\/access_to_fertility_treatment_by_gays_lesbians_and_unmarried_persons-pdfmembers.pdf\">other position statement<\/a> under a blurb titled, \u201cInterests of Nondisclosed Spouses\u201d, where providers may refuse to provide fertility treatment unless they have adequate assurance that a spouse has been informed of the treatment and does not object to it. Not to mention their statement that clinics can deny services to individuals or couples based on \u201cserious and substantiated doubts about whether they will be fit or responsible child-rearers\u201d, which leaves the door wide open for personal biases and discriminatory assessments by providers to stack the odds against LGBTQIA+ patients.&nbsp;<\/p>\n\n\n\n<p>ASRM states that their goal is to provide the opportunity for the creation of families, but the underpinning of the language used squeezes people interested in reproducing with assisted reproductive technologies (ART) into a narrowly defined box and adds additional barriers for those that might need to rely on ART to build a family. We can and we should be doing better. Healthcare providers should not have the right to decide who is allowed to create a family or have children.<\/p>\n\n\n\n<p>Genetic Support Foundation stands with other medical providers and organizations in the fight for inclusive healthcare. If you\u2019d like to talk with a genetic counselor about your family planning goals and options for preconception screening, contact us today to meet with one of our reproductive genetic counselors via telehealth.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Devin Shuman, MS, CGC and Jenny Rietzler, MS, CGC Hopefully after reading part one of our new series, LQBTQIA+ Discrimination and Eugenics in the American Society for Reproductive Medicine (ASRM) Guidelines for Gamete and Embryo Donation, you&rsquo;ve reviewed the ASRM recommendations and realized that their failure at inclusivity extends far beyond their discriminatory practices &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/blog.geneticsupportfoundation.org\/index.php\/2023\/04\/21\/series-2-nod-towards-cisgender-heterosexual-couples\/\"> <span class=\"screen-reader-text\">LGBTQIA+ Discrimination and Eugenics in the American Society for Reproductive Medicine (ASRM) Guidelines for Gamete and Embryo Donation: Series 2: Nod towards Cisgender, Heterosexual couples<\/span> Read More \u00bb<\/a><\/p>\n","protected":false},"author":1,"featured_media":4579,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"site-sidebar-layout":"default","site-content-layout":"default","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"categories":[63,18],"tags":[],"class_list":["post-4578","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-advocacy","category-genetic-testing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.13 - 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