#4 The Money Problem
Why isn't fertility treatment universally available on the NHS?
In the darkest depths of online fertility forums (namely Mumsnet), there is a never-ending debate about whether having a baby is a right or a privilege. This war of words feeds into a discussion about whether lesbian couples should be entitled to fertility treatment on the NHS.
The major argument against allowing us to access medical care is that most of us aren’t infertile, so we shouldn’t be entitled to help in the same way a straight person with a physical problem with their reproductive system would be.
When we first signed up with the London Women’s Clinic, we were sent reams of paperwork to sign and send off into the ether. In one of the forms, we had to select our ‘reason for infertility’. The box that we had to tick said ‘no male partner’; something I don’t consider an ailment deeming me infertile.
My gayness isn’t something I can switch off for a bit in order to conceive. Does my inability to sleep with a man in order to conceive make me infertile? No; but it does impact my ability to access treatment on the NHS.
In 2013, NICE released new guidelines for NHS fertility treatments. There were three major changes: the upper age limit for IVF was raised from 39 to 42, heterosexual couples had to try and conceive unassisted for two years rather than three, and same-sex couples were to be offered treatment on the NHS.
From the limited information I could gather (a combination of web trawling and conversations with other LGBTQI+ people), it seems that Homerton Hospital in Hackney is one of the only hospitals to offer NHS treatment to same-sex couples, aside from in Scotland, where treatment is free for all. Other hospital websites state that they offer treatment, but there is no evidence suggesting that they do.
The problem is that NICE guidelines don’t have to be adhered to; they’re merely suggestions that NHS practitioners are asked to take into account. This opens up loopholes everywhere, where different trusts are able to interpret the guidelines in different ways.
We know first hand that the Kent and Medway NHS Trust don’t offer treatment to couples who need to use donor sperm or eggs; ruling out same-sex couples in one fell swoop. Of course, this impacts heterosexual couples too, but not half as much as it does LGBTQI+ ones.
With NHS treatment off the cards where we live (despite it being illegal for the NHS to deny medical treatment on the grounds of sexuality), we were forced to seek private treatment. There is not a day that goes by that I don’t think about and recognise our privilege in being able to pursue this route.
There is a gaping class divide in fertility treatment for LGBTQI+ people, which is not just discriminatory, but dangerous. Unaffordable fertility treatment creates a market for people’s vulnerability to be profiteered.
There are websites like Pride Angel where unregulated donors can volunteer their services – a black market for sperm. Of course, there are donors in it for the right reasons, but there are also a lot of them who aren’t. There are hundreds of threads on parenting forums about people ending up in hideous situations like being forced into sex or blackmailed by so-called donors.
Pride Angel’s donors are entirely untested, meaning they could have STIs or genetic diseases that would have been picked up in a sperm bank. The sperm is free, but you have to wade through a lot of men to get to the good ones, and even then you can’t be sure who you’re meeting or what their motives are.
Conceiving outside of a registered clinic also means that the non-birth mother in unmarried couples won’t be able to be on the birth certificate, and in most cases has little to no legal rights to the child.
As well as unregulated sperm markets, there are also businesses set up entirely to profit on people’s gamble on fertility costs. Access Fertility market themselves as family-making angels, while forcing couples to take expensive gambles on their future. They offer something similar to an IVF insurance policy that offers multi-cycle or unlimited IVF packages with refund options if you’re unsuccessful. Their entire business model is based on people becoming pregnant on the first few rounds, thus paying over inflated costs.
For instance, people under 35 would pay £15,500 for unlimited IVF for two years, with a 100% refund at the end if they don’t conceive. That £15,500 doesn’t include medication, initial consultations or any additional tests; nor does it include donor sperm. The true cost would be more like £20,000, and you could get pregnant on the first round which would’ve cost a quarter of the price.
The inaccessibility of fertility treatment for same-sex couples is abhorrent. It shows the clear lack of thorough thought from those at the top; making victories like gay marriage seem tokenistic when there’s such little effort to support LGBTQI+ people as they grow their families. The only way to end the capitalisation of desperate people is to make NHS fertility treatment available for everyone, a decision that would give so many queer families the option to grow.
AMA: Have you ever considered using your brother’s sperm?
This week a kind lesbian slid into my DMs to say that she’d been really enjoying Open Arms, and asked whether we’d ever considered using my brother’s sperm.
The short answer is no. We started IVF with the intention of me going first (the guinea pig), so it’s not something we considered fully. Jess and I discussed using a known donor and decided against it. I wrote about this in more detail in last week’s newsletter.
I think it can be a great option for people with boundaried, healthy relationships with their family – and I fully understand why it’s an attractive option for some couples – but it’s just not for us. It makes me feel a bit squeamish, in the same way that I imagine some people feel about using donor sperm. While my relationship with my brother is one of the greatest things in my life, it’s not one that’s strong enough to bear the weight of that dynamic.
I also think that anyone who has met both Jess and my brother would agree that they would create the weirdest little creep babies the world has ever seen. The world is not ready.
Got a question? Ask me anything! I want for Open Arms to become a source of support, information and guidance for anyone considering starting a family, but particularly those in LGBTQI+ relationships and those going solo. Please message me on Instagram or email me if there’s anything you’d like to ask. There’s no question too big, too small or too silly! If there’s a question I can’t answer, I’ll find someone who can and report back.
The Reading List
Where do we draw the red line on embryo ethics?
Judith Woods has written an opinion piece on Molly Gibson, the IVF baby born in 2020 but conceived in 1992, whose birth broke a world record. Given that Woods also conceived her children by IVF, there’s something pro-life about this piece that makes me feel uncomfortable. Woods writes that “freezing [embryos] would have felt as unthinkable as destroying them or giving them away,” which I find fascinating to hear from someone who knows the pain it takes to get eggs out and embryos made. I’d love to hear your thoughts on this one, DM me.
No evidence Pfizer Covid-19 vaccine affects women’s fertility
I, like many other people, have been thinking a lot about the Covid vaccine and how I feel about getting it in the middle of fertility treatment (or potentially when I’m pregnant). Fake news busters Full Fact have debunked the fertility myth shrouding the vaccine, but have confirmed that Pfizer vaccine is untested – and therefore not recommended – for pregnant women.
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Disclaimer
I’m not a doctor! I’m not a fertility consultant! I’m just writing about my own experience. I’m happy to guide you in the right direction, but you must know that I’m wrong a lot of the time. As with anything you find on the internet, it’s imperative that you do your own research.