Family Planning for LGBTQ+ Couples | Fertility Out Loud

What to Consider When Family Planning as an LGBTQ+ Person

By M Hardwick (they/them), Certified Full-Spectrum Doula, Certified Childbirth Educator, Fertility Doula

The views and opinions expressed are those of the authors and should not be considered medical advice. Always consult your doctor, or a mental health professional, for the most appropriate treatment.

So, you’re in the process of family planning. There are many questions that people have when trying to conceive (TTC) or build their families in another way. Knowing your priorities and what you can do when it comes to growing your family is important in this process, helping to narrow down how to get children into your life. This becomes even more important when you are part of the LGBTQ+ community. Here are 6 things to consider when growing your family: legal, health, financial, support, methods, and anything that you morally or ethically feel strongly about when it comes to fertility and conception.

Legal considerations

When you are looking at building a family as a lesbian, gay, bisexual, transgender, or queer couple, one of the first things you should look into is what obstacles you may have to overcome. Every state in the United States has different legal considerations for families. Talk to a family or reproductive and gestational lawyer that you trust, and get to know what specific obstacles you may have to face. Some things to think about would be:

Second parent adoption

According to Family Equality, a non-profit that helps to ensure everyone has the freedom to find, form, and sustain their families, second parent adoptions usually happen when:

  • The state requires LGBTQ+ couples go through separate court procedures to adopt a child 
  • The second parent in an LGBTQ+ couple who isn’t biologically related to the child needs to establish the parent-child relationship legally 
  • The legal parent agrees to have the new step-parent adopt the child from another marriage
  • The person(s) who will parent are not biologically related to donor sperm or egg 

It might not seem like these adoptions are necessary, but knowing how families are built for LGBTQ+ folks and that the laws can change at any moment, having legal rights and custody of your children is incredibly important. Whether you have given an egg during reciprocal in vitro fertilization (IVF) or used a surrogate, there can be claims that you or your partner are not the legal parents of your children, and it can jeopardize your parental rights to those children.

Second parent adoption is important but can still be a challenge for same-sex couples and LGBTQ+ parents since some state laws are different from others. It’s crucial to reach out to a lawyer that you trust to get a full picture of the challenges that you may face and what you can do to protect your family. There are options that might help your family stay legally protected and connected.

Adoption agreements

There are different paths for adoption in the United States. You can go through an adoption agency, a private or independent adoption, or in some cases fostering children can result in adoption. The laws surrounding each type of adoption vary greatly by state. You don’t necessarily have to have a lawyer, but keep in mind that adoptions can be tricky and typically involve a lot of paperwork—so having a lawyer can help during the process. 

Adoption agencies are state-licensed agencies that “supervise the care of biological mothers who are willing to have their children adopted by others, and assist in the placement of children after birth.” These agencies can be specialized based on the specific children that they place with new families. These agencies can also have long wait lists and take quite a bit of time.

Private adoptions are handled by lawyers, who may work with people who know others who are willing to have their children adopted by someone else. This route can sometimes be faster than going through an agency. But it’s important to be aware of “black-market adoption,” which is the buying and selling of children. Paying the gestational carrier to give up their child is a crime in every state. You are, however, typically able to pay for medical expenses and other costs if your state allows it with legitimate adoptions. 

You might have heard about open adoptions. These adoptions allow the biological parents to have some continued contact with the child that is very specifically laid out in the adoption agreement. The laws regarding these kinds of adoptions are developing.  

Surrogacy contracts

There are actually 2 different kinds of surrogacy, traditional or gestational. Traditional surrogacy happens when the surrogate inseminates their own egg, while gestational surrogacy is using a sperm and egg donor. In gestational surrogacy, the egg and sperm are inseminated outside of the uterus (using IVF), and are not related to the gestational carrier. Most laws and restrictions in the United States deal with gestational surrogacy because traditional surrogacy can cause legal problems with parental rights between the intended parents and the surrogate. And in many states, traditional surrogacy is actually illegal. A good way to find whether any surrogacy is legal in your state is through a map like the one provided by Creative Family Connections, which shows exactly where and what is legal in each state. 

But with any surrogacy pregnancy, a contract between the parents and surrogate is important to make sure that any legal implications over parental rights are established before the pregnancy. Surrogacy agencies usually have those agreements in place, but sometimes people ask friends or family members to help. Just be sure to draft a contract with a lawyer that you trust and who understands the laws surrounding surrogacy. If surrogacy is a path that works for you to build your family, make sure that you know who you want to be your surrogate, and how or whether you might want them to be in your child’s life.

There are a few other agreements and contracts that can be important to explore with a lawyer you trust and who has familiarity with this part of family law. These range from donor agreements (egg or sperm), to knowing when you need to be legally married for certain contracts and agreements to be certified in court. Many of the contracts and agreements have different requirements in each state, and some are not even legal in some of the states. Knowing your legal rights and what you should do to have the most protections with regards to your family is important.

Health considerations

Knowing your reproductive health can be essential to building your family, especially when it comes to biological children. Most options for LGBTQ+ families include assisted reproductive technology (ART), which means you will need to know more about your fertility. Finding a fertility specialist (or reproductive endocrinologist) at a fertility clinic that you trust is a must to find out more about your health and any infertility issues.

Fertility treatment options like IUI (intrauterine insemination), IVF, or surrogacy require healthy donors or surrogate mothers to hopefully grow your family.

Financial considerations

Having a family is expensive, but especially so if you are LGBTQ+. There are generally added costs to building your family depending on your needs. These can include additional medical tests and treatments, legal fees, purchasing sperm or egg donations, and more. These can have hefty price tags, especially depending on the length of time the process takes. It’s important to take a good look at your finances and consider what you need and want to do during this time. Try to determine how much it will actually cost you to grow your family. Be sure to add some cushion in your budget, because building a family often does not go the way that you expect. That extra cushion can give you the space to do what you need.

You might want to look into grants or loans that can help cover some costs, like those listed by Connecting Rainbows. There are also fertility doulas, who will sometimes have sliding scale pricing for their services, and can potentially help you find scholarships available for your needs to be met. 

Support considerations

Building your family can be difficult. Knowing that you have people who support you through difficult times is essential to taking care of yourself and your family. There will be healthcare providers and lawyers who can help you, and you may have biological and/or chosen family members that will support you. But sometimes the additional support of a fertility doula or fertility coach can help you navigate the family-building process without any judgment or opinions—just support. Ask yourself what kind of support you want and need and go from there. 


There are many ways that people can build their families. Knowing what those are, and what you actually want, can be important considerations. It’s important to learn more about the different family growing methods and get to know your options. Be sure to think about your goals for how you want to build your family. Do you want them to be biologically related to you? Would you want to adopt? Do your research and talk with your family to manage your priorities.

Other considerations

All the considerations above are incredibly important to understand when you are building your family as a member of the LGBTQ+ community. One thing that doesn’t often get talked about is your own moral and ethical opinion on how you want to grow your family. The history and stories within the communities of donor-conceived children, surrogates, and more are tales that do not get discussed and brought up enough when people are considering growing their families. Make sure to consider adoption, donor conception, and more from the perspective of the children involved, and talk more about what you are comfortable with pursuing. Something that fits one person does not fit everyone. That is probably something that everyone within the LGBTQ+ community understands deeply.

My hope is that these considerations help you start asking the questions that you and your family need to answer. No matter where you are in your journey, I’m sending you good vibes that everything will work out for you, and your family will grow. Good luck on building your family!

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