Health Disparities in Procreation: Unequal Access to Assisted Reproductive Technologies

Abstract

There is a significant increase in the use of assisted reproductive technology to treat infertility, yet access to services is not equal for all women in the United States. Some marginalized groups face significant barriers accessing assisted reproductive technology. The authors review obstacles preventing marginalized populations from procreating, based on class, race and ethnicity, age, marital status, sexual orientation, and disability. The sociopolitical climate in the United States that maintains these obstacles is evaluated by the authors in this article. Finally, suggestions are provided for structural changes to decrease disparities in access to assisted reproductive technology and recommendations for family therapists working with clients who are unable to access assisted reproductive technology.

Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services?

“…Conversely, if distressed patients declined to participate so as to avoid discussing difficult topics, this could have underrepresented the rate of psychological distress reported. Additionally, only heterosexual couples were studied; same-sex couples may face additional barriers to MHS (31,32). Furthermore, limited information regarding MHS was obtained, and future studies could examine in greater depth how it happened that such distressed patients did not report receiving MHS information.…”

Family Resilience Amid Stigma and Discrimination: A Conceptual Model for Families Headed by Same‐Sex Parents

“…Gay men who do not adopt may choose surrogacy to become a parent, which poses legal and discriminatory challenges (Berkowitz, ). Further, lesbian mothers historically have encountered a lack of access to reproductive health services (e.g., in vitro fertilization; Kissil & Davey, ) as well as stigma and discrimination during pregnancy and throughout parenthood (Bos, ). Discrimination also is an obstacle for lesbians and gay men who wish to adopt.…”

Contraception‐related knowledge, attitude, belief contexts among US women experiencing homelessness: A scoping review

“…For example, based on the US single‐payer insurance structure and the limited expansion of Medicaid, adequate insurance coverage for more effective contraception may be especially limited for women experiencing homelessness (Darney et al, 2020). Women experiencing homelessness, especially women with intersecting identities such as racial or sexual minorities, typically have later access to new technologies and worsening access due to policy trends, reducing opportunities for affordable, accessible reproductive services (Kissil & Davey, 2012; Miles et al, 2018). For additional context outside of the timeframes of when some of the older included studies were conducted, it is also critical to consider how current technological advances in contraception (especially for LARCs) and the current political landscape in the United States regarding sexual and reproductive health accessibility affects contraceptive access and decision‐making.…”