Now more than ever, employers are stepping up to support under-served areas of healthcare – including fertility and the healthcare needs of the LGBTQ+ community. As it turns out, when these two areas come together, LGBTQ+ employees need extra help.
“For LGBTQ+ people, conception often involves fertility treatments as well as donor sperm, donor eggs or surrogacy, it’s a huge journey in terms of mental and physical challenges. It’s also tricky to find the right information,” says Francesca Steyn, Director of Fertility Services at digital health app, Peppy.
The IVF process is hard enough, but people in the LGBTQ+ community have even more to contend with. “For one thing, they may not even come out to their employers,” says Francesca, “but planning on starting or growing their family could potentially ‘out’ them to the rest of the organisation”.
Why allyship matters
To be an ally means that an individual or organisation as a whole accepts, supports and promotes LGBTQ+ rights and equality. Ultimately, being an ally is the right thing to do – but that’s not the only reason it matters.
The war on talent means people are looking for employers who will support them holistically, not just for the highest paycheque. Encouragingly, last year 57% of employers said they addressed or planned to address LGBTQ+ wellbeing within their wellbeing strategy.
Support for fertility and family planning has become a priority for job-seekers, and LGBTQ+ people are no exception. 63% of LGBTQ+ Millennials aged 18-35 are considering becoming parents for the first time or having more children. Here’s what you need to know to be an ally to your LGBTQ+ staff on their journey towards parenthood.
The LGBTQ+ path to parenthood
What it involves
Trying to conceive as an LGBTQ+ person or couple can be a long, emotionally taxing and expensive road.
“If you’re a gay man, you may need to go down the route of surrogacy, which is a very long and expensive process and also involves legalities around the whole process of a surrogacy arrangement,” says Francesca. “For same sex female couples, there’s the issue of using donor sperm, for which a donor has to be found, which can be difficult and longwinded, after which there’s the whole fertility journey to go through”.
How the fertility journey impacts day-to-day life
Laura-Rose Thorogood and her wife, founders of The LGBT Mummies Tribe, have been through a decade of treatment to start and grow their family, and now have three children.
“We have both been birthing parents, with my wife carrying our first child who was conceived via IUI (intrauterine insemination) treatment. I carried our second and third children. The second was also conceived via IUI, and the third via IVF.
“The physical impact of the treatment can be gruelling for the gestational carrier, but regardless of who carries the baby, the fertility journey involves a great deal of pressure both psychologically and emotionally.
“When going through fertility treatment for our first child, my employers were great. They gave me time off for appointments and were supportive when we had failed cycles. But my wife didn’t feel comfortable telling her boss, and this is the case for a lot of LGBTQ+ people. There’s a fear that it makes you more vulnerable and could hold back your career progression.
“To then have to ask for time off if you have multiple failed cycles adds another layer of pressure. As a result, when my wife was having fertility treatment, we’d have to go to appointments by cab before her day started or in her lunch hour and then dash back in time for work.”
Fertility treatment is invasive, involving self-injected hormonal treatments, scans, surgical egg collection and embryo transplants. Side effects can include swollen ovaries, PMT symptoms, migraines, cramping and bleeding. “Egg retrieval is a surgical procedure – rushing back to work immediately afterwards is really far from ideal,” says Francesca.
The cost of treatment
Across the board, IVF is a postcode lottery, but these financial inequalities are exacerbated for the LGBTQ+ community as most don’t qualify for NHS funding for IVF. Standard IVF treatment costs between £4,000 and £8,000 per cycle (HEFA).
“LGBTQ+ people generally have to pay thousands of pounds if they want to have a family,” says Francesca. “This is due to the financial ethics they have to navigate. Parents must consider paying for donor eggs, sperm and embryos, along with finding a surrogate or considering adoption.”
“As a result, LGBTQ+ people can’t always afford to have the number of children they would have wanted,” says Laura-Rose. “If your partner is the birthing parent and a colleague says something like, ‘Well at least you won’t have to go through the physical experience of having a baby’, it can really impact you. It might not be that you don’t want to ever carry a baby, but actually that you can’t afford it, or are infertile. As a non-biological or non-gestational parent, your role is just as valid.”
Plus, fertility treatment can impact a person’s ability to work; 85% of people say fertility treatment had a negative impact on their work and 19% had to reduce hours or leave the workplace altogether.
Becoming an ally to LGBTQ+ colleagues and staff
“LGBTQ+ people have to overcome barriers, micro-aggressions and discrimination often throughout their lives. One place they should feel supported wholly is at work, by their employer,” says Laura-Rose.
If, in their workplace, people feel that becoming a parent will be littered with judgement and lack of support – whether through lack of understanding or outright prejudice – employers will lose staff.
Foster an inclusive environment, says Laura-Rose. “If you want to be supportive of an LGBTQ+ colleague who is starting or growing their family, the most respectful way is to ask open questions. Apologise if you make mistakes or use the wrong pronouns, while letting them know you really want to understand what they’re going through. They may not feel comfortable going into details, but at least you’re showing support.”
“Make sure your benefits and work environment are inclusive, and that you’re signposting the support available,” says Francesca. “At Peppy, we provide practical and emotional support for people on a fertility journey and fill the information gap once they’re outside of the clinic.”
How to offer inclusive support
Offering company support can really make a difference – 96% of employees said they would feel more positive about their employer if they were offered specialist fertility support.
“Companies need to be open about what’s available for staff who are on the journey of adoption, surrogacy or fertility treatment,” says Laura-Rose. “Be clear that this is an organisation that really cares, empowers and supports staff on their journey.”
Implementing an LGBTQ+ network or wellbeing group is a great first step to giving affected staff the support they need from people who have been in a similar situation, who will have a deeper understanding of what they are going through.
“Offering the services of a counsellor or fertility specialist would be ideal – especially if it’s free to the employee. Crucially, every HR person and line manager within the organisation should be educated about the different types of fertility treatment, so they can offer appropriate support at the right time,” says Laura-Rose
The first step to being an ally is to be inclusive. Accessible, confidential health and wellbeing benefits can help LGBTQ+ access the support they need during a fertility journey, without fear of judgement or cost, and help your organisation become an employer of choice for LGBTQ+ people and their allies.
 REBA Employee Wellbeing Research, 2021
 Multi-employer pilot of Peppy Fertility support, 2020
About the authors
Francesca Steyn: Francesca Steyn is Director of Fertility Services at Peppy and current Chair of the Royal College of Nursing Fertility Nurses Forum. She is also one of the RCN Fertility Nurses Forum’s six UK steering committee members. Francesca has over 15 years of experience in the NHS and private fertility sectors. She was awarded Surrogacy Professional of the Year in 2018 and 2019. She has co-authored publications including the Royal College of Nursing (RCN) Education and Career Progression Framework for Fertility Nursing.
Laura-Rose Thorogood: Laura-Rose Thorogood is a married lesbian of fifteen years & mother with three children by IUI & IVF treatment spanning over a decade. She is the Founder of The LGBT Mummies Tribe, a global organisation that supports LGBT+ women and people on the path to motherhood or parenthood.
She is an LGBT+ Family Activist, fertility advocate, educator, writer, speaker and campaigner for policy change for LGBT+ families. She works with the NHS, has met with Government and works with other global organisations to improve policies, educate and normalise LGBT+ families on the path to parenthood through pregnancy, birth, general healthcare across society and the media.
The LGBT Mummies Tribe also provides LGBT+ competency education and training to organisations who wish to become more inclusive and learn how to best support them on the path to parenthood including through fertility treatment.