Mind the Gap: A Nationwide Audit of LGBTQ+ Inclusion in Fertility Care Providers in the United Kingdom
Abstract
LGBTQ+ patients comprise one of the fastest-growing user demographics in fertility care, yet they remain underrepresented in fertility research, practice, and discourse. Existing studies have revealed significant systemic barriers, including cisheteronormativity, discrimination, and gaps in clinical expertise. In this article, we present a checklist of measures clinics can take to improve LGBTQ+ inclusion in fertility care, co-created with members of the LGBTQ+ community.
This checklist focuses on three key areas: cultural competence, clinical considerations, and online presence. The cultural competence criteria encompass inclusive communication practices, a broad understanding of LGBTQ+ healthcare needs, and knowledge of treatment options suitable for LGBTQ+ individuals. Clinical considerations include awareness of alternative examination and gamete collection techniques for transgender and non-binary patients, the existence of specific clinical pathways for LGBTQ+ patients, and sensitivity to the psychological aspects of fertility care unique to this demographic. The online presence criteria evaluate provider websites for the use of inclusive language and the availability of LGBTQ+-relevant information.
The checklist was used as the foundation for an audit of fertility care providers across the UK in early 2024. Our audit identified a widespread lack of LGBTQ+ inclusion, particularly for transgender and non-binary patients, highlighting deficiencies in clinical knowledge and cultural competence. Our work calls attention to the need for further work to understand the barriers to inclusive and competent LGBTQ+ fertility care from both healthcare provider and patient perspectives.
Authors: Chloe He, Nour Al-ma’ani, Mei Francis, Jules Sales, Isabella Marson, Neringa Karpavičiūtė, Rishabh Hariharan, Ranya Derrick, Sotirios Saravelos, Luca Sabatini, Sofia Tzouganatou, Devika Nair, Danielle Ellis, Céline Jacques, Timothy Ferrand, Tash Oakes-Monger, Teodora Popa, Francisco Vasconcelos, and Cristina Hickman
https://rep.bioscientifica.com/view/journals/rep/aop/rep-24-0173/rep-24-0173.xml?body=pdf-62778
Article ID: REP-24-0173
Article Type: Research Article
Online Publication Date: 01 Sep 2024
Copyright: © 2024 The authors 2024
Correspondence: Chloe He, Email: chloe.he.21@ucl.ac.uk