State-funded fertility treatment should not discriminate against queer couples

Clare Egan: "About 25% of heterosexual couples who want to become parents require fertility treatment. All same-sex couples who want to become parents do. We need medical intervention to do something many straight couples can do accidentally, and yet we are not allowed to access the State’s first publicly funded fertility programme."

The introduction of State funding for couples experiencing infertility has been broadly welcomed. The guidelines, which were approved by the Cabinet in July, offer fully funded fertility treatment for couples struggling to conceive. 

However, funding is not available in cases where donor gametes — either egg or sperm — are used. In practice, this means that State funding for fertility treatment is only available to heterosexual couples.

If my partner and I — two cis women — wanted to become parents, our first step would be to visit the fertility clinic. Like all queer couples, the work towards childbearing begins long before conception. We would look at donors, test our hormones and prepare to spend thousands of euro to conceive a baby.

About 25% of heterosexual couples who want to become parents require fertility treatment. All same-sex couples who want to become parents do. We need medical intervention to do something many straight couples can do accidentally, and yet we are not allowed to access the State’s first publicly funded fertility programme.

Speaking to RTÉ’s News At One, Minister for Health Stephen Donnelly talked about “targeting the resources”, about how this is a “first step”. When questioned about the discrimination inherent in these proposals, the minister pointed to the need for the bill on Assisted Human Reproduction to be made law. 

Countless deadlines have been missed in enacting this piece of legislation which has been in the works for 15 years. Fertility treatment is often a battle against time. With each passing month, the likelihood of a successful pregnancy recedes. While straight couples get access to funding from September, gay couples must continue to wait.

Clare Egan: "There shouldn’t be one rule for heterosexual couples, and another for gay couples. The State shouldn’t choose to value, support and invest in one kind of family — the heterosexual couple — to the exclusion of everyone else."

Government sources have also said that the criteria will not be reviewed in the lifetime of this government. There is no biological reason for this. It is a policy choice. 

Right now, across Ireland, thousands of same-sex couples are accessing fertility treatment. Donor conception is common practice. It is regulated under the Children and Family Relationships Act 2015 and practised every day in private clinics. The same private clinics the Government plans to fund to provide treatment for heterosexual couples.

Gay people are also more likely to experience poverty and economic disadvantage, particularly lesbian couples who are twice penalised by the gender pay gap. A recent report found that queer women are more likely to be living pay cheque-to-pay cheque. Gay people are among those most in need of support when it comes to the cost of fertility treatment, and yet we have been excluded.

There are many ways to bear children. Some queer families use surrogacy. Others conceive through fertility treatment either in Ireland or abroad. Others opt to conceive outside of clinical settings. Children born in these circumstances are often legal strangers to one or both of their parents. This results in innumerable challenges for them as they grow up, including issues accessing medical treatment, school enrollments, foreign travel, tax and inheritance rights.

This discrimination takes a huge financial and emotional toll on queer families around Ireland.

I’m glad that straight couples will get some much-needed support toward starting their families. I only ask that women like me not be excluded based on who we love.

There shouldn’t be one rule for heterosexual couples, and another for gay couples. The State shouldn’t choose to value, support and invest in one kind of family — the heterosexual couple — to the exclusion of everyone else.

According to the CSO, just 4% of Irish couples are in same-sex relationships. LGBTQ+ parents are almost always left out of mainstream narratives about fertility and family making. As a result, most people don’t know the physical, emotional and financial costs for queer families trying to have and raise children.

It’s the children of queer parents who suffer most in a society that refuses to see queer parenting as valid, important and worthy of protection. It’s the children who are born without a legal relationship with one of their parents, and it’s the children who absorb the bigotry this government has written into the law.

Such discrimination likely won’t lose the Government any votes. It generated very little public conversation, and even less consternation. As a community, we are easy to let down and the Government surely knows that. They can discriminate against us without much fear that they’ll be held to account for it.

Gay people in Ireland have always been second-class citizens. We often exist in the blind spots of a heteronormative society. Human reproduction is a complex area. It’s not easy to legislate for the wide spectrum of human sexual diversity, but there is nothing about having children that isn’t complicated. 

The Government’s first step toward making fertility treatment more accessible shouldn’t be to exclude people in gay relationships. State fertility support should be available to everyone, regardless of who we love or how we intend to become parents. The guidelines should be revised to better reflect the kind of inclusive, tolerant and diverse society we want to be.

This article was edited on August 23, 2023 to remove a reference to the legal effects of reciprocal IVF treatments.

• Clare Egan is a queer freelance writer based in Dublin.