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UK same sex couples face barriers to fertility services

The month of June is Pride Month, so we are shining the spotlight is how same sex couples can access fertility services. However, a new study in the UK has found that same sex couples are facing barriers to fertility treatment. Barriers to National Health Service (NHS) treatments are not experienced by heterosexual couples.

The British Pregnancy Advisory Service (BPAS) is a not-for-profit charity dedicated to removing barriers to reproductive choice, they commissioned this study and feel these barriers could mean that the NHS is in breach of equality legislation.

The study found that:

  • Some same sex couples are forced to pay up to £20,000 before they can access care
  • More than a quarter of NHS clinical commissioning groups (29%) will not fund the cost of donor sperm to be used in IVF treatments.

Female couples paying £20,000 for treatment

For instance, three quarters of the 106 clinical commissioning groups (CCGs) in England require a minimum of three artificial insemination cycles to be paid for by female same-sex couples, with more than a quarter (29 CCGs) saying 10-12 cycles were needed. This can easily create a bill of up to £20,000.

The unfairness arises because, while the NHS will happily fund care for heterosexual couples who say they have been trying to conceive naturally, female same-sex couples have to prove their fertility status by undergoing rounds of artificial insemination. And these rounds have to be paid for privately.

Donor sperm cost not funded

About a third of the CCGs (29%) also said they do not fund the cost of donor sperm to be used in IVF treatments for female same-sex couples. This is despite National Institute for Clinical Excellence guidance stating that intrauterine insemination (IUI) should be considered as a treatment option for people in same-sex relationships.

Same barriers not faced by heterosexual couples

Obviously, this has a disproportionate impact on female same-sex couples, since it effectively bans them from accessing NHS-funded care unless they spend a considerable amount of money. And this is not the case for heterosexual couples.

Surely this must be considered discrimination.

Couples wonder if they can afford to start a family

One patient said, “The requirement of our CCG to self-fund 12 attempts to conceive means that we have ruled this out as a viable option. We would likely have spent tens of thousands of pounds and be a few years down the line by the point we are eligible for support. Our heterosexual friends who have required fertility support from the NHS have had a very different experience. It has made my partner and I feel unsupported and discriminated against by the NHS for which we both work. At times it has made us seriously consider whether we will be able to start a family at all. This has inevitably put our relationship under pressure. I generally feel quite comfortable with my sexuality, but the fertility process is the first time in my life that I have felt deep sadness at being gay.”

Harsh reality faced by female couples

Marta Jansa Perez, director of embryology at BPAS Fertility sympathises, she said,  “This report lays bare the harsh reality of access to NHS-funded treatment for female same-sex couples. The barriers faced by these patients are striking and amount to a tax on LGBT+ families. Going through fertility treatment can be a vulnerable experience and even more so for patients funding their own treatment at great personal cost. As a society we are not used to paying for healthcare and an already complex process can be complicated further by unfair gate-keeping and red tape.”

Gay rights organisations are also concerned by the report. Eloise Stonborough, Associate Director of Policy and Research at Stonewall, said, “All lesbian, gay, bi, trans and queer people should be able to start their own families. While accessible, inclusive, and fair fertility services should be available to everyone who needs them, in reality, there are many barriers to LGBTQ+ people accessing NHS-funded care and causing obstacles to LGBTQ+ people forming a family of their own. BPAS’s vital report shines a light on the inequalities that still exist for female same-sex couples looking to start their family, from lack of funding to a postcode lottery.”

Equal access should be available

A spokesperson for the NHS said, “While these decisions are legally for CCGs, who have to balance the various competing demands on the NHS locally, it is absolutely right that they should provide equal access to services according to need for people within their areas.”

In reality, the NHS response, while offering a feeble excuse for the issue offers no remedy. It is likely, therefore, that the issue will be tested in court at some point.

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