In a major win for equality, the U.K. government has announced that female same-sex couples will no longer have to pay for expensive rounds of assisted insemination to prove infertility before accessing in vitro fertilization (IVF). The country’s leading LGBTQ advocacy organization has clarified that this will also apply to trans people.
The new measures, part of a larger Women’s Health Strategy, address a major failing of the National Health Service (NHS), the country’s government-funded health care. Previously, in order to access IVF treatment, in which sperm and egg are combined outside the body before being placed in a uterus, couples first had to prove infertility. For different-sex couples, this meant simply asserting that they’d been trying via unprotected intercourse for two years. Same-sex female couples, trans men, and nonbinary people with uteruses, however, had to pay out of their own pocket for multiple rounds of intrauterine insemination (IUI, aka “the turkey baster” method, but in a clinic) before they could qualify for the more effective IVF treatments. The cost could run into the tens of thousands of pounds. (One U.K. pound is currently $1.20 U.S.)
Now, according to the Women’s Health Strategy, the government will fund six cycles of IUI for “female same-sex couples,” prior to covering IVF if needed. The Strategy does not specifically mention IVF for trans people, but LGBTQ advocacy organization Stonewall, in an Instagram post, said the rules will apply to “Lesbians, bi women and trans people” (presumably trans people with uteruses).
Nancy Kelley, CEO of Stonewall, said in a statement on Twitter:
We are delighted that the UK government has listened to our call for fair and equal access to IVF treatment.
For years, lesbians, bi women, and trans people have been forced to pay for up to £25,000 of private healthcare before they can access IVF on the NHS, or face giving up their dream of becoming parents.
This is a giant step towards a world where LGBTQ+ people have the same opportunity as everyone else to build a loving, thriving family of their own.
LGBT Mummies, a U.K. organization for LGBTQ parents, noted in an Instagram post, however, “We would still love to see how single women & people, asexual & non binary people will be included in this, those with children already (sometimes a barrier to funding).” Despite the need for these further clarifications, though, the new rules are still a major advance.
The Strategy also promises “greater transparency” about “the provision of IVF services across the country,” where the specific services covered can vary by postcode and the NHS trust (the organizational unit of the NHS) that provides the services there. The government will, the Strategy says, “explore mechanisms to publish data nationally on provision and availability of IVF.” That feels a little half-hearted to me, but is a step in the right direction.
The change was the result of years of advocacy work by Stonewall and by many individuals, including Whitney and Megan Bacon-Evans, who sued the NHS for equal treatment, and Laura-Rose Thorogood and her wife Stacey, who founded LGBT Mummies. The Bacon-Evanses posted today on Instagram:
We screamed and cried when we found out the news. This is exactly what we hoped to achieve when starting our campaign and legal action in the fight for fertility equality. We hoped it would create awareness and to set a precedent and be a catalyst for change. We dreamed it would help create a future where LGBTQ+ families would be treated as equal. The fact we may be seeing this day very soon, that it’s actually going to be a reality that will positively impact the lives of hundreds of thousands of LGBTQ+ people who can now create a family is more than a dream come true.
In the U.S., coverage of IVF depends upon one’s state and health insurance provider. While some employers are not only offering IVF coverage, but are doing so without requiring a medical diagnosis of infertility, others are not, as I have explained previously. The Biden administration is considering a new rule requiring some health plans to cover fertility treatment regardless of policyholders’ sexual orientation or gender identity, reported Bloomberg Law in May.
There are still inequalities for queer parents and prospective parents in the U.K., too, most notably that commercial surrogacy is still illegal and grants parental rights to the surrogate and the surrogate’s husband (if there is one), notes PinkNews.
In addition to the new rules around IVF, the Strategy will also ensure “that transgender men and non-binary people with female reproductive organs are aware of cancer symptoms that may impact them, as well as receiving screening invites, and being able to access screening services for cervical and breast cancer screening.”
On a different topic, but worthy of note in these times, is the Strategy’s section on abortion services. It says:
Under the Abortion Act 1967, women have access to safe, legal and regulated abortion services.
The wellbeing and safety of women and girls accessing abortion services has been, and will continue to be, our first and foremost priority.
We will set out our plans for sexual and reproductive health later this year, including ensuring women can continue to access robust and high-quality abortion services.
Yes, it should have included all people who can get pregnant, not just women and girls. But the fact that the government—and a Conservative one at that—is stressing abortion access at all is a stark contrast to the U.S., where the federal government is struggling against conservative efforts in many states and in the Supreme Court to ban and restrict abortion.
Kudos to all who worked for these changes in the U.K. and congratulations to the many families and families-to-be who will benefit.