Transcription:
LGBTQ Family Planning

Melanie Cole (Host): While the decision and process to have a baby for heterosexual couples may seem relatively straightforward. For same-sex couples, the path to parenthood is quite different. But knowledge is power.

Welcome to Back To Health, your source for the latest in health, wellness, and medical care. Keeping you informed, so you can make informed healthcare choices for yourself and your whole family.

Back To Health features conversations about trending health topics and medical breakthroughs from our team of world-renowned physicians at Weill Cornell Medicine.

I'm Melanie Cole. And joining me today is Dr. Georges Sylvestre. He's an assistant attending obstetrician-gynecologist at New York Presbyterian Hospital and an Assistant Professor of Clinical Obstetrics and Gynecology at Weill Cornell Medical College Cornell University. And we're here to talk about LGBTQ parenting and family planning.

Dr. Sylvestre, I'm so glad to have you join us today. I love this topic. I'd like you to start with some important considerations for LGBTQ planning, parenting planning, just what you want them to think about when they're thinking about starting a family.

Dr Georges Sylvestre: I think it's important to consider and to remember that it's much easier today to be an LGBT person. If you think about the political climate 20, 30, 40 years ago, it was very difficult to be out, to have a relationship, to be in a relationship. And it was impossible to get married. Now, things have changed. So, there are over 500,000 married gay couples in the United States as of 2017 and the number is going up.

So now that LGBT people are free to live much easier now than it was in those days, a lot of them want children. If you look at stats today, the number of LGBTs wanting children went up from 40% to now almost 80%, meaning that 80% of LGBTs currently are already parents or planning to have children. It is much easier than it used to be. A lot more insurance plans will include the partner. A lot of insurance plans will allow management of family planning in women and men via surrogacy or artificial reproductive techniques. And also, on the flip side, women and men who want to adopt or foster, they were not welcome in the past. But now, almost all the programs having children for fostering or adoption open their doors to LGBT people or couples.

Melanie Cole (Host): I think that's just awesome. And as somebody with a daughter in the community, I know that she wants to have babies and she wants to get married and do all the things. And as I understand it, doctor, you have your own personal surrogacy journey. Are you comfortable? Would you be willing to share that with us today? Because it's a great story.

Dr Georges Sylvestre: Absolutely. Being now in my late 40s, early 50s, I came out at an age when having children for gays, especially gay men, was almost unthinkable. It was very difficult, very expensive, to the point in my 20s and early30s, I was comfortable with the fact that I would never have children and because it was very unusual to have children, like I said, for gay people. I met my husband in my mid-30s and he was a bit younger than me, not much, but he wanted children all his life. So it was not too hard to convince me to start a family, because it's something that I was comfortable not having, but I think it was just because it was not common when I came out. But now, we were in the early 2000s thousands and a lot more gays were having children. So we decided to start a family. We explored adoption, fostering, surrogacy. And we decided to have children via surrogacy. So our children were born in 2010 and 2013. We are the proud parents of a nine and a twelve-year-old, and we couldn't be happier.

Melanie Cole (Host): That's so awesome. So while you're speaking to the community, how did you find a surrogate? How did you decide who would carry? How does that process work?

Dr Georges Sylvestre: Typically, for surrogacy, and like I discussed, there's many other ways of having children, but that's the route we chose. Whether you're a gay or heterosexual person, wanting to have children via surrogacy, you seek a surrogate in general surrogacy agencies. That is usually a firm of lawyers, specialized in surrogacy family building. So they typically recruit women that want to become gestational carriers and they match them with individuals that want to have children via surrogacy.

Another way, which is more and more popular now since we have social media, is that sometimes intended parents will seek surrogates via social media without the help of an agency. That's another way to do it.

Melanie Cole (Host): I was asked to be a surrogate and I was so happy to do it. And I couldn't because I was already 37 years old and they did not want that and older eggs. But I would have been thrilled to be a surrogate at that point for my cousins. Now, for female couples is different than for male same-sex couples. For a female couple, doctor, how do they decide? Do you have talks with them sometimes about who will carry the baby? How they will decide to go about it? How different is it when we're talking about female versus male same-sex couples?

Dr Georges Sylvestre: It's a completely opposed. Obviously, it's much easier for female couples to have a baby, because they both have a uterus in general, they both are healthy enough to carry a baby in general. It often happens that one woman carries a child for the number one, say, and the other female of the couple carries the second child. But sometimes, it's always the same person. I can't speak for all the gay female couples. But in general, very often, there's one who's more willing to carry a baby, more eager to be pregnant than the other, but not always, like I said. Sometimes they alternate. It's much easier, because all they have to do in general is to find a fertility clinic or an OB-GYN who's comfortable doing insemination. They have to find a sperm source very often with a sperm bank, sometimes with a friend or designated sperm donor. And also, like anybody else, heterosexual females, sometimes they have to go through IVF, but that's a minority of women.

Melanie Cole (Host): Can you speak to us about specifically what's available locally for New York state?

Dr Georges Sylvestre: For women, a woman can consult with a local gynecologist. We're lucky in New York state to have so many fertility clinics that are excellent that can help women finding the sperm source, optimizing the pregnancy building or starting your pregnancy via insemination or IVF. So that's what's available.

For men, it's much more complicated and much more costly. They have to, like I said, get in touch with a surrogacy agency or find a surrogate of their own. Typical wait time to obtain to get a surrogate or gestational carrier can be any time between six months and two years. So it takes a long time to find a gestational carrier. And at the same time, it's important to mention that surrogacy is no longer using women with their own eggs. So over 95% of surrogacy journeys in the United States involve a third person who's an egg donor. So it's very rare that a surrogate will carry children who are from their own genetic material, like via insemination. Almost always what happens now is that the intended parents find an egg donor or in the case of a heterosexual couple, the intended mother will use her own eggs and have the gestational carrier carry the baby that's created via IVF. That's unfortunately very pricey and complicated, but it's still done very commonly.

Melanie Cole (Host): And doctor, the social and emotional aspect of this to be sure, and we're being honest here. There are places in this country right now, you said the political climate, that same-sex couples may not feel welcome or free to start their family. I'd like you to speak specifically about the caring specialists at Weill Cornell Medicine. And you are obviously one of them and taking this into account, how you all help to guide your couples towards family planning and parenting and how that social and psychosocial, emotional situation that we've got now in this country, how that comes into play and how couples feel comfortable and are worked with and supported emotionally and physically.

Dr Georges Sylvestre: We try to support all our patients who are having babies or planning to have a baby and encourage them as much as I encourage women who don't want children not to get pregnant, that can be done easily. We'd like to tell my lesbian patients, for example, that if you want children, it's possible. We still live in a country that's LGBT family friendly. Of course, some places in the states are more gay family friendly than others, but I'm lucky enough to live in New York City where that's not a problem.

I train a lot of healthcare workers, nurses, administrators who work in the healthcare to be more welcoming to LGBT families and sort of open the door to different types of families. Avoiding terms necessarily like, "Oh, is your wife pregnant?" or "Is your husband around?" because there's not always a husband around. Sometimes it's a wife, sometimes a partner. Sometimes it's non-binary people. So we try use a more inclusive language when addressing patients.

Melanie Cole (Host): That's an excellent point. And I think for healthcare providers across the board, learning those kinds of things and the diversity and learning how best to help different communities is so important in the healthcare community today. Doctor, give us some final thoughts, what you would like listeners to know about family planning and building in the LGBTQ community.

Dr Georges Sylvestre: Being a parent is a wonderful thing. And I think LGBTQs make phenomenal parents. Because if you think about it in the general community in United States, statistics show it that 50% of pregnancies in the US are unplanned, right? Only half of them are planned. In the LGBT world, all our kids are planned and desired. This is why we make fantastic parents. So if you want to become a parent, go ahead, give it a try. It's much easier now than it used to be. And it's really a phenomenal experience.

Melanie Cole (Host): What a great point you just made. Thank you so much, doctor, for joining us today and for sharing your story with us and the caring and compassionate care that's available at Weill Cornell Medicine. And Weill Cornell Medicine continues to see our patients in person as well as through video visits. And you can be confident of the safety of your appointments at Weill Cornell Medicine.

That concludes today's episode of Back To Health. We'd like to invite our audience to download, subscribe, rate, and review Back To Health on Apple Podcasts, Spotify and Google Podcasts. And for more health tips, go to weillcornell.org and search podcasts. And parents, don't forget to check out our Kids Health Cast. I'm Melanie Cole.

Promo: Every parent wants what's best for their children. But in the age of the internet, it can be difficult to navigate what's actually fact-based or pure speculation. Cut through the noise with Kids Health Cast, featuring Weill Cornell Medicine's expert physicians and researchers, discussing a wide range of health topics, providing information on the latest medical science.

Finally, a podcast to help you make informed choices for your family's health and wellness. Subscribe wherever you listen to podcasts. Also, don't forget to rate us five stars.

Disclaimer: All information contained in this podcast is intended for informational and educational purposes. The information is not intended nor suited to be a replacement or substitute for professional medical treatment or for professional medical advice relative to a specific medical question or condition. We urge you to always seek the advice of your physician or medical professional with respect to your medical condition or questions.

Weill Cornell Medicine makes no warranty, guarantee or representation as to the accuracy or sufficiency of the information featured in this podcast. And any reliance on such information is done at your own risk.

Participants may have consulting, equity, board membership, or other relationships with pharmaceutical, biotech or device companies unrelated to their role in this podcast. No payments have been made by any company to endorse any treatments, devices, or procedures. And Weill Cornell Medicine does not endorse, approve or recommend any product, service or entity mentioned in this podcast.

Opinions expressed in this podcast are those of the speaker and do not represent the perspectives of Weill Cornell Medicine as an institution.