Family Building
People build their families in various ways, including through pregnancy, adoption, fostering, and surrogacy. The provider’s role is to offer personalized, non-biased, nonjudgmental, medically appropriate care to meet the needs and desires of individual patients.
For persons who wish to carry a pregnancy and give birth, providers can help enable healthy pregnancy by providing pre-pregnancy care and offering basic fertility services as needed. For persons in need of infertility services and for people with sperm, providers can help safeguard their health and optimize fertility. Depending on the scope of practice and clinical setting, providers may offer or refer patients to medically assisted reproduction services—including comprehensive infertility evaluations, medications to increase fertility, therapeutic donor insemination (TDI), and intrauterine insemination (IUI). Providers should understand the importance of timely referrals for patients requiring more specialized care, such as donor gametes or embryos, in vitro fertilization (IVF), or gestational surrogacy. Providers should also offer resources for adoption services for patients who want to explore building their family through adoption.
It is important to recognize that family building can present social, economic, and systems-level challenges. The services that enable many LGBTQI+ people, unpartnered people, and people experiencing infertility to achieve their reproductive goals and build families are often expensive, not covered by insurance, and inaccessible, especially to people from groups that are marginalized and in many geographic regions of the country. In addition, people from these groups may face stigma or discrimination in the process of family building. Some people also may wish to focus on building families at an early stage in their life, including but not limited to people with progressively debilitating disorders or heritable conditions that may result in early cessation of fertility. Providers can affirm an individual’s family-building plans or goals, including whether, how, or with whom a person desires to build their family.