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Chloe He C He, Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom of Great Britain and Northern Ireland

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Nour Al-ma'ani N Al-ma'ani, Research Team, Sapphic Bison, London, United Kingdom of Great Britain and Northern Ireland

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Mei Francis M Francis, Department of Philosophy, University of Warwick, Coventry, United Kingdom of Great Britain and Northern Ireland

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Jules Sales J Sales, Product Team, Apricity, Paris, France

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Isabella Marson I Marson, Acquisition Team, Apricity, London, United Kingdom of Great Britain and Northern Ireland

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Neringa Karpavičiūtė N Karpavičiūtė, Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland

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Sotirios Saravelos S Saravelos, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom of Great Britain and Northern Ireland

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Luca Sabatini L Sabatini, Centre for Reproductive Medicine, Barts Health NHS Trust, London, United Kingdom of Great Britain and Northern Ireland

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Sofia Tzouganatou S Tzouganatou, Embryology, Centre for Reproductive and Genetic Health, London, United Kingdom of Great Britain and Northern Ireland

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Danielle Ellis D Ellis, Care Team, Apricity, London, United Kingdom of Great Britain and Northern Ireland

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Teodora Popa T Popa, EGA Institute for Women's Health, University College London, London, United Kingdom of Great Britain and Northern Ireland

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Francisco Vasconcelos F Vasconcelos, Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom of Great Britain and Northern Ireland

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Cristina Hickman C Hickman, Institute of Reproductive and Developmental Biology, Imperial College London, London, United Kingdom of Great Britain and Northern Ireland

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LGBTQ+ patients comprise one of the fastest-growing user demographics in fertility care, yet they remain underrepresented in fertility research, practice, and discourse. Existing studies have revealed significant systemic barriers, including cisheteronormativity, discrimination, and gaps in clinical expertise. In this article, we present a checklist of measures clinics can take to improve LGBTQ+ inclusion in fertility care, co-created with members of the LGBTQ+ community.

This checklist focuses on three key areas: cultural competence, clinical considerations, and online presence. The cultural competence criteria encompass inclusive communication practices, a broad understanding of LGBTQ+ healthcare needs, and knowledge of treatment options suitable for LGBTQ+ individuals. Clinical considerations include awareness of alternative examination and gamete collection techniques for transgender and non-binary patients, the existence of specific clinical pathways for LGBTQ+ patients, and sensitivity to the psychological aspects of fertility care unique to this demographic. The online presence criteria evaluate provider websites for the use of inclusive language and the availability of LGBTQ+-relevant information.

The checklist was used as the foundation for an audit of fertility care providers across the UK in early 2024. Our audit identified a widespread lack of LGBTQ+ inclusion, particularly for transgender and non-binary patients, highlighting deficiencies in clinical knowledge and cultural competence. Our work calls attention to the need for further work to understand the barriers to inclusive and competent LGBTQ+ fertility care from both healthcare provider and patient perspectives.

Article Type:
Research Article
DOI:
https://doi.org/10.1530/REP-24-0173
Volume/Issue:
Accepted Manuscripts
Open access