Exploring 2SLGBTQIA+ Couples’ Experiences of Third-Party Reproduction

IF 2.9 2区 社会学 Q1 PSYCHOLOGY, CLINICAL
Sonia Stanger, Ashley A. Balsom, Jennifer L. Gordon
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Abstract

The purpose of the present study was to explore the experiences of two-spirit, lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, or otherwise gender or sexually diverse (2SLGBTQIA+) couples pursuing third-party reproduction (TPR). A sample of 31 2SLGBTQIA+ couples (n = 62) from the USA and Canada attempting to conceive via third-party reproduction were recruited online, underwent a semi-structured interview about their experiences, and completed an online survey assessing fertility quality of life, anxious and depressive symptoms, and institutional betrayal in healthcare. Descriptive statistics were used to assess mean levels of quality of life, mental health symptoms, and institutional betrayal. Rates of clinically significant reductions in quality of life and mental health were assessed. Thematic analysis was applied to the interview transcripts. Data were collected between November 2021 and July 2022. Thematic analysis identified numerous challenges in pursuing TPR, many of which were specifically tied to participants’ membership in the 2SLGBTQIA+ community. Two overarching themes were identified: “system-level issues,” such as a lack of information pertaining to their unique situation, and “provider-level issues,” such as the holding of heteronormative assumptions by providers. Quantitative findings revealed that a large proportion of the sample, 34%, scored in the clinical range on anxiety and depression questionnaires. The intended gestating partners reported poorer quality of life relative to their non-gestating partners. 2SLGBTQIA+ couples attempting to conceive via third-party reproduction experience psychological distress and reduced quality of life and face inequities and challenges at the system and provider level. These findings lead to concrete recommendations for clinicians providing fertility services to cultivate competence and improve care standards for this population according to their ethical responsibility and highlight the need for policy change and the development of targeted supports. Key recommendations include 2SLGBTQIA+-specific training for staff, using inclusive language, visuals, and documentation processes, refraining from hetero- and cisnormative assumptions, developing anti-discrimination policy and a process to assess and respond to clients’ mental health needs, and identifying and sharing information and supports.

Abstract Image

2SLGBTQIA+夫妻第三方生殖体验探讨
本研究的目的是探讨双性恋、女同性恋、男同性恋、双性恋、变性人、酷儿或质疑者、双性人、无性恋或其他性别或性多样性(2SLGBTQIA+)夫妇追求第三方生殖(TPR)的经历。从美国和加拿大在线招募31对2SLGBTQIA+夫妇(n = 62),试图通过第三方生殖怀孕,对他们的经历进行了半结构化访谈,并完成了一项评估生育生活质量、焦虑和抑郁症状以及医疗机构背叛的在线调查。描述性统计用于评估生活质量、心理健康症状和制度背叛的平均水平。评估了生活质量和心理健康临床上显著下降的比率。对访谈笔录进行专题分析。数据收集于2021年11月至2022年7月。专题分析确定了追求TPR的许多挑战,其中许多挑战与2SLGBTQIA+社区的参与者成员关系密切。确定了两个主要主题:“系统级问题”,例如缺乏与其独特情况相关的信息,以及“提供者级问题”,例如提供者持有异规范假设。定量调查结果显示,很大一部分样本(34%)在焦虑和抑郁问卷上得分在临床范围内。与未怀孕的伴侣相比,预期怀孕伴侣的生活质量较差。2SLGBTQIA+夫妇试图通过第三方生殖方式受孕,会经历心理困扰和生活质量下降,并面临制度和提供者层面的不公平和挑战。这些发现为提供生育服务的临床医生提供了具体的建议,以培养他们的能力,并根据他们的道德责任提高对这一人群的护理标准,并强调需要改变政策和发展有针对性的支持。主要建议包括:对工作人员进行2SLGBTQIA+专项培训,使用包容性语言、视觉和文件流程,避免异性恋和反规范假设,制定反歧视政策和流程,以评估和应对客户的心理健康需求,以及识别和共享信息和支持。
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来源期刊
CiteScore
5.60
自引率
13.20%
发文量
299
期刊介绍: The official publication of the International Academy of Sex Research, the journal is dedicated to the dissemination of information in the field of sexual science, broadly defined. Contributions consist of empirical research (both quantitative and qualitative), theoretical reviews and essays, clinical case reports, letters to the editor, and book reviews.
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