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Health Inequalities

The alien world of fertility clinics

by Ivy Taylor

I’m at that age now where all of the cisgender and straight people in my life are having kids. Siblings and friends alike just seem to be popping them out one after another. A relentless tide of adorable new babies that I am supposed to care about. And I do, honest. But each new baby or pregnancy announcement just reminds me how unlikely I am to have kids of my own. 

I accepted that I was trans at the age of 31. The NHS waiting list for my first appointment was two years. After a lifetime of doubt and denial, I simply felt like I couldn’t wait another moment to start transition. So I went private and was on hormones within two months. 

I am privileged enough to have found private transition related care to be surprisingly affordable. It was hundreds of pounds instead of thousands, but that was just for the barebones package. Once you started to throw regular therapy sessions and gamete storage into the mix, costs quickly became prohibitive. I decided to move forward without them, because the emotional toll of existing without gender affirming care was more than I could handle. 

Having lived my entire life up until that point as a man, I never imagined that I would want kids. As my transition progressed however, my relationship to the idea of parenthood evolved. It turns out I did want kids, I just never wanted to be a father. 

After around two years of HRT, I am functionally infertile. I know that it’s not a one hundred percent guarantee but the chances are impossibly slim. It’s far more devastating than I ever realised it could be, yet if I had my time again I wouldn’t choose differently. My transition was life-saving and I wasn’t going to delay it for anything. I knew this was the price I was paying, but I hate that I was forced to choose between my own survival and my ability to have children. 

While I know that plenty of cis-het couples face infertility, I don’t think their hands are ever forced in the same way it is for trans people. I could afford transition or store my sperm, not both. And what’s the point of gamete storage if I’m not transitioning? 

There are options, of course. But even assessing my current fertility involves navigating the incredibly cisnormative world of fertility clinics which – in my experience so far – don’t even seem to recognise the existence of trans people. This is complicated further by the fact that I’m in a lesbian relationship.  

Fertility clinics might as well be alien planets where people drink gravy instead of water because why would you want or need anything else. As such, I’ve found the experience strangely hostile. Not necessarily aggressive, but a lingering atmosphere of ‘this isn’t for you.’ My non-binary partner and I don’t fit into the established understanding of their world. They don’t know what to do with us. The cisnormative expectation means we are entering this vulnerable process with our guard up, carefully vetting every clinic before even considering contact.

For the vast majority of cis-het people, having a kid is simply a case of making a decision and getting busy. And that’s assuming it’s a deliberate choice and not an accident. The fact that there are people out there having kids by accident is like a slap to the face when even my best effort is met with institutionalised resistance. 

Fertility clinics and IVF treatment are built with cis-het couples in mind and I don’t begrudge those people. The inability to conceive can be heartbreaking no matter who you are. I just long for a world which takes more seriously the desire for trans people to have and raise families. One that recognises the vulnerability of the process and holds our fragile hearts with care.

This article was funded by The LGBT+ Futures: Equity Fund in partnership with the The National Lottery Community Fund.