The enormity of uncertainty — how the pieces will fall into the right places — is a daunting prospect for everyone. These feelings are only exacerbated for LGBTQ+ families who are forced to deal with additional challenges everyday, from legal to social to financial issues. Oftentimes either people aren’t sensitive to where they come from, or simply ignorant about the same. With the continuous drag of discrimination and trauma, starting a new chapter becomes even more intimidating and frightening for them. Futhermore, if one identifies as transgender or gender nonconforming, there is an additional stigma that they have to face around these deeply sensitive issues.
Transgender people frequently report intense discomfort with their primary and secondary sex characteristics or their birth sex, often describing their experience as “being trapped in the wrong body” developing an emotional vulnerability gender dysphoria while remarking that gender nonconformity is not a mental disorder itself.
Despite such circumstances, transgender people too have the same interests in having children and accessing fertility services for fertility preservation and reproduction as others. Potential rationales for a right to parenthood includes the value of family, the basic human desire to have a child, normal human biological functioning, the principle of equal freedom of action, and existing laws that support the right.
Human Rights Approach
Trans people have faced seemingly insurmountable barriers to parenthood — including sterilization requirements that have precluded them from giving birth— plausibly in violation of the right to create a family established in the Universal Declaration of Human Rights.
The question of Assisted Reproductive Technology (ART) comes to the foreground while supporting a person's attempt to become a parent; However, Patients who differ from the heteronormative family have historically been denied access to assisted reproductive technology.
Recently, it has been encouraging to see a rising acceptance rate of the use of ART by gay and lesbian patients (refer to the graph showing acceptance in different countries), however, unfortunately when it comes to providing fertility services for transgender patients, some doctors/specialists still express discomfort. Resistance to giving treatment may be naturally grounded in either concern for the welfare of the patient or for the welfare of the offspring, or both. Some projects favour kindness only for Female-to-Male (transgender) patients with female spouses because of reservations about treating all trans patients. According to the Ethics Committee of the American Society for Reproductive Medicine, physicians, psychologists, and ethicists have argued that transgender patients should have access to the same options as any person who will lose or has lost their reproductive capacity.
The fact that the responses to requests for treatment from transgenders are often flatout denials, shrouded in humiliation, raise some specific questions about their reproductive rights, the welfare of offspring, and non-discrimination. Historically, the ethical firestorm over providing fertility services has been established on the balance of these values.
Rethinking Procreative Rights
In the past, most trans parents had their children before coming out as trans. Giving birth after transitioning has never even been an option for trans men living in countries with sterilization requirements as conditions for legal gender transitioning. For instance, a unanimous panel of Japan’s Supreme Court decided in 2019 to promote a law where people wishing to register a gender change will have to get their original reproductive organs removed thereby barring legally recognized trans men from retaining their natal reproductive capacity. The court supported its account by stating that the 2004 law was intended to reduce confusion in families and society. However, in countries with advanced cultures like Denmark and Netherlands, these requirements have been rolled back due to the advancement of trans rights and concerns about bodily autonomy and integrity.
Recognizing that transgender people face discrimination in every possible field including health care, governments should begin to incorporate anti-discrimination clauses into policy and ethics documents instead of disheartening them. Although, there have been only a handful of studies on parenting by transgender persons, which have enrolled a relatively small number of subjects, much of the research has shown that recent facts and figures do not support the concept of restricting access of transgender persons to reproductive technologies. Outdated concerns, that children are harmed when raised by transgender parents, contradicts modern research which suggests that people identifying as transgender may have more challenges but are just as committed to their families as any other person. They have reported positive relationships with their children, and research shows that the loss of contact with the transgender parent may cause more harm than the gender change itself. Transgender parents exhibit the same characteristics associated with good parenting, including warmth, commitment to the child, caring and responsible relationship as well as attention to the child's needs. Several studies have proved that children with trans parents have experienced challenges related to societal transphobia, including harassment by peers and neighbours. Further research has reflected children’s fear of bullying resulting in children‘s attempt to conceal their trans parent’s identity to some extent. Whereas all of these experiences could potentially directly affect children’s psychological well-being, as conceptualized by the minority stress model, and, it’s possible that for this very reason, trans people are ignored by modern medicine. Physicians hesitate in providing treatments to trans people because of the future challenges that the child is going to face. But why should one person face such intense emotional turmoil at the expense of an obsolete and irrelevant societal mindset?
Therefore, all transgender patients who request assisted reproduction should be informed about known medical risks related to their use of hormones and psychological counseling should be mandated to assist them with questions about disclosure to society and the offspring, as well as to act as pillars of support for the “bio-psycho-social” consequences of treatment.
A bill should be passed to provide LGBTQ community with the reservation, the same as for other castes in our country. To make it more effective and fair, this reservation should be concluded before passing on to the next generation of the family. Also, humiliating an LGBTQ member by public servants or in a workplace should be made a punishable offense at the micro-level, it costs the economy with lost labor time, lost productivity, underinvestment in human capital and decreased investment in human capital and suboptimal use of human resources.
There exists a positive correlation between rights and economic development that appears to vary across different rights. In particular, the anti-discrimination laws covering sexual orientation have a very strong correlation with GDP per capita, since with the increase in the human resource as a country we can contribute to the Gross National Income by actively interacting with the economy as consumers and producers. The importance of non-discrimination laws is linked to their stronger connection to the treatment of trans community in the workplace and other settings that have direct economic relevance such as schools, health care facilities, absentism of trans workers can be bad for business which can lead to low productivity, inadequate training, and high turnover make for higher labor costs and lower profits.
Multinational companies know they’ll have trouble convincing a trans executive to accept a transfer to a country that is LGBT intolerant, thus, paving the way for economic losses.
The correlation of additional transgender rights and economic progress is not the result of increasing gender equity within a country, since the impact of transgender rights is strong even when taking into account an indicator of gender equity in the statistical model.
Since this is an era of law that continues to evolve, at this moment there aren’t any robust policies regarding the use of assisted reproduction or parenting by transgender persons. It's important to conclude by reinforcing the fact that ART or any other method is just a secondary step towards normalising parenting by transgenders. What's far more important and impactful is to accept that transgender people are not that different after all, and parenting is a gender neutral role.