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Family-Building Options for LGBTQIA+ Individuals and Couples

The LGBTQIA+ community has historically faced significant barriers to reproduction and family-building. It wasn't until 2016, following the Supreme Court's 2015 ruling on marriage equality, that same-sex individuals and couples were legally allowed to adopt children in all 50 states. 1 Since these federal proceedings and advancements in fertility science, a wealth of family-building options have become available for LGBTQIA+ couples and individuals to have children. As a result, families are beginning to represent the rich cultural diversity present in our society. At Ebb & Flow Counseling & Coaching, we are dedicated to increasing access to family-building options for all family orientations and ensuring the psychological wellness of LGBTQIA+ parents.

What are the Available Family Building Options?

Family building refers to the process of having a child or children through naturally conceived pregnancy, assisted reproduction with the aid of medical technology, or through social services such as adoption or foster care. Assisted reproduction options available to LGBTQIA+ individuals and couples include donor gametes, intrauterine insemination (IUI), in vitro fertilization (IVF), reciprocal IVF, and surrogacy (use of a Gestational Carrier).

Donor Gametes

Donor gametes involve selecting donor sperm, donor egg, or donor embryo to facilitate the reproductive options outlined below. Individuals or couples can select a donor through a donor bank, which provides information about the donor, often including a picture, demographics, medical history, family of origin information, and sometimes personal narratives. Alternatively, individuals and couples can have a person in their life, such as a family member or a friend, donate their sperm or eggs directly.

Intrauterine Insemination (IUI)

IUI is the assisted reproduction process of placing sperm cells into a person's uterus during peak ovulation. To achieve the necessary levels of LH hormones during ovulation, many doctors will prescribe ovulation-stimulating drugs that can be taken orally or injected. Sperm cells can be from a partner or donor as described above. It is a less invasive procedure done in a doctor's office where the sperm is deposited into the uterus by a catheter through a speculum.3

In Vitro Fertilization (IVF)

IVF involves the creation of an embryo in a laboratory and the transfer of the embryo into the uterus through the cervix.3 Embryos can be made with the gamete(s) of one or both partners or with donor egg or sperm. Before the embryo transfer, the embryos are monitored to verify they are growing, and a round of genetic testing is completed. Using existing donor embryos will cut this laboratory period out of your fertility journey, and can streamline this process.

Reciprocal IVF

Reciprocal IVF is another option for a lesbian couple or a trans man, where a partner has a functioning uterus. An embryo is created from one partner's egg and a sperm donor or from one partner's sperm and donor egg. This embryo, which has a biological relation with one partner, is then transferred into the opposite partner's uterus.This type of IVF process allows both partners to take part in the gestation of their future child.

Surrogacy (use of a Gestational Carrier)

Surrogacy involves an individual or couple (the Intended Parent(s)) working with a gestational carrier. A gestational carrier is a woman who carries a child for another couple. Embryos made with one's own gametes and a donor egg/sperm or a donor embryo are transferred into the gestational carrier.

How Ebb & Flow Counseling & Coaching Can Help 

Ebb & Flow Counseling & Coaching offers counseling services to LGBTQIA+ individuals navigating their fertility journeys or new parenthood. Additionally, we offer consultations required by fertility clinics for intended parent(s) using donor eggs, sperm, or embryos, or planning to use a gestational carrier. We understand that third-party reproduction can bring about uncertainties and anxieties. Our sessions offer a safe environment to explore feelings of identity, attachment, and familial connection. Developing coping strategies with one of our licensed mental health professionals can help you navigate the emotional and relational dynamics involved in your journey to parenthood.

Ebb & Flow Counseling & Coaching also conducts psychological evaluations for individuals interested in becoming gestational carriers to assure their psychosocial readiness to take on the responsibility of carrying someone's child. We also hold group sessions with Intended Parent(s) and their gestational carrier so that all parties can share concerns openly, ensuring the journey goes as smoothly as possible.


The journey of third-party reproduction is a deeply personal and transformative experience. We are here to help you navigate the psychosocial aspects of LGBTQIA+ families' path to parenthood. We're dedicated to equipping you with the knowledge and tools you need to embark on 3rd party reproduction, ensuring you feel informed and supported.


Q: How can LGBTQIA+ individuals choose the right donor?

A: Choosing the right donor involves considering factors such as medical history, physical characteristics, and personal values. Consulting with a fertility specialist can also provide valuable guidance.

Q: What are the legal considerations for surrogacy in LGBTQIA+ family-building?

Ebb & Flow's LGBTQ Family Building Resource List

Ebb _ Flow LGBTQ Family Building Resources
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