With enhanced access to reproductive technologies and adoption for same-sex parents over the past few decades, the “gayby boom” has ushered in significant opportunities for LGBTQ+ people to build families. However, the reproductive challenges LGBTQ+ families continue to face have received little attention. In fact, these have been exacerbated by increasingly restrictive laws regarding LGBTQ adoption and family recognition following the 2016 elections. Moreover, experts estimate that a quarter of all pregnancies end in loss, and a similar number of adoptions fall through; 12% of US women are diagnosed with infertility and transgender people are often faced with difficult reproductive decisions relating to transition. With the rise in LGBTQ+ family-making, the numbers of reproductive losses—through miscarriage, stillbirth, failed adoptions, infertility, and sterility—have also increased. LGBTQ+ (intended) parents face multiple layers of invisibility and isolation as they combat the well-documented cultural silence surrounding reproductive loss, in addition to heteronormative assumptions about who should have children. Even among those who support LGBTQ families, there is often political silencing of queer family-making narratives when they do not produce a “happy ending.” Craven’s study of over fifty LGBTQ people (including those who carried pregnancies, non-gestational and adoptive parents, and families from a broad range of racial/ethnic, socio-economic, and religious backgrounds) considers how they experience loss, grief, and mourning. This case study drawn from that study presents three examples that highlight the need for more inclusive support resources.

Following the 1990s “gayby boom,” LGBTQ+ people have had unprecedented access to assisted reproductive technologies (ART) and adoption opportunities. Queer people have a long history of creating family in many different ways, including “chosen families” among adults (and sometimes children) who may or may not be biologically related. Yet with the enhancement of legal rights in recent years, such as same-sex marriage, many LGBTQ+ people are feeling more pressure than ever to form families that include biological and/or adopted children. As several participants in my study commented: “After we got married, the next logical question from our families and friends was ‘When will you have kids?’”

While these options are continually under attack by conservative lawmakers—particularly with the rise of conservatism following the 2016 election—LGBTQ+ family-making is also politicized within queer communities by progressive efforts to create a seamless narrative of progress towards enhanced marital and familial rights. These contentious political battles often eclipse the challenges and barriers LGBTQ parents face in establishing and gaining recognition as families.

Although estimates vary substantially by country, US physicians and public health experts estimate that 10–20% of all recognized pregnancies and 30–40% of all conceptions end in pregnancy loss. The knowledge that a pregnancy has ended is likely higher for LGBTQ+ people who are often intentional in planning their families, and thus more likely to be doing early home pregnancy tests than many of their straight peers. However, public perception regarding pregnancy loss differs substantially from public health estimates. A 2015 survey of over 1000 US adults showed that 55% thought miscarriage was rare (occurring in 5% or fewer pregnancies). In addition, 12% of US women are diagnosed with infertility, and fertility preservation options are not always made available to transgender people considering hormones or surgery. Likewise, although statistics on what adoption agencies euphemistically refer to as “disruptions” to the adoption process are not kept nationally in most countries, a US-based review of studies among different populations estimate adoption failure rates of 10–25%.

In this case study, I present three stories from LGBTQ+ parents that highlight the need for more inclusive support resources. These are drawn from over fifty interviews with LGBTQ people who experienced loss, including those who carried pregnancies, non-gestational and adoptive parents, and families from a broad range of racial/ethnic, socio-economic, and religious backgrounds. In many cases, stories of loss, death, and reproductive challenges that accompany queer family-making are ignored or silenced both within and outside LGBTQ+ communities, resulting in personal and political isolation.

Alex and Nora’s Story

When I spoke with Alex and Nora, they had experienced a second trimester loss less than a year before. Although Nora, a cisgender lesbian, had physically carried their first daughter, she had developed health complications that made another pregnancy dangerous for her health. The couple had agreed that Alex, who had previously identified as an “FtM [female-to-male] transman” but adopted a “genderqueer lesbian” identity after becoming pregnant would carry their next child. Alex was pregnant at the time of our interview, and Nora explained how her experience of their loss was not only a physical and emotional one, but one that was complex both personally and legally.

In losing our daughter … I lost not only a biological and a physical connection […] I also lost the ability to have legal rights [to our future children], to have my name on this child’s birth certificate […] I’m not even going to be able to petition for that [where we live].

In 2011, Nora would have had no legal rights to their child born by Alex since the couple lived in a state where non-gestational queer parents were denied access to “second-parent” adoption of their children. The fact that Nora would have had to formally adopt in any jurisdiction and be evaluated on her “fitness as a parent” was devastating.

Nonetheless, the couple continued to consider the viability of pursuing legal adoption in another state or country and then returning to their home state to request a reissued birth certificate that would recognize both of them as legal parents. Unlike the non-recognition of same-sex marriages or civil unions across US states prior to federal recognition in 2015—and countries in cases where laws do not permit same-sex unions—adoptions are recognized across jurisdictions. However, as a fulltime graduate student, and with Alex’s income as an administrative assistant, financial instability left the couple unable to pursue this option in order to give both of them legal status as their future child’s parents.

Although the couple lived in a liberal midwestern town, the homophobic state and federal laws that governed Nora’s relationship—or lack of legal relationship—with the child born by her partner heightened her experience of loss. Both encountered silencing within queer communities following their loss that resulted in feelings of isolation. As Alex explained, LGBTQ+ reproductive loss “complicates the political rhetoric. It’s the same reason you don’t hear about gay divorce, because it complicates the political rhetoric of trying to get marriage equality.”

There have been significant changes in the legal landscape for LGBTQ couples and families over the past decade, both in the US and throughout the world. After the national recognition of same-sex marriage in 2015 following the Obergefell v. Hodges US Supreme Court case, many LGBTQ parents assumed that the presumption of parenthood (that individuals in a marital union are both legal parents to any child born within that union) would be extended to lesbian and gay married couples, as it is for heterosexual couples. However, legal precedent on this issue has been inconsistent, which can leave LGBTQ families—even those formed within legal marriages—vulnerable in ways that heterosexual married couples are not. Additionally, any children born to same-sex parents outside of a legal marriage must still be formally adopted by the same-sex “second parent.” In the case that the couple legally marries (or their marriage becomes legally recognized) after the child (or children) are born, a “step-parent” adoption is required.

As of April 2019, only 15 states allow unmarried parents to petition for second parent adoption. Laws also exist that allow discrimination against LGBTQ parents by adoption agencies citing religious beliefs against same-sex parenting in some states. In 2019, US legal experts in the American Bar Association (ABA) acknowledged that despite the federal recognition of same-sex marriage in 2015, “state-sanctioned discrimination against LGBT individuals who wish to raise children has dramatically increased in recent years.” Among adoptive parents, many also expressed the fear that homophobia and heterosexism within adoption agencies and among birth families meant they had a higher likelihood of “disruption” than heterosexual couples.

Mike’s Story

Mike shared a particularly heart-breaking story about suffering the loss of twins in an open adoption. He and his then-partner Arnold had travelled to Vermont to get a civil union during the 1990s and began the adoption process shortly afterward in their home state that didn’t legally recognize their relationship. With their stable jobs and multi-racial family—Mike a white paediatrician and Arnold an African American high school teacher—the adoption agency they worked with thought they were an ideal family to place bi-racial twins, whose 18-year-old mother had two children already and was living in a battered women’s shelter. They moved forward with an open adoption, meeting with the birthmother on multiple occasions, and attending all doctor’s appointments. When the twins were born, the names that Mike and Arnold gave them appeared on their birth certificates. They spent ten days at home with the twins, but on the tenth day—the last day that birthmothers in their state could legally reclaim their children—at 30 minutes to midnight, the call came.

When Mike and Arnold later spoke with staff from their adoption agency, they explained that the birthmother had contacted the biological father of the twins, whom she had been estranged from for months, to tell him that she had put them up for adoption to a gay male couple. He did not approve of having a gay couple raise the twins and convinced her to reclaim them. Despite several desperate calls she later made to Mike and Arnold pleading with them to take the children, the adoption was never formalized. Arnold had struggled with depression previously, but after losing the twins, he began to abuse drugs and alcohol and was unable to return to work. Ultimately, after two years, his addiction led to the end of their relationship.

When we spoke, Mike had recently begun the adoption process again as a single man. This time, however, he was pursuing the adoption of an older child:

… in the foster system, with parents whose parental rights had already been terminated […] I don’t want the chance of a birth parent reclaiming again. There’s no way I could do that again […] It was like they [the twins] had suddenly died. One minute they were here and the next hour they weren’t here. It was horrible.

Yet, as many adoptive parents told me, what was sometimes most difficult about their losses was that the child had not died and that their heartache couldn’t be “a pure sense of grief or loss” that one might experience mourning the death of a loved one. Rather, the child they had come to know and love was “out there somewhere” and that knowledge created ongoing questions and multi-layered grief.

Mike’s story is one of multiple interlocking losses and demonstrates how reproductive losses do not always involve the death of a child, nor are they centered solely around the absence of that child (or children) in one’s life. LGBTQ adoptive parents, as well as those who experienced pregnancy loss, infertility, and sterility frequently spoke about the “loss of innocence” that shattered their initial expectations of linear progress surrounding reproduction. Reproductive losses can also result in the loss of dreams for particular kinds of family, as Vero’s story highlights.

Vero’s Story

When Vero came out in the late 1970s, she initially thought she didn’t want to have kids. She explained when we connected over Skype, “I waited longer than I should have … being gay, being raised in a Hispanic Catholic family, I didn’t even see it as a reality.” Coming out prior to the 1990s “gayby boom,” and then leaving home as a teen to serve in the US Army for ten years, like many other LGBTQ people who grew up during this time, she felt that forming a family would not be an option for her. But as she found a more supportive community, and many of her LGBTQ friends began having kids, “it started to feel like a reality.” Although she didn’t initially wish to carry a child, when she desired children with a long-term partner who was unable to carry, she decided to begin monitoring her ovulation. A year and a half later, that relationship had ended …

But I kept thinking about it, and thinking about, and thinking about it and decided that that was something I really wanted with or without that relationship. So, I went on with the process. I had a donor. Everything was a good to go […] And so, I went to get a physical and during that physical was when they found my cancer. And so, it quickly became–, I was staged pretty high and so that quickly became the focus. Even though it [having a baby] was sitting in the back of my head, it was more about getting it [the cancer] staged, having biopsies, and starting treatment, blah blah blah. So, all of that kind of consumed me … I didn’t have to think about it [losing my ability to conceive] right away. But then that came. ((fighting back tears)) I still get emotional about it.

At the time, Vero’s doctors estimated that because of the advanced stage of her cancer, she would have between three months and ten years to live. Although well-meaning friends suggested she consider adoption after initial chemotherapy treatment seemed successful, Vero felt that would not be fair to the child because of the uncertainty about her future health. When I asked Vero how she did cope once she was able to focus on her experience beyond the immediacy of her cancer treatment, she spoke about struggling, “because some people don’t even see my experience as a loss, because I never conceived.” She also recounted complex feelings that others struggled to understand:

Once all of the dust settled [after three years of chemotherapy and experimental treatment], I felt very grateful. I mean if it hadn’t been for this child that I had already named, but that I never had, I wouldn’t even be here. ((through tears)) I think what helped me find peace in it all was the gratitude that I was still here and in the last sixteen years that my life would have been completely different. It took a really different turn … not a 180, but at least a 45-degree angle ((laughing)). It gave me more time to be with all of my friends’ kids … If I’d waited any longer than I did to get my physical, I probably wouldn’t have made it, period. It kind of gave me a different gift. It hit me in a bunch of different ways and it still hits me every once in a while. I was thinking about it just yesterday: that kid would probably have been 14 or 15 by now, and how different my life would be … just completely different.

Vero’s experience underscores not only the depth and complexities of losing one’s dream of family, but also the ways in which grief can shift and evolve over time. As others have frequently echoed, “it never leaves you.”

Together, Alex & Nora’s, Mike’s, and Vero’s stories paint a vivid picture of the multiple interlocking losses that frequently accompany the loss of a child or dreams of a child. LGBTQ parents face general social taboos about discussing reproductive loss, but these expectations are frequently magnified by the legal and political barriers they face in gaining recognition as families. Additionally, they face pressures within LGBTQ communities where stories of loss are often silenced in efforts to present a political vision for LGBTQ progress.

More inclusive support resources that embrace the diverse realities and challenges of forming LGBTQ families are necessary to better support bereaved LGBTQ+ individuals and families. A notable outcome of my study was that over half of the participants faced financial struggles in their efforts to expand their families. Most felt that the urgency to become pregnant or adopt again after a loss drove them to invest more (both financially and emotionally) in those efforts. Yet many discussed this with a great deal of ambivalence, for fear that it would detract from the emotional loss they experienced. Their stories challenge the assumed affluence of LGBTQ individuals who seek to expand their families, even among those who do so via expensive ART procedures and adoption.

As a queer parent who found few resources after my own second trimester loss and bore witness to the ways that my partner was further isolated as a non-gestational parent, this project has always had a public focus. When I published Reproductive Losses: Challenges to LGBTQ Family-Making, I launched a companion website—http://www.lgbtqreproductiveloss.org—an interactive and expanding resource for LGBTQ+* individuals and families. Readers can access an archive of commemorative photos and stories, as well as advice to both LGBTQ parents experiencing loss, and those who support them. But there is far more work to be done to challenge the silencing and isolation surrounding reproductive loss and create opportunities for sustained dialogue among LGBTQ+ (intended) parents, medical and adoption professionals, and other support professionals to acknowledge the ways that grappling with grief and mourning—particularly in a moment of legal and political uncertainty—is inescapable for many queer people.