What Happens if There is Infertility?

Co-Written with C.J. Fitzpatrick

“First comes love, then comes marriage, then comes baby in a baby carriage” Nursery Rhyme

For most heterosexual couples, that’s how they expect marriage to go. I, for one, expected that when we started trying it would just happen – immediately, with little or no effort. It took some time, more than I expected, but happen it did. I believe that had it not, I would have been devastated.

According to the CDC, among married women aged fifteen to forty-nine years with no prior births, about one in five are unable to get pregnant after one year of trying, which is the clinical definition of infertility. Despite such a staggering statistic, people tend to put little forethought into the possibility that this might happen to them and are therefore unprepared if and when it does.

This is definitely a conversation worth having, seeing as a study done by the medical journal Obstetrics and Gynaecology found that following unsuccessful fertility treatments, couples were three times more likely to end their relationship than couples whose treatments were successful.

Not everyone enters into a long-term relationship with the intention of having children. This is a good question to start off the conversation: do we want to have children at all? Some people enter into marriage without even having put much thought into the matter. They assume their partner is simply on the same page as them. Sometimes, couples have had the conversation, know they’re on different pages, and simply assume the other will change their mind. There are likely couples who have entered into marriage knowing their partner is on a different page, said they will think about it, all the while knowing they’re never going to change their mind. Is this fair?

Should infertility become an issue, how devastated would you be? Is having children a dealbreaker for you? Infertility can affect one partner, but not the other, or be an issue for both partners. Would you stay with someone if they were the problem, but you were fully capable of having children?

It seems that women are often more willing to accept that they’re the ‘problem’ – and therefore more willing to seek treatment options – while men may have more difficulty accepting their infertility. Oftentimes, a man’s virility is seen as being a sign of his ‘manliness’ and when infertility strikes them, they may feel as if they’re less of a man and it becomes a very shameful secret. Would this become an issue for your relationship, should this happen to you?

It’s also worth mentioning here that this is an issue that equally – if not moreso – affects LGBTQ+ couples for whom there isn’t always the luxury of an unassisted pregnancy.

1. Are you aware and prepared for the costs of fertility treatments? Have you considered additional expenses, such as travel costs, etc.

2. Are you aware of the different types of fertility treatments and are you open to any/all of them?

3. Do you have a limit of what you’re willing to spend and/or try? What is your time frame for trying?

4. What if the treatments are unsuccessful?

5. Is adoption something you’ve considered and are comfortable with?

6. Would you be willing to adopt an older or disabled child?

7. Would you use a surrogate if fertility issues only effected one member of the couple?

8. If you had a child that biologically belonged to only one member of the couple, would you feel differently towards that child?

9. Would you feel comfortable talking openly about your fertility issues or would it be secretive?

10. How would you feel about fostering children?

11. If you’re going the adoption route, would you want to adopt from a foreign country?

LGBTQ+:

12. Would you both want to try to become pregnant?

13. Would you want the sperm/egg donor to be someone you know?

14. If you’re using a known donor, are you prepared to accept that person’s medical history?

15. Have you done research into the laws concerning biological parent rights?

16. Should you later split up, how will you navigate the legalities if one person is biologically related to the child and the other not?

17. If using a known donor, would they have a role in the child’s life? Would you tell the child and if so, when?

Having a child is a serious decision and it’s not one that should be made lightly. Facing infertility can then feel like navigating a field of landmines, but the first step should be having conversations long before it ever becomes an issue.

Have You Explored How Having Children Can Impact a Relationship? Part II

Guest Post: C.J. Fitzpatrick

If you read the previous article on how having children can impact a relationship, you probably have a pretty clear idea of some of the questions you should ask. This section, will address the same question, but from a perspective of the queer community.

If you’re in a same-sex relationship, the issue of having children is one that will require much more thought and preparation than it does for your friends in heterosexual relationships. It’s simply not going to ‘just happen’...

There’s likely three routes that you’re going to see your relationship take:

1. You decide children aren’t a want or need for you.

2. You know children are wanted, but you either can’t become pregnant, don’t want to be pregnant, or can’t afford the medical intervention necessary to become pregnant and therefore decide to adopt.

3. You want children and one or both of you are prepared to become pregnant.

All of these are equally valid. But let’s look more in-depth at the latter two options.

Studies have found that queer couples and heterosexual couples experience similar levels of stress when becoming parents, as many of the aspects (such as sleep deprivation and less time spent as a couple) are the same. Of course, there are added aspects that make the experience different... For example, there are matters of ‘legal invisiblity’ that result when only one parent is able to be legally considered the child’s parent. As well, there is the issue of homophobia among doctors – the 2006 study by Goldberg found that as many as twenty percent of lesbians experience homophobia when trying to conceive.

While most heterosexual couples seem to divide household labour based on ‘gender roles’, research has largely found same sex couples divide labour in a more egalitarian fashion (Farr & Patterson, 2013). Research seems to suggest that, in lesbian couples, the biological mother does more of the childcare labour (Patterson et al., 2004); on the other hand, in gay couples, the biological father is not more likely to perform these same tasks. It has been proven that sharing in household and childcare tasks provides more satisfaction in a relationship, regardless of the genders involved in said relationship.

While it’s important that couples looking towards having children ask a lot of questions, such as parenting styles and division of labour, there are a number of questions that are unique to same sex relationships.

Before even beginning on the journey, a couple should do research into the different methods of growing their family – i.e. adoption vs. insemination – and each method’s strengths and challenges. Among these concerns are cost, availability, and legal matters.

An important conversation to have is how to manage and cope with stigma and discrimination that will inevitably be faced. Regardless of how understanding a society you live in, there will always be people who disagree with your lifestyle. A 2015 study by Sabin et al. has found that heterosexual health care providers have in implicit bias that favours heterosexual individuals – this bias will effect the way in which they treat their same sex patients during their conception journey. Experiences such these have a strong impact on the mental health of prospective parents.

One of the things that counteracts such discrimination is having a strong social network (Goldberg & Smith, 2011). It’s important to build up such supports – from family, neighbours, church, etc. - before a child comes along.

Having children as a same sex couple is never going to be as simple as it is for the average heterosexual couple, but take heart! A three year follow up after assisted reproduction (Borneskog et al., 2014) found that lesbian couples reported stable relationships and a high satisfaction with their relationship. As well, in 2012, Huebner et al. found that, among gay couples, there was increased commitment to each other and their relationship following children.

As a note: an excellent resource for lesbians looking to have children is The Essential Guide to Lesbian Conception, Pregnancy, and Birth by Kim Toevs.

Are You Ready for Children Worksheet - Non-Traditional Families

 Lesbians:

1. Do one or both of you want to carry a child? Who will go first?

2. Whose eggs will you use?

3. Will you use IUI or IVF?

4. Do you want to use a sperm donor who is known to you or a stranger?

5. If using a known donor, do you want them to be part of your child’s life? Are you prepared to negotiate a legal contract to make your wishes clear?

6. Do you want to use a sperm donor who has similar looks to your partner?

7. Is the non-birthing partner prepared for the child potentially being more bonded to the birthing person?

8. How will you negotiate the legal issues involved in making sure both parents go on the birth certificate (if any exist)?

9. Does the non-birthing partner want to breastfeed as well?

10. How will you deal with homophobia that comes up during and after the process of assisted reproduction?

11. Do you have a strong support network?

12. If pursuing adoption, how will you deal with the homophobia that may come up during the adoption process?

13. How and when will you have the discussion with your child about why their family is different?

Gay Men:

1. Who will you choose to be your surrogate? Do you want someone you know or a stranger?

2. Do you want the surrogate to also donate eggs or will you do that separately?

3. Do you want the egg donor to be a part of your child’s life? Are you prepared to negotiate a legal contract to make your wishes clear?

4. Who will donate sperm?

5. Do you want to use an egg donor who has similar looks to your partner?

6. Do you want to be present for the birth? How involved do you want to be during the birth?

7. Do you want/expect a say in how the surrogate chooses to give birth?

8. How will you negotiate the legal issues involved in making sure both parents go on the birth certificate (if any exist)?

9. Will you ask the surrogate to donate breast milk? If possible, would you want to induce lactation to breastfeed the child yourself? (Yes, this is possible!)

10. How will you deal with homophobia that comes up during and after the process of assisted reproduction?

11. Do you have a strong support network?

12. If pursuing adoption, how will you deal with the homophobia that may come up during the adoption process?

13. How and when will you have the discussion with your child about why their family is different?

Transgender:

1. How will you deal with any dysphoria that may come up during pregnancy?

2. Is your healthcare provider knowledgeable in transgender pregnancy?

3. As a trans man, are you prepared to stop taking testosterone to get pregnant?

4. How will you deal with the stares and conversations that will come with being a pregnant man?

5. Have you done research into trans pregnancy?

Do They Respect Your Bodily Autonomy?

 Co-written with: C.J. Fitzpatrick

The issue of bodily autonomy is hardly a new one. “My body, my choice” – a slogan for female bodily autonomy was first coined in 1969, but the struggle clearly predates the so-called ‘second wave’ feminist movement started largely by Betty Friedan’s The Feminine Mystique.

Even so, a United Nations Population Fund report published in 2021 found that roughly half of all women are denied bodily autonomy, unable to make decisions regarding sex with their partner, contraception, and seeking health care.

This has been thrown into even sharper relief lately as debates concerning overturning the 1973 Roe vs. Wade Supreme Court decision rage on in the United States...

Let’s make it clear, though, that bodily autonomy is not purely an issue of those that identify as women. It’s an issue that concerns all genders – male, female, and nonbinary; not only cis-gendered people, but trans people as well.

Bodily autonomy is one of those things that you really don’t think all that much about...until it’s violated.

The first thing that comes to mind when you read the previous sentence is probably rape which is, of course, the most clear and obvious form of violated bodily autonomy. But there are many many ways in which one’s bodily autonomy can be violated that, while perhaps less severe, are no less insidious.

For example, there was recently a post on the ‘Am I the Asshole’ Reddit board in which a woman described an issue she had with her partner telling her not to use tampons because they made him uncomfortable... He even went so far as to throw out a box of her tampons when he found them. This is a clear example of someone not being allowed to exercise their bodily autonomy.

In a relationship – any relationship, not just a romantic relationship – both partners should respect their own and each other’s bodily autonomy. It’s impossible to be equals if one partner looks upon the other as something they have control over.

In the 1800’s and earlier, it was simply a fact of life that a woman was a man’s property, but the simple fact of the matter is that, through today’s lens, it’s abuse to try to control another’s body and the choices they make about it.

Psychologist Willard Harley Jr., in his practice, has identified ten needs that, when fulfilled, will ‘affair proof’ a marriage. One of the needs he asserts that – as a general rule – men have is an attractive spouse. While I admire much of what Harley has to say, I feel his advice in this chapter is antiquated. He says, “If he doesn’t like a certain hairstyle and colour, abandon it. In fact, consult with him ahead of time and get his opinion before ever getting a different style or colouring.”

Would you put up with a friend that felt the need to tell you what you could and couldn’t do with your appearance? Unlikely. It should, therefore, be just as egregious when a partner tries to do the same.

We expect a partner to respect our wants and needs. This should extend to choices we make about our body as well. That’s really what it boils down to: respect. Does your partner truly respect you as an individual if they feel the need to monitor your social media or your diet or your doctor’s visits?

Marriage vows often include phrasing along the lines of ‘becoming one’. But at the end of the day, you’re still two separate people with separate wants and needs and it’s important that both of you remember that, even when they get an ugly haircut or a new tattoo.

Can a Relationship Work if One Partner is Still in the Closet?

Guest Post: C.J. Fitzpatrick

If you’re a person whose identity falls somewhere under the LGBTQ+ umbrella, you’ve most definitely – at some point in your life – struggled with the quandary of if/when to come out of the ‘closet’... (If you’ve never heard this term before, it means making the choice to openly and publicly identify as queer.)

Coming out is a very vulnerable – and sometimes dangerous – experience for someone, as it may mean losing friends and/or family or even risking physical harm, in some cases. Even when someone’s new identity is fully embraced, it is often still met with a degree of sadness, as parents likely mourn the loss of their child’s imagined future or experience grief knowing that their child’s path will be more difficult.

Coming out is a life-long process. It’s not a one and done thing. In a quote I can no longer find, Sir Ian McKellen talks about how every interaction involves an internal debate about whether or not to address the fact that you aren’t straight, as is assumed to be the default.

A 2019 study by the Yale School of Public Health found that as much as eighty-three percent of the world’s LGBT+ community hides their identity from all or most of the people in their lives. John Pachankis, Ph.D., associate professor of the YSPH said, “Given rapidly increasing acceptance of the sexual minorities in some countries, it might be easy to assume that most sexual minorities are out in 2019, but actually, most sexual minority people in the world today are probably not out.”

Keep in mind, this number may be skewed by the populations of LGBT+ people in countries where same-sex attraction is criminalized and often brutally punished. As well, certain identities – such as gay and lesbian – are more universally accepted than identities such as being transgender.

It’s hard enough to make a relationship work when both of the participants are open about their sexual identity, which begs the question: is it possible for a relationship to work long-term if one partner is still closeted?

My personal feeling is that this answer is going to look different for every individual couple.

First, let’s divide people into two categories: those who place a high importance on queer visibility and those who would rather avoid the attention.

The former category tends to feel that, since a straight couple doesn’t have to hide their relationship, why should a queer couple? Since we’re supposedly all equal, we should be able to act and, therefore, be treated as such. They’re the kind of person who is likely to attend a Pride march or a protest for LGBT+ rights.

The latter is likely someone who prefers not to rock the boat, so to speak. This doesn’t mean they don’t wholly support the fight for LGBT+ rights and may even be involved in the fight, but it’s more likely in a behind-the-scenes manner. This may be because they’ve faced discrimination in the past or they may simply be a quiet, meek person.

Let’s also look at the closeted partner’s situation – namely, whether it’s safe or unsafe.

People have many reasons to stay in the closet, but oftentimes, it boils down to whether it’s safe for them to be out. I, personally, have the great privilege of living in a country where it’s illegal to discriminate against someone based on their sexual preferences; but I have the even greater privilege to have family who supports and celebrates my identity. Many people do not – even if they live in a country where they won’t be jailed or stoned for being publicly out, they may face being kicked out of their house, disowned by their family, or even outright physical violence.

It’s easy to understand why someone might choose to stay in the closet when the alternative may be living on the streets or being beaten or subjected to conversion therapy (which, by the way, is still legal in Canada!).

So, with all that in mind, let’s address the central question here...the answer being: how important is it to you that you can attend a Pride march with your partner? How important is it to you that you that you can walk down the street holding hands? Would you feel badly if your relationship caused strife between your partner’s friends and family?

Once you’ve answered those questions – and evaluated how important your partner is to you – then can decide whether this relationship is going to work out.

Coming Out of the Closet - Worksheet

 In the space below, define what SAFETY means to you:

On a scale of one to ten, how SAFE do you feel your situation is, in regards to your sexual identity?

On a scale of one to ten, how SAFE does your partner feel their situation is, in regards to their sexual identity?

On a scale of one to ten, rate how important the following activities are to you:

1. Attending Pride events, including marches:

2. Attending protests for LGBT+ rights:

3. Holding hands in public:

4. Kissing in public:

5. Introducing your partner to your friends and family:

6. Being introduced to your partner’s friends and family:

7. Introducing your partner to people as your significant other:

8. Living together:

9. Getting married:

10. Having and/or adopting children:

11. Being your partner’s legal next of kin/power of attorney/etc.:

Are any of the above activities dealbreakers to you, if you were unable to have/do them?

Does your partner have a timeline for when they anticipate being able to come out? Is the timeline acceptable to you, based on your current goals and desires for the future?

Could You Be With Someone Who Identifies as Asexual?

Guest Post: C.J. Fitzpatrick

Everyone enters into a relationship – whether it be romantic, platonic, or otherwise – seeking to fill a need. When you apply for a job, you’re filling a need. When you make a friend, you’re filling a different need. And, most pertinent to this blog, when you seek out a romantic partner, you’re looking to fill, likely, many needs.

Sometimes this need is companionship, someone with which you can spend time to ease the sense of loneliness in one’s life. Sometimes, the need relates to one’s ticking biological clock. And, oftentimes, this need is largely physical...namely, sex.

We’re taught that this is normal, a need we’re hardwired to try to satisfy. Especially in the beginning of the relationship when everything is new and hormone-fuelled.

But a growing number of people – especially millenials and subsequent generations – identify with the umbrella term: Asexual. Simply put, it means someone who doesn’t experience sexual attraction. (This is juxtaposed with someone who is aromantic, meaning they don’t experience romantic attraction. And yes, it is possible to be both.)

There are different labels that fall under the Asexual category, including, but not limited to: demisexual (someone who only experiences sexual attraction after a deep emotional connection has been formed) and grey ace (someone who very rarely experiences sexual attraction). It’s important not to confuse the term with celibacy which is when someone makes a conscious choice to abstain from sex, but may still experience sexual desires.

Just to be clear, just because someone doesn’t feel sexual attraction, doesn’t mean that they can’t – or won’t – have sex. Sexual action is different than sexual attraction and one doesn’t necessarily require the other. There are any number of reasons someone who identifies as ace may choose to have sex, such as to satisfy their partner or procreation.

On the other hand, an asexual person may identify with the term ‘sex repulsed’, in which case they’re unlikely to ever have sex, though they may still masturbate, depending on their personal attitudes and needs.

A 2016 survey querying people aged eighteen to thirty found that sixty-three percent identified with the label of female, eleven percent with the label of male, and twenty-six percent with neither identity. According to the Canadian psychologist Anthony Bogaert, “...women will be more likely than men to be asexual because they are, on average, less likely to have had conditioning experiences relevant to sexual orientation development.”

Loosely interpreted, Bogaert is saying that during prepubescence and puberty, those people who identify as men often experience both positive and negative reinforcement pertaining to their sexual identity. They may be rewarded when they show affection – or even outright sexual attraction – to the opposite gender and punished for the opposite.

We can suppose, based on this information, that in a relationship between a man who experiences sexual attraction and a woman who identifies as asexual, the male partner would be more likely to have a difficult time adjusting to the potential lack of physical intimacy than a female partner would if the situation were reversed.

If your partner identifies as asexual, there are a number of questions you should ask yourself:

1. How important is regular sex to me?

2. If I could never have sex with my partner, would I feel in some way short-changed?

3. Could my sexual needs be satisfied by masturbation alone? Is non-sexual intimacy enough?

i. Non-sexual intimacy can take on many forms – for more information, see the following worksheet.

ii. Non-sexual physical intimacy can include: holding hands, cuddling, kissing, hugging, massages, and more.

4. Would I feel the need to cheat if sex were not an option with my primary partner?

5. If my partner were only participating in sex to satisfy my needs, would I feel in some way guilty or as if I were pressuring them into sex?

Obviously, these are just a few of the questions to be asked and discussed with your partner.

As a final note, here are a few questions you can ask yourself if you’re suddenly wondering if you might be asexual:

1. How do I define sexual attraction? What does the concept mean to me?

2. Do I experience sexual attraction?

3. How do I feel about the concept of sex?

4. Do I feel the need to be interested in sex because it’s what’s expected of me?

5. Is sex important to me?

6. Do I see attractive people and feel the desire to have sex with them?

7. How do I enjoy showing affection? Does sex factor in?

What Does Intimacy Mean to Me - Worksheet

 In the space below, define what intimacy means to you:

In the space below, define what you think intimacy means to your partner:

On a scale of one to ten, rate the following forms of intimacy based on their importance to you in a romantic relationship:

1. Experiential Intimacy (bonding through leisure activities):

2. Emotional Intimacy (bonding through sharing feelings):

3. Intellectual Intimacy (bonding through sharing ideas and opinions):

4. Physical Intimacy (bonding through physical contact, often sex):

5. Spiritual Intimacy (bonding through sharing common values and beliefs):

6. Creative Intimacy (bonding through creating together):

7. Crisis Intimacy (bonding through shared experiences of pain and/or difficulty):

Of the above forms of intimacy, choose the three that you believe are essential to your relationship working:

1.

2.

3.

Of the above forms of intimacy, choose the three you believe your partner would think essential to your relationship working:

1.

2.

3.

What is the one form of intimacy that would be a dealbreaker for you if you couldn’t have it?