When Ben Enfield went on his third date with Chris Lydick, he asked three questions to see if their budding relationship was headed in the right direction. Did Lydick want to be in an exclusive relationship? Did he want to have children someday? And would he be willing to take lots of hikes? “Hiking is one of my favorite things to do in life,” says Enfield. “So I needed to make sure he would be willing to hike with me. I’m lucky: He said yes to all three.”
Shortly after that date, Seattle-based Enfield and Lydick began to think through their options when it came to having children. While they realized that it is still very tricky for LGBTQ couples to start families, neither of them was totally prepared for the two-year-long quest they were about to embark upon to have a baby. It involved multiple trips to Mexico to visit adoption agencies, and when they finally settled upon surrogacy, identifying an egg donor, paying for her to freeze her eggs, flying around the country to meet potential surrogates, working through her IVF treatment and pregnancy, and hiring many, many lawyers.
But it was all worth it in the end. Enfield and Lydick recently celebrated the first birthday of their baby boy, and despite the sleepless nights, diaper changes, and the general chaos in their lives, they are happier than they have ever been. (They often bring the little one with them on hikes throughout the Pacific Northwest.)
The cost of becoming an LGBTQ parent
Enfield and Lydick admit that getting here wasn’t easy. Not only was the process of having a baby complicated and exhausting, it was much more expensive than they could have imagined from the outset, to the tune of $150,000.
Both Enfield and Lydick work for progressive employers. Enfield, a senior structural plans engineer for the City of Seattle, received three months of paid paternity leave, while Lydick, the director of data architecture, systems, and solutions at telecom giant T-Mobile, received three weeks of paid paternity leave, plus $13,400 of expense reimbursement for surrogacy, which helped defray some of their expenses.
While it is just a drop in the bucket for a couple who have a baby through a surrogate, Enfield and Lydick were grateful for a policy that was applied to all employees regardless of sexual orientation or title. “The policy applies to all workers at the company, from engineers like Chris all the way to a retail worker in a store,” Enfield says. “It helped us defray some expenses for sure. But for someone who earns less than we do, it could be the difference between choosing to have a baby or not.”
And the couple realize they are very lucky, because most American companies–and the insurers they partner with–still do not have fertility benefits for LGBTQ couples. Nor do most men get paternity benefits, which can make it very hard for gay couples who have just adopted a child or had a baby through a surrogate.
The rise in fertility benefits
Back in 2014, Facebook created a groundbreaking policy that covered the cost of egg-freezing treatments for female employees. This set off a wave of conversations about whether, and how, companies can help support the fertility needs of their employees. This has spurred dozens of other companies, from legal firm Ropes and Gray to Bank of America to Chanel, to follow Facebook’s example by offering fertility benefits. But these discussions focus largely on women who are interested in delaying pregnancy to focus on their careers.
However, many of the new benefits companies are beginning to offer–like egg freezing, IVF treatments, and fertility assessments–are valuable to LGBTQ couples who are interested in having babies. Given the steep costs of starting a family, members of the LGBTQ community often seriously examine whether a company has inclusive fertility benefits when they make a decision about taking a job. “Both Chris and I are planners, so we had basically started saving from the very beginning of our relationship, which is how we were able to afford this process,” Enfield says. “But we were very grateful for any help our employers could offer to help mitigate the cost, because they are incredibly high.”
In Facebook’s case, it worked with its insurer, Aetna, to cover up to $100,000 in egg-freezing expenses, something that was not available to employees at the time. But Facebook is a massive company with the leverage to change policies with its insurance company. According to Tammy Sun, founder and CEO of Carrot, a startup that helps businesses offer fertility benefits, most companies are not able to work with their health insurance company to modify what fertility treatments to cover and who is entitled to the benefit. And many insurers have a relatively narrow definition of who qualifies for infertility treatments, if they cover them at all. “You have to have a medical diagnosis of infertility to even quality for the benefits,” she says. “Only a straight couple that has sex for 12 months without conceiving can access this.” Sun points out that while LGBTQ couples obviously don’t qualify for this benefit, neither do single women who want to freeze their eggs.
Given how complicated it is to navigate the insurance system, Sun’s company has created a way for companies to give their employees benefits without going through an insurer. Businesses can work with Carrot to determine a specific financial amount it will offer for each employee, who can then use Carrot to get access to employer-subsidized medical consultation and fertility services. Importantly, an employee doesn’t need a medical diagnosis to take advantage of Carrot; they can get fertility treatments for whatever reason, whether they simply want to delay pregnancy, or are working to have a baby through a surrogate. “We’re basically building our own infrastructure to process reimbursements related to fertility care in a reliable way,” she says.
Other companies work around the complexities of both the healthcare and the insurance systems by simply offering financial assistance to those whose families are growing. In the case of Enfield and Lydick, Lydick’s employer, T-Mobile, had a straightforward policy when it comes to family benefits, simply reimbursing $13,400 in expenses for any employee who is going through the process of adopting or having a baby through a surrogate.
There is some evidence that it is not just in the employees’ interest to have strong fertility benefits. In a survey earlier this year conducted by Carrot, 50% of millennials said that fertility coverage should be an equal part of the healthcare benefits package, alongside medical, dental, and vision. And 54% of millennials said they would feel more loyal to their employer if they extended fertility benefits to LGBTQ colleagues, even if they themselves never used the benefit.
“There seems to be a “halo effect” at work,” says Tammy Sun, Carrot’s founder and CEO. “People who see their LGBTQ coworkers receiving benefits have a sense of goodwill toward their employer, and believe that their company is sensitive toward its workers’ needs.”
The many ways to become parents
For LGBTQ couples, there’s a complex web of decisions that come into play when deciding to start a family. Many–including Enfield and Lydick–consider adoption, but there are still many barriers to this process for the LGBTQ community. Many countries ban gay couples from adopting, and in the U.S., some adoption agencies are biased against nontraditional families and prioritize straight couples, or find an arbitrary reason to deny LGBTQ couples during a home visit. This can be one reason among many that an LGBTQ couple might opt to have a biological child.
And given the diversity within the LGBTQ community, there are many ways to have biological children. There’s the path of surrogacy, which Enfield and Lydick took. For lesbian couples, there is artificial insemination. And for transgender people, there are many possibilities. For transgender men and women who have not removed their ovaries or testicles, it is possible to regain reproductive capability by refraining from taking hormones for several months.
This was the case with Trystan Reese, the director of family formation at Family Equality Council, and a trans man who recently gave birth to a son. He says that in his case, carrying the baby himself was the easiest way to continue to grow the family he had built with his partner of seven years. But for trans people who are about to undergo gender reassignment surgery, they might opt to do fertility preservation procedures, like freezing their eggs or sperm. “It’s heartbreaking for me to know that some people transitioned at a time when they never believed they would see a world where trans people could have biological children or could be viewed as great parents,” Reese says. “They tell me that they wish they had done some sort of fertility preservation, but no one ever told them they should.”
Making fertility benefits more inclusive
For LGBTQ people who want to start families, things have certainly changed for the better over the last few years. But for all this progress, it’s still not the norm for companies to help support their LGBTQ employees who are interested in starting families. There’s been a wave of activists working to make fertility benefits more inclusive. Last year, legislators in New Jersey enacted a bill that requires the health benefits plan for state employees, including public school teachers, to offer fertility benefits to LGBTQ couples. This meant redefining “infertility” to go beyond heterosexual couples that have tried, without success, to get pregnant. But there is also a lot of resistance to expanding fertility benefits: A gay couple in Hawaii pushed for legislation that would require insurance companies to cover in vitro fertilization for surrogates, but the bill was killed by state lawmakers.
Given the complexities around growing your family as an LGBTQ person, having support from your employer can make a huge difference, whether it comes in the form of health benefits, financial assistance, or time off to bond with a new adoptive or biological child. Reese points out that many people want to be supportive of the LGBTQ community, and doing so through corporate policies can go a long way to making an impact.
“It’s just a matter of looking at policies and asking whether they are providing parity between the average straight couple and those of us who might need a little extra help and support to build our families,” Reese says. “The desire to have a family can feel and be limitless, which is why people adopt and foster and find surrogates. Some of us do have this need inside of us to create systems of support and love around us, and family is one really great way to do that.”