LGBTQ

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“This guidance has been written for same-sex female couples who are planning to conceive a child through artificial insemination:

What is donor insemination?

“Donor insemination involves using donor sperm. This can be obtained by using an anonymous sperm donor (from a sperm bank), or using a known donor or a friend. All information below is for babies that are conceived, through donor insemination, after 6 April 2009 when laws changed affecting the rights of same-sex female couples.

In the UK, women can inseminate through a licensed fertility clinic or at home. Depending on which method you use there are implications with regards to legal parenthood.

For couples in a civil partnership or marriage

If a baby is conceived in a UK licensed fertility clinic or at home and the couple are in a civil partnership or married, then the non-birth mother will automatically be the second legal parent and will be named as such on the birth certificate. The donor will have no legal parenthood status.

For couples not in a civil partnership or marriage

If a baby is conceived in a UK licensed fertility clinic and the couple are not in a civil partnership or married, they will need to complete a simple form at the clinic for the non-birth mother to be the legal parent, and to appear on the birth certificate. The donor will have no legal parenthood status.

If the baby is conceived outside of a UK licensed fertility clinic and the couple are not in a civil partnership or married, the non-birth mother must apply to adopt the child to gain legal rights.

Fertility treatment
For many, the first place to go for information about fertility treatment is their GP. They can give you advice on the services available, help with health checks, and advise you whether you’ll be eligible for NHS fertility funding.

NHS funding for fertility treatment is limited for everyone, and what is available varies from place to place, with criteria set by each area’s Clinical Commissioning Group (CCG).

Until February 2013, there was no official guidance on what NHS funding should be offered to same-sex female couples seeking fertility treatment. Now CCG’s can refer to guidelines published by the National Institute of Clinical Excellence (NICE). This guidance offers NHS trusts best practice for the assessment and treatment of people with fertility problems. For the first time, these guidelines set out what same-sex female couples can expect when looking for fertility treatment.

What does the NICE guidance say?


NICE’s new guidance says that couples must attempt to conceive before being considered for NHS treatment. Opposite-sex couples are expected to try and conceive through sexual intercourse for two years before being considered. This is obviously not an option for female same-sex couples.

The NICE guidance therefore expects female same-sex couples to have tried to conceive six times using artificial insemination (funded themselves, not by the NHS) before they would be considered for NHS-funded fertility treatment.

The guidance does not stipulate whether couples need to try to conceive using a fertility clinic, or whether attempts to conceive at home with donor sperm makes you eligible for NHS treatment. This is a decision for your local NHS trust to make. Many NHS trusts will require same-sex couples to use fertility clinics to conceive before considering funding treatment, meaning many same-sex couples will need to pay fees before being eligible for NHS funded treatment.

Why might I be expected to pay for fertility treatment?
Your NHS trust will make its own decision about whether they expect you to try to conceive six times at a clinic (for a fee) or at home (for free). Stonewall expects many trusts to say you have to try to do so at a clinic, as they will want you to try to conceive using a safe and clinically effective method of conception, using approved and tested sperm.

Other criteria

Even if you have tried to conceive six times, you still may not be eligible for NHS funded treatment in your local area. Your local NHS trust will have a number of other criteria that you may also need to meet before they will fund treatment. These can include things like your age, whether you smoke, and other lifestyle factors such as alcohol consumption and levels of fitness.

It is therefore important to find out what your local NHS trust’s criteria on funding fertility treatment before beginning the process of conceiving.

The law is clear, however, that these criteria should apply equally to opposite-sex and same-sex couples – it would be unlawful for a trust to deny you fertility treatment simply because you are a same-sex couple.
The laws on parenting rights when a child is conceived through artificial insemination place a focus on biological sex rather than gender identity.

Legal parents for children conceived through donor insemination
The Human Fertilisation and Embryology Act (2008) sets out who a child’s legal parents will be when conceived through donor insemination. This legislation was particularly significant for same-sex couples as it allowed, for the first time, a child to have two mums or two dads named as legal parents.

Under UK law, a child can only have two legal parents although a number of people can hold parental responsibility. For children conceived through donor insemination, who the legal parents are will depend on the circumstances at the time a child is conceived.” – From: Donor insemination and fertility treatment – Stonewall

A guide for the NHS – Stonewall

“The laws on parenting rights when a child is conceived through artificial insemination place a focus on biological sex rather than gender identity. 

Legal parents for children conceived through donor insemination

The Human Fertilisation and Embryology Act (2008) sets out who a child’s legal parents will be when conceived through donor insemination. This legislation was particularly significant for same-sex couples as it allowed, for the first time, a child to have two mums or two dads named as legal parents.

Under UK law, a child can only have two legal parents although a number of people can hold parental responsibility. For children conceived through donor insemination, who the legal parents are will depend on the circumstances at the time a child is conceived.

Fertility law experts Natalie Gamble Associates provide useful information on how these rules apply to trans people on their website;

Other useful sources of support 

You can find local LGBT-friendly solicitors and other useful contacts through Stonewall’s online database What’s In My Area.

For further information you can fill out our enquiry form, call Stonewall’s Information Service on 08000 502020, tweet to @StonewallUKInfo or email info@stonewall.org.uk  ”   –

From: http://www.stonewall.org.uk/help-advice/parenting-rights/trans-parenting-rights

“Preserving fertility before a gender transition

 

How we can help you

 

“You may want to know whether you will still be able to have children after a gender transition.  Hormone therapy and gender reassignment surgery usually impairs fertility, so it is sensible to seek medical advice about your options and the best timing for storing eggs or sperm for your future use.  If you are storing eggs, you will need to go through a cycle of IVF treatment in order to stimulate your egg production and this will involve hormone treatment.

The World Professional Association for Transgender Health’s Standards of Care state:

“Many transgender, transsexual and gender nonconforming people will want to have children. Because feminizing/masculnizing hormone therapy limits fertility, it is desirable for patients to make decisions concerning fertility before starting hormone therapy or undergoing surgery to remove/alter their reproductive organs… MtF patients, especially those who have not already reproduced, should be informed about sperm preservation options and encouraged to consider banking their sperm prior to hormone therapy… Reproductive options for FtM patients might include oocyte (egg) or embryo freezing. The frozen gametes and embryo could later be used with a surrogate woman to carry a pregnancy.”
In respect of the UK legal position, you must consent to the storage of your eggs or sperm (or to the storage of embryos created using them).  Find out more about the consent rules for gametes.

The law also governs how long your gametes can be stored for.  The basic storage period for eggs or sperm in the UK is ten years. However, if you are storing eggs or sperm in anticipation of hormone therapy or surgery that will render you ‘prematurely infertile’, you can extend this storage period every ten years, up to a maximum of 55 years. It is important that you renew your storage period before each ten-year period expires, when a doctor also has to certify that you are prematurely infertile. Find out more about storage period for gametes and embryos.

If you are planning children having changed gender, questions may arise about whether you will legally be your child’s mother or father.  Find out more about legal parenthood following transgender conception.

Depending on your circumstances, you might also be considering conceiving with the help of a surrogate, or an egg or sperm donor.  Find out more about surrogacy law and donor conception law.” – nataliegambleassociates.co.uk

LGBT people living with cancer:
An estimated 5% to 7% of the population in the UK are lesbian, gay or bisexual, according to Treasury actuary estimates, which equates to approximately 3.6 million people. It has been estimated that 300,000 people in the UK are transgender.

LGBT (Lesbian/Gay/Bi-sexual/Transgender) people with cancer are less likely than heterosexual people with cancer to be given information about the type of cancer they have or be informed about the available self help and support groups for people with cancer. They also report feeling excluded from support groups because they are not able to come out. There is a concern that some LGBT partners of cancer patients treated in hospital may be denied visiting rights and information because they are not seen as the ‘next of kin’.” – From: Macmillan

IMG_6036(On Twitter)

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LGBT Cancer Support (UK)

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LGBT Cancer Support Alliance – “An alliance of health professionals, researchers and patients seeking to improve experiences and outcomes for LGBT people with a cancer diagnosis in Manchester.”

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LGBT & Cancer, Staffordshire – Talking about cancer with LGBT communities to address health inequalities in Staffordshire

LGBT Foundation – Routes to parenthood using a fertility clinic

LGBT Foundation – Trans Fertility Rights.

Lesbian, Gay, Bisexual and Queer Experiences of Cancer Care

All about Trans . org.uk

This Gay Cancer Patient Was Told Fertility Treatment Was Only For Straight People (BuzzFeed/UK) (Dean Eastmond)

The cancer side effect we don’t talk about: losing masculinity by Dean Eastmond

Reducing health inequalities for Lesbian Gay and Bisexual people: Evidence of health care needs (UK)

Improving the Cancer Journey for LGBT people (UK)

Fertility Friends

This Transgender Couple Is Expecting a Child – womenshealthmag.com

Britain’s first pregnant man gives birth to girl – Independent

Stonewall (the lesbian, gay and bisexual charity) http://www.stonewall.org.uk

Pink Therapy – We are the UK’s largest independent therapy organisation working with gender and sexual diversity clients. http://www.pinktherapy.com

Terrence Higgins Trust (HIV and sexual health charity) www.tht.org.uk

Exploring the needs of gay and bisexual men dealing with prostate cancer A report by Prostate Cancer UK and Stonewall – gay_and_bisexual_men_dealing_with_pc_report.pdf

Lesbian and bisexual women and breast cancer (Breast Cancer Care) – lesbian_and_bisexual_women_and_breast_cancer_report.pdf

Links for below on  https://lgbcancer.wordpress.com/

Macmillan Cancer Support (2014) The Emerging picture: LGBT people with cancer

Fish, J. (2010) Coming out about Breast Cancer

Practical Guide to supporing LGBT people with Cancer

Fish (2015) Improving The Cancer Journey

Johnson and Fish (2015) Diversity and equality in cancer care

Macmillan Cancer Support (2017) Supporting LGBT people with Cancer

Websites

National LGBT Cancer Network – An American based cancer support network for LGBT people. They have also produced a report on LGBT patient centred outcomes.

Memoral Sloan Kettering Cancer Centre – An LGBT affirming cancer support centre in the US

LGBT Cancer Support Alliance – An alliance of health and social care professionals seeking to improve the experience and outcomes for LGBT people with a cancer diagnosis in Manchester.

Rant from the subburbs – A Blog written by Jim, one of the contributors to this website, about his experiences of prostate cancer

LGBT walnut – An LGBT support group for people with prostate cancer based in London (UK)

Out With Prostate Cancer – A prostate cancer support group for gay and bisexual men, meets in Manchester (UK) at the LGBT foundation

Midlands Gay, Bi and Trans* prostate cancer support group – A new group facilitated by volunteers from Prostate Cancer UK, meets at Birmingham LGBT centre

Macmillan LGBT online support group – a dedicated forum on the Macmillan Cancer Support website for LGBT people

 

Hulbert-Williams et al (2017) The Cancer experiences of gay, lesbian and bisexual patients: a secondary analysis of data from the UK Cancer Patient Experience Survey European Journal of Cancer Care http://onlinelibrary.wiley.com/doi/10.1111/ecc.12670/full

Nelson et al (2015) LGBT Trainee and Health Professional Perspectives on Academic Careers—Facilitators and Challenges LGBT Health http://online.liebertpub.com/doi/abs/10.1089/lgbt.2015.0024

 

 

 

 

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