LGBTQ Couples Fight for Reproductive Healthcare Benefits

As a growing number of same-sex couples turn to assisted reproductive technology (ART) to create their families, many are disheartened to find disparities in reproductive healthcare benefits provided by employers and insurers compared to their heterosexual counterparts. In many cases, LGBTQ couples are being denied fertility benefits, because they don’t fit into an antiquated mold of traditional male and female gender roles.

The World Health Organization (WHO) defines infertility as a “disease of the male or female reproductive system defined as the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.” The Centers for Disease Control and Prevention (CDC) has an almost identical definition. The issue with this outdated definition is that it only pertains to the family dynamics of yesteryear when most households were made up of heterosexual couples and does not reflect the advancement of society and the changing dynamics of families, which now include thousands of LGBTQ individuals and couples.

With state fertility benefit mandates and insurers still using this definition as a qualifier for reproductive healthcare, the entire LGBTQ community is being categorically excluded as they cannot become pregnant from unprotected sex. As we have regularly reported before on this high-interest topic for LGBTQ-intended parents, in the competitive workforce, many employers are now offering reproductive healthcare benefits to recruit and retain talent. Still, many of these benefit policies have disclaimers stating that IVF or other assisted reproductive technologies will only be covered after a couple has not been able to conceive after one year of unprotected intercourse.

States Mandate Reproductive Healthcare Benefits but Leave Out LGBTQ Couples

According to RESOLVE The National Infertility Association, as of September 2023, “21 states plus DC have passed fertility insurance coverage laws, 15 of those laws include IVF coverage, and 17 cover fertility preservation for iatrogenic (medically induced) infertility.” However, of those 21 states, many of the mandates are still exclusionary, and according to USA Today, Arkansas, Hawaii, and Texas even state that couples must use their own eggs and sperm to conceive. Tarun Jain, associate professor of obstetrics and gynecology at Northwestern University, tells USA Today, “There are some populations that still are not getting their fair shake at getting the treatment that they need. The LGBTQ (community) for sure. Some states have very specific language that really excludes that community.”

LGBTQ Female Couples Face Hurdles to Qualify for Fertility Benefits

Emma Goidel and Ilana Caplan tell ABC News that they spent almost $50,000 of their savings to have their one-year-old son Avi. None of their expenses for intrauterine insemination (IUI) and in vitro fertilization (IVF) were covered or reimbursed by their insurance. Goidel tells ABC News, “How is it OK to say if you’re straight and your partner can’t get you pregnant, you come into the doctor, and we’ll cover your treatment, but if you’re a queer and your partner can’t get you pregnant, too bad, you’re going to pay?”

After having their first child in 2020 through self-funded fertility treatments, the couple consulted their newly obtained Aetna health plan about fertility benefits they might be able to use for a second pregnancy. They were shocked to find out that they would have to go through 12 months of self-funded IUI treatments in order to qualify. They go on to tell ABC News that they got pregnant after five IUI attempts and once after one cycle of IVF, both resulting in a miscarriage. Goidel and Caplan brought a class-action lawsuit against Aetna in 2021 citing inequalities in fertility benefits for LGBTQ couples. The case is still pending in federal court.

Although same-sex female couples may have IVF covered after a year of trying IUI, they still have to pay for each IUI during that year, which can cost anywhere from $500 to $4,000 per cycle depending on medication, monitoring, bloodwork, and the actual process of insemination, according to Fertility IQ.

Same-Sex Male Couples Have Even Harder Hurdles to Jump Over for Fertility Benefits

For same-sex male couples who would like to have their own children, the path to parenthood is even more complicated and costly. They must use an egg donor and surrogate in order to have a child. However, the inability to conform to the outdated infertility definitions that many state mandates and insurers base their qualifying coverage for infertility on completely excludes same-sex male couples from any type of reproductive healthcare benefits.

Married couple Corey Briskin and Nicholas Maggipinto tell ABC News that neither of their health insurance plans would cover any fertility treatments involved with a surrogate. Maggipinto says, “There’s just no way that that’s not some form of discrimination.” The couple resides in New York City, and according to The New York Times, the city’s insurance benefits policy states that a person must be deemed infertile to qualify for benefits. Maggipinto goes on to say in ABC News, “The No.1 hurdle that every same-sex couple faces is that they can never meet the definition of fertility, which is the threshold qualifier for covered IVF.” In April of 2022, Briskin and Maggipinto filed a discrimination complaint with the Equal Employment Opportunity Commission (EEOC) seeking a nationwide order that employers must also offer fertility benefits to LGBTQ employees just as they do their heterosexual plan participants, per ABC News.

The financial and medical hurdles are too high for LGBTQ couples or individuals. A single round of IVF can cost well over $12,000 with many intended parents needing more than one round to create their families. This does not include genetic testing or the yearly storage fees to keep any extra embryos in cryopreservation facilities, as we have also reported before. And for same-sex male couples, the price for an egg donor and a surrogate can cost upward of $200,000 with surrogate compensation alone costing around $55,000, per USA Today.  Adding into the costly mix, a lack of financial clarity, confusing verbiage in benefit policies, and few choices in insurance policies from employers, same-sex couples face an exorbitant uphill battle when choosing to grow their families compared to heterosexual couples.

It is time to change the definition of infertility to include all intended parents regardless of sexual orientation. Antiquated heteronormative ideals do not reflect our modern society, and state insurance mandates for employers and their insurance policies should not conform to ideals that completely alienate an entire community. At IFLG, we take great pride and care in helping the LGBTQ community.  We stay current on state laws regarding ART benefits and how to best navigate changes state by state. Our expert team of fertility law professionals consistently engages with reproductive rights advocates and tracks any new developments for LGBTQ-intended parents. We will continue to report on the progression of LGBTQ fertility rights and answer any questions that may arise during your fertility journey. Please feel free to contact us anytime. We are fierce advocates for the LGBTQ community and are happy to help.


Richard Vaughn

Attorney Rich Vaughn is founder and principal of International Fertility Law Group, one of the world’s largest and best-known law firms focused exclusively on assisted reproductive technology, or ART, including in vitro fertilization (IVF), surrogacy, sperm donation or egg donation. Rich is co-author of the book “Developing A Successful Assisted Reproduction Technology Law Practice,” American Bar Association Publishing, 2017.

Peiya Wang
Paralegal (律师助理)

Peiya Wang joined IFLG as a paralegal in 2015, where she manages surrogacy, egg donation and parental establishment cases and provides translation services for many of IFLG’s international clients. Peiya moved to the United States in 2012 to attend Northeastern University in Boston, Massachusetts, receiving a Master of Science degree in Global Studies and International Affairs in 2014. Peiya moved to Los Angeles in 2015, received her paralegal certification from UCLA Extension, and obtained her second Master of Science degree in Legal Studies from Loyola Law School. Peiya relocated back to her hometown, Beijing, China in 2019 and works from IFLG’s Beijing office. When away from the office, Peiya is a dragon boat paddler and a ballroom dancer, where she favors Rumbas and Cha-chas. She is fluent in Mandarin and English.

Luis Sosa

Luis R. Sosa joined IFLG as a paralegal in 2016, where he enjoys pursuing his passion for family and reproductive law. While working toward his bachelor’s degree at Florida International University which he received in 2013, Luis worked as a paralegal and legal assistant for family law litigation firms in Miami and Washington, D.C. As a paralegal and case manager for IFLG, Luis, who is bilingual in English and Spanish, manages surrogacy, egg donation and other reproductive law cases. Luis has worked for IFLG in both Los Angeles as well as San Francisco, and is currently based in Dallas, Texas. In addition to spending time with husband Randy and dog Marty, Luis enjoys being outdoors and appreciating the arts.

Toni Hughes

After receiving her B.S. in Business Management, Toni joined IFLG to pursue her dream of working in the legal field. As a Paralegal with over 10 years of experience in the assisted reproduction technology field, Toni is our Managing Paralegal, responsible for training and managing our paralegal staff. From drafting legal documents to assisting our clients with post-birth matters, Toni embraces the challenge of learning something new in this field each day. Besides spending time with her son, Jordan, Toni enjoys exploring new things, cooking, spending time with family and friends, and serving as a Youth Advisor for “Next Generation.”


Kim has over 30 years of experience in the legal field and has worked exclusively in surrogacy and assisted reproduction law since 1999. Kim is a senior case manager responsible for managing parental establishment cases and interacting with IFLG’s Of Counsel attorneys across the country. With three children of her own, Kim understands the importance of family and finds working in this area of law a rewarding experience.

Rich Vaughn

Attorney Rich Vaughn combined his personal passion as a father of twin boys born via assisted reproductive technology (ART) with more than 20 years of experience in business and technology law to build International Fertility Law Group. Today IFLG is one of the most successful and best-known law firms in the world focused exclusively on fertility law, helping thousands of intended parents through empathetic listening, compassionate guidance, and unmatched legal expertise. As an advocate for reproductive freedom, Rich also contributes his knowledge and time to improving the understanding and practice of ART law, most recently as a founder of and speaker at the first Cambridge University International Surrogacy Symposium held in June 2019, as immediate past chair of the American Bar Association ART Committee, and as a popular presenter to law schools, faculty and advocacy organizations all over the world.

Elizabeth Tamayo

Elizabeth received her Bachelors of Science degree in Criminal Justice from California State University of Los Angeles. Shortly after graduating, she continued her education at the University of California, Los Angeles where she obtained her Paralegal certificate. Elizabeth is fluent in Spanish and has been in the legal field since 2009. She is excited to be a part of the IFLG Team helping families realize their dreams.

Sunny Chien

Sunny joined IFLG as a paralegal in 2017, where she manages surrogacy, egg donation and parental establishment cases for many of IFLG’s international clients. She holds a Bachelor of Arts degree in Philosophy from California State University of Los Angeles, where she graduated cum laude. Sunny is bilingual in English and Mandarin and has extensive experience as a legal assistant and paralegal at Los Angeles-area law firms. She is excited to be part of the IFLG team. In her spare time, Sunny enjoys spending time with her family and their dog, going to the beach, cooking, and being outdoors.

Los Angeles

5757 Wilshire Blvd., Suite 645

Los Angeles, CA 90036

Phone:  +1 323 331 9343

Email:  info@iflg.net

Website:  www.iflg.net

New York

501 Fifth Avenue, Suite 1900

New York, NY 10017

Phone:  +1 844 400 2016

Email:  info@iflg.net

Website:  www.iflg.net

Molly O'Brien

Fertility law attorney Molly O’Brien began working in the field of assisted reproduction technology (ART) in 2005, at an egg donation agency and a surrogacy agency where she became familiar with all aspects of in-vitro fertilization, egg donation and the financial aspects of surrogacy. Since becoming an attorney in 2011, Molly has drafted and negotiated surrogacy, egg donation, sperm donation embryo donation agreements for hundreds of her clients all over the world.

Phoebe Sadler

Fertility law attorney Phoebe Sadler has a background in family law and has been practicing exclusively in the area of assisted reproduction technology (ART) law since 2018.

Rubina Aslanyan

Rubina has an extensive background in the legal field as a paralegal in Family Law and has worked in surrogacy and assisted reproduction law since 2012. Her area of focus is in managing and assisting clients with surrogacy, egg donation, and parental establishment cases for many of IFLG’s domestic and international clients. During her spare time, Rubina enjoys spending time with her family and dog Bella, traveling and cooking.

Alexander Espinoza
Legal Assistant

Alexander joined IFLG as a legal assistant in 2019, where he manages surrogacy, egg donation and parental establishment cases. Alex is bilingual in English and Spanish and has been in the legal field for 23 years. Alex is excited to join the IFLG team and pursuing his will to help others in the reproductive law process. In his spare time he loves spending time with his family and friends, being outdoors, road trips, loves music and dancing.

Cara Stecker
Senior Paralegal

After receiving her paralegal certificate in 2005, Cara began working in assisted reproductive law. During the fifteen years Cara has worked in this field, she has gained a wide range of experience and knowledge that she uses to help better assist clients and those involved in the assisted reproductive journey. Cara’s primary roles involve managing parental establishment matters and coordination with IFLG’s Of Counsel attorney network, drafting contracts and parental establishment court documents and providing support to other team members. Cara finds great joy in being a small part of a team of caring people who help others achieve their dream of having a family. In her spare time, Cara enjoys spending time with her husband and three children, watching her children play the sports they love, and she enjoys, running, cycling and exploring the outdoors in the sun.

Stephanie Kimble

Stephanie received her BS in History and Political Thought from Concordia University Irvine in 2015 and her Paralegal Certificate from University of San Diego later that same year. She has been working as a Paralegal since 2016 in Family and Reproductive Law. She is excited to be part of International Fertility Law Group working on managing Surrogacy, Egg donation and Parental Establishment Cases.

Trish Pittman
Assistant Financial Coordinator

With more than 20 years of experience in the field of accounting, Trish joined the IFLG team in 2019 as Assistant Financial Coordinator. Her client-facing focus at IFLG is to assist with all client trust accounting. Trish is the mother of two daughters and enjoys spending time teaching and learning new things from them. In her free time, she loves long walks in the park and reading suspense and mystery novels.

Katie Deaquino
Senior Paralegal

Katie is a Senior Paralegal with IFLG and has dedicated over sixteen years to the areas of surrogacy and reproductive law. She received her Paralegal Certificate from Coastline Community College and has worked with some of the top law firms in the assisted reproduction community. Katie is also a commissioned Notary Public. With IFLG, Katie manages Surrogacy, Egg Donation, and Parental Establishment cases and provides support to other IFLG team members. Katie truly enjoys helping others build their families through assisted reproduction and is thankful she has had the rewarding experience of assisting IFLG clients. Katie often spends her free time with her Husband, four young children and her bulldog “Bella”.

Elsa Jimenez
Legal Assistant

Elsa joined IFLG as a Legal Assistant in 2019, bringing more than 35 years of experience working in the legal profession (concentrating in tort and litigation matters). At IFLG she assists surrogates with their surrogacy and parental matters. The oldest of five siblings, born and raised in East Los Angeles to Mexican immigrant parents, Elsa loves “seeing the beauty of families forming” through assisted reproductive technology. She and her husband Carlos have four children and one grandson. Elsa enjoys jazz and ’80s music, being outdoors in nature, collecting teacups and tea pots, and spending time with her close-knit family.