LGBTQ Intended Parents Face Higher Costs, Extra Hurdles to Creating Families

Even as some states and a growing number of corporations offer support for family-building expenses such as adoption or IVF, LGBTQ intended parents are still likely to face higher medical and legal costs than their heterosexual peers.

As I told reporter Contessa Brewer for CNBC earlier this month, a handful of states have mandates requiring insurers and employers to offer coverage for fertility treatments such as egg or sperm donation or in vitro fertilization (IVF). The expansion of insurance coverage to fertility services has helped make assisted reproductive technology (ART) accessible and affordable for thousands of would-be parents. However, often those state requirements are very gender-specific and not inclusive of LGBT intended parents in general.

High Cost of Parenthood

Parenthood is expensive, regardless of how a family is created. According to advocacy organization Family Equality’s 2019 report, “Building LGBTQ+ Families: The Price of Parenthood,” the average cost of raising a child to age 18 in the United States is $230,000. Intended parents who create families by adopting or using egg or sperm donation, IVF and/or surrogacy undertake extra legal and medical costs. In addition to those extra costs of conception, LGBTQ individuals and same-sex couples, even those who are legally married, often must take legal steps to establish their parental relationships.

According to the report, adoption fees and legal costs can range as high as $45,000 for domestic adoption and $70,000 for international adoption. The cost of surrogacy in the United States can total $200,000 including medical procedures, legal services and surrogate expenses, according to CNBC.

In addition to the added expense that comes with alternative ways of family-building, LGBTQ intended parents must also be aware that the laws of some states and countries restrict assisted reproduction, surrogacy or adoption to married or heterosexual couples only. As NBC News reported in December 2019, several states allow state-licensed child welfare agencies to refuse to place children with LGBTQ families on the basis of religious belief. And even though same-sex marriage has been legal since 2015, some U.S. states have (and continue to enact) laws that limit assisted reproduction or surrogacy for LGBTQ individuals.

As the Family Equality report concludes:

“For those struggling with fertility challenges or without the anatomy necessary to create a child within the context of their relationships, the initial cost of becoming a parent can be significant. For single parents, those in same-sex relationships, those living with HIV/AIDS, and the transgender community thinking about gender affirmation surgery or medical transition, the cost of bringing a child into the family ranges from a few hundred dollars to hundreds of thousands of dollars, depending on the specific path chosen".

“Many of these options are financially inaccessible to the majority of LGBTQ+ people.”

According to the 2018 Family Building Survey, which sampled 500 LGBTQ adults and 1,004 non-LGBTQ adults, nearly a third of LGBTQ families surveyed reported household incomes below $25,000 per year. A 2019 analysis of Gallup poll data by the Williams Institute reported that 25 percent of all LGBTQ people surveyed have annual incomes below $24,000.

Fertility Insurance Helps Offset Expense of Assisted Reproduction

For intended parents lucky enough to live in a state or work for a corporation that provides fertility insurance, the benefits can knock tens of thousands of dollars off the cost of assisted reproduction—the difference for some people between becoming a parent or not.

But here LGBTQ people often face an additional burden as well: in a bizarre Catch 22, the definitions of “infertility” used in many state laws and insurance policies, developed generations before assisted reproduction technology became widely available, automatically exclude LGBTQ couples as well as single heterosexual people. That’s because, as we wrote earlier, fertility often is defined as the inability to conceive a pregnancy or to carry a pregnancy to live birth after a year or more of regular sexual relations without contraception or similar language. As we wrote earlier, “Obviously, for gay or lesbian couples, that definition doesn’t work.”

While fertility medical professionals and advocates are working incrementally, state-by-state and insurer-by insurer, to modernize and expand definitions of infertility, today LGBTQ people who need the financial support of insurance benefits to offset the high cost of family-building often find they don’t qualify.

With all the challenges faced by LGBTQ would-be parents, you’d think a lot of them would simply give up and go home. But the numbers tell a different story. Despite all the obstacles in their paths, including the high cost of medical and legal services and discriminatory policies, LGBTQ people still want to create families. What’s more, LGBTQ people living on less than $25,000 a year want to become parents at similar rates to LGBTQ people making over $100,000 a year. Some 40 percent of LGBTQ people are considering assisted reproduction as a path to parenthood, NBC News reports.

Many LGBTQ People Want Families

Our team here at International Fertility Law Group could have told you how many people have a strong desire to become parents. Every year we work with hundreds of people who have undergone great difficulty, spent years of their lives and thousands of dollars to create the families of their dreams. The advance of assisted reproductive technology has made and is making those dreams possible for more people than ever before.

Our team was shaken and disappointed, along with most of our fellow Americans, with the U.S. Supreme Court’s June 24 decision to overturn Roe v. Wade, stripping American women of a right they have held for 50 years. As shocking and dangerous to women’s health as this decision is, the June 24 ruling basically states that the U.S. Constitution doesn’t provide a right to abortion—and therefore it should be left to the legislatures (federal and states). Certainly, there are states that have trigger laws. About 13 will go into effect soon, and perhaps another 10-13 more will follow with restrictive laws and/or laws to criminalize all abortion and attempt to go even further. Despite this, today abortion remains legal in most parts of the country.

Supreme Court precedent on the 14th Amendment makes it clear that every person has a constitutional right to travel (in this case, to seek abortion care in states where it is allowed). Surrogates will continue to be able to travel to another state for a procedure if they live in one of the restrictive states. Supreme Court precedent also makes it crystal clear that one state cannot regulate that which is permitted in another state. While one might wonder about the current court’s appetite to overturn established precedent, there is no countervailing interest on the other side of the equation of these two issues, as there is in the potential life in the abortion analysis. I think the right to abortion is truly unique because of this and that the court will uphold well-established precedent, especially precedents that benefit from broad support and consensus, such as the right to travel and the freedom of the states to regulate themselves without interference from another state.

Additionally, while the Supreme Court’s ruling carries the implicit threat that increasingly draconian state abortion bans might also spell the end of life-affirming fertility treatments such as in vitro fertilization, some 8 million babies have come into the world as a result of assisted reproductive technology. The fact that, despite financial hardship and discriminatory laws, LGBTQ people continue to fight for the right and ability to create families is a testament to the strength of the human desire to parent. I do not believe the majority of Americans are ready or willing to reject and criminalize the miracle of assisted reproductive technology that makes that parenthood and the dream of family possible for so many of us.




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.