Grant: CIHR Fellowship

Assisted reproductive technologies (ART) have made it possible for people around the world to have children. While technological advancements have benefitted some people needing fertility treatments to become pregnant, there are legal, social, and clinical barriers to accessing that care, especially for diverse sexual and gender minority populations. Stigma-including homophobia and transphobia-is rampant throughout medicine as providers are not adequately trained to care for LGBTQ2SIA+ populations. For example, obstetricians often inadvertently make assumptions about a patient's gender, sex, sexual orientation, anatomy, gametes, and family configuration. Additionally, LGBTQ2SIA+ populations with multiple marginalized identities-particularly those that are Black, Indigenous, and People of Colour-experience even more barriers to access due to interlocking systems of oppression. This postdoctoral project, based in Harvard Medical School's Department of Population Medicine aims to address these issues by elucidating sexual orientation- and race-related differences in ART utilization. I will use both qualitative and quantitative methods to address three specific aims. First, I will quantitatively elucidate ART use by sexual orientation and race using large, prospective, and intergenerational cohorts housed at Harvard Medical School, namely, the Nurses' Health Study and Growing up Today Study. Second, I will conduct focus groups and interviews with ART providers to identify gaps and opportunities to improve service provision. Third, I will develop a conceptual model of queer reproductive justice with various recommendations for improving clinical practice and policymaking. Findings will be disseminated through peer review publications and reports for key stakeholders. These contributions will lay the groundwork for transforming ART use among vulnerable populations.