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November 11, 2019

Preparing for Parenthood: A LGBTQ+ Quick Guide

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Like many first-time parents who are over 30, my husband and I thought we had considered everything when we decided to bring a child into our family. And like most first-time parents, we underestimated all that was involved in starting a family, particularly as members of the LGBTQ+ community.

Preparing for Parenthood: A LGBTQ+ Quick Guide

Luckily, we were both on the same page about wanting to have children — we each felt that having our own family was important. After attending a Men Having Babies conference, I understood that we were not getting any younger and needed to pursue a path to parenthood immediately. So, we began exploring different options.

I’m writing this in the hope of sharing knowledge and some of our profound and tiny learnings along the way. Before I get started, know this: Your decision to become a parent is an incredibly personal decision, and at the end of the day, it’s none of anyone else’s business how you choose to start your family.

Adoption

For women and pre-op trans men with a female partner, one option is artificial insemination. But for two men, adoption is often the first choice for starting a family. It can be the easiest and least expensive option; for instance, fostering to adopt in California typically costs $0 to $500 through California Department of Social Services district offices. (You will, however, be expected to pay for fingerprinting, medical exams, court filings, and CPR or other safety classes.)1 Private adoptions in the U.S. can cost anywhere from $8,000–$40,000 while international adoptions can cost $30,000 or more.2 There are emotional and legal obstacles that can make adoption a difficult road for LGBTQ+ people, as many countries will not knowingly permit gay people to adopt.

Surrogacy

My husband and I felt it was important to have a genetic relationship with our child, and so we chose surrogacy. This route is very expensive and can be very emotional. For us, it was worth all the money and heartache.

If you choose surrogacy, as a gay couple, you should expect to spend $250,000. A “simple” surrogacy with the fertilized egg of a male-female couple costs up to $130,000 in the U.S.3 As a gay couple, you need to also factor in the costs of an egg donor ($12,000–$20,000).4 We decided to go with an anonymous egg donor rather than ask a family member. This option is more expensive but also less complicated legally and emotionally since the egg donor does not have an interest in or a potentially perceived parental relationship with your child. In addition, there is the cost of in vitro fertilization (IVF), which is typically $1,500–$3,000 for one cycle (from the time the eggs are retrieved to the time a fertilized egg is transferred to the uterus), and generally a few cycles are needed.5 And then there is the difficult reality that the first pregnancy might not make it full term; miscarriages are common and other complications may arise. This means you may need to go through the entire process more than once.

KEY TIP: You will want to talk to the hospital two months before your due date. Talk to nurses in the maternity unit and the hospital billing office. Ask about having your own room prior to and after the baby’s birth and negotiate the rate. Good surrogacy agencies have agreements that attempt to spell out costs at almost every intersection. However, as good as they are, other costs, sometimes large ones due to miscarriage or complications during pregnancy, unexpectedly appear.

When considering surrogacy, it is important to find the right agency and gestational carrier for you, and unless you have a friend or family member who is willing, you should brace yourself for a long wait. We waited more than eight months before we spoke to our first candidate. We also sought out and checked references for the agencies we were interested in working with. Trust but verify.

You also need to consider the geographical proximity of your surrogate. For instance, if you live in California and you want to be super involved during the pregnancy, then you might want to limit your surrogate search to California. If you are most interested in securing a surrogate ASAP, you might widen your search. Some states in the U.S., such as Oregon, have larger pools of potential surrogates,6 and this year, Washington State reduced wait times from eight+ months to two to four months.7 An out-of-state surrogate, however, will increase your travel costs, including the expense of last minute travel should the need arise.

Beyond the financial and legal considerations, we were struck by the pushback from straight people in our lives who encouraged us to adopt rather than use a gestational carrier. Our reply to them was usually, “This might be new to you, but if you’ll allow me to ask you (if they have children), why didn’t you adopt?” Asking this question has helped create greater understanding for our decision and increased support from our extended community.

Insurance Options

As with any pregnancy and birth, there are insurance considerations. Bear in mind, most health insurance plans in most states do not cover fertility treatments for same-sex couples because most insurers cover infertility as it is medically defined — a man and a woman under age 35 unsuccessfully trying to conceive through unprotected sex for one year. However, some insurers have different parameters, so it is worth investigating the options.

For example, since 2013, health insurance plans in California must offer coverage for fertility treatments to homosexual couples and unmarried individuals. Under these plans, many fertility treatments are covered, including diagnostic tests, medication, surgery, and artificial insemination. However, IVF is excluded.8 In terms of surrogacy, you are responsible for your surrogate’s insurance, copays, and all medical expenses not covered by insurance.

A September 2019 BBC article explores how expanded fertility benefits are a way companies are retaining talent, particularly LGBTQ+ employees. These benefits may cover the costs for egg and embryo freezing, semen analysis, adoption, and sometimes surrogacy.9

Life and Long-Term Disability Insurance

It may seem premature to think about life insurance before your child is born, but both life and long-term disability insurances are critical to building a family. Shortly after we got married and right after we signed the surrogacy contracts, we bought life insurance. That way, if something should happen to one of us, the surviving spouse could continue the process without worrying about financial constraints.

Both partners should have life insurance—not just the higher earner. This coverage will help defray costs of childcare and other “hidden” costs if something happens to a partner who may have chosen to stay at home or to reduce their workload to focus on raising the child. And, it is always a good idea to get the supplemental long-term disability insurance typically offered during an employer’s open enrollment period. You pay a little extra, but you get extra coverage that may prove critical if something happens to either you or your partner.

Estate Planning

If you are starting a family, you should plan your estate and review your insurance options. “Be proactive, not reactive,” notes my colleague Judith Gordon, an estate planning advisor at B|O|S. “Talk to someone knowledgeable about parental rights, keeping all the potential (tax and nontax) consequences in mind.”

Before marriage equality was solidified into law in 2015, LGBTQ+ couples and individuals went to specialized lawyers to handle their estate planning, as it was more complicated. Now, however, if you are a married couple, your estate is handled the same as the estate of a heterosexual married couple. That said, lawyers familiar with LGBTQ+ community issues can be instrumental in addressing delicate matters, such as ensuring your money does not go to people or organizations that are not aligned with your values. If you know your beneficiary might use your money to support an anti-LGBTQ+ group, for instance, you could consider making a bequest instead.

Another partner at B|O|S, Myles VanderWeele, offers this advice: If you have more than $150,000 in assets, you may consider creating a trust to avoid the expensive and lengthy probate process. In addition to creating a trust, make sure you have:

  • A will
  • An explicit healthcare directive for each partner
  • A durable financial power of attorney
  • A designated guardian(s) in the event something happens to both parents

You may even choose to have a letter outlining your wishes for your child’s chosen guardian(s).

Adoption After Birth

I return to the topic of adoption because you want to make sure both partners are regarded as the legal parents in all cases. Most estate planning documents have a reference to or definition of a descendant as anyone adopted before 18. Adopting, even if you and your partner are both on the birth certificate, provides additional peace of mind if your relationship (married or unmarried) should end or if anything should change in terms of LGTBQ+ rights at the federal level, such as Social Security benefits to dependents.

For us, even though we had a pre-birth judgment of parentage that allowed us to have both our names on the birth certificate, we opted to have the nongenetically related father formally adopt our child.

Update Estate Plans When Needed

Estate rules change all the time. Whether people are married or not, it is common to update estate plans on a periodic basis. Check in with your B|O|S wealth manager or estate planning attorney when a trigger happens, such as tax changes, changes in your relationship status, additions to the family, a child is born with special needs, or a guardian is to be changed, etc.

Last Words of Advice

Beware the illusion that all of this applied science is a simple equation that results in a live birth. The fact is it is an incredibly human journey complete with feelings of anxiety, uncertainty, failure, catastrophe, and pure joy. Miscarriages are common. Talk with people close to you; your support and allies are all around you. Talking about the lows, opens the door for understanding and connection.

Your relationship will be tested. I’ve learned more about myself through our journey than during any other period of my life. Going down this path has been difficult and disruptive to the life we had prior to our child’s birth, but it has also been incredibly magical. We are blessed to have our happy and healthy child, and we are considering adding another member to our family soon.

Footnotes:

1. California Department of Social Services, “Frequently Asked Questions About Adoption,” https://www.cdss.ca.gov/Adoptions

2. Human Rights Campaign, “How Much Does Adoption Cost?” https://www.hrc.org/resources/how-much-does-adoption-cost

3. West Coast Surrogacy, “Surrogate Mother Costs, https://www.westcoastsurrogacy.com/surrogate-program-for-intended-parents/surrogate-mother-cost

4. American Pregnancy Association, “Donor Eggs,” https://americanpregnancy.org/infertility/donor-eggs/

5. Forbes Magazine, “The Cost of IVF: 4 Things I Learned While Battling Infertility,” February 6, 2014, https://www.forbes.com/sites/learnvest/2014/02/06/the-cost-of-ivf-4-things-i-learned-while-battling-infertility/#3c6a272f24dd

6. Oregon Public Broadcasting, “Fertile Ground: Why Oregon Is The Surrogacy State,” April 21, 2016, https://www.opb.org/news/series/surrogacy-oregon/surrogacy-oregon-explainer/

7. SeattleMet, “Seattle: The New Paradise for Gay Parents-to-Be,” May 28, 2019, https://www.seattlemet.com/articles/2019/5/28/seattle-the-new-paradise-for-gay-parents-to-be

8. The Mercury News, “Fertility coverage protected for same-sex couples in California,” October 9, 2013, https://www.mercurynews.com/2013/10/09/fertility-coverage-protected-for-same-sex-couples-in-california/

9. BBC News, “The workplaces that will pay for surrogacy,” September 12, 2019, https://www.bbc.com/worklife/article/20190906-the-workplaces-that-will-pay-for-surrogacy

Filed under: Autumn 2019

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