LGBTQ+ and Pregnant: How to Advocate for Yourself and Your Care

Common Barriers to Equal Care

When medical staff ask Amanda Brock about the father of her baby, she tells them the baby will have two loving parents, who both happen to be women. To that, the lesbian Nevadan woman in her late 30s usually gets one of two responses: Self-correcting and over-explaining they “have another friend that’s also gay with kids,” or they say something like, “Well, kids need a dad.”

Amanda also recalls medical professionals acting like her wife was her sister, and treating it as a burden when she asked whether she was supposed to put her wife’s name in the “father” spot on the birth certificate.

Christina Bailey, a 34-year-old teacher in California, had a similar experience being asked about her husband by healthcare professionals. “I had to announce several times I was a lesbian and then deal with the silence,” she says.
Stigma, discrimination, and misinformation can show up in different ways. Besides insensitive, othering questions about partners, common barriers that LGBTQ+ individuals may face during pregnancy include:

• A refusal of services, or limited access to services
• Difficulty finding providers who understand their needs
• Feelings of isolation and judgment
• Healthcare delays and mistreatment

“Microaggressions, biases, and discrimination experienced among any minority population are amplified in pregnancy,” explains Kara McElligott, M.D., an ob-gyn in Durham, North Carolina, and the medical advisor at Mira, a fertility tracker. “This is because pregnancy is a state of increased societal expectations and emotional and physical vulnerability.”

In fact, a recent national survey found LGBTQ+ people are twice as likely to report mistreatment during pregnancy than cisgender, heterosexual women. And those who were unmarried and used Medicaid faced an even higher risk. A literature review from 2020 says transgender men face substantial challenges during pregnancy and birth, informed by the cisnormativity embedded in healthcare norms.

Ways to Advocate for Yourself

You don’t have to accept any level of mistreatment or judgment during your parenthood journey, whether it’s intentional or not. Try these suggestions for advocating for yourself and your family.

Find Trustworthy Providers

All pregnant people should feel comfortable around their providers. You may find that it takes a bit more work to find someone you trust. For recommendations of healthcare professionals who have experience supporting LGBTQ+ individuals, look through the LGBTQ+ Healthcare Directory.

Learn What Excellent Care Involves

Find out what the process of your care should entail as well as what your rights are. “Learn as much as you can about what to expect so that you can identify when your care needs are not being met,” McElligott says. “Make a list of questions for your provider before each visit.”

Prepare Responses

Decide what you want to say to common unwanted comments, if anything at all. “Whenever people would talk about my baby not having a dad, I would turn it around and talk about all the things she does have, including five loving grandpas, two amazing uncles, several older male cousins, and lots of male family friends,” Amanda says. “I definitely feel like it’s important to share our thoughts on what makes a family, and it’s certainly not genitalia or even blood/genetic relationships.”

Correct Your Healthcare Providers, If You Feel Comfortable

You’re allowed to stand up for yourself and be true to yourself. “Whenever someone misspoke in the doctor’s office, I would always politely correct them,” Amanda says. “Sometimes it would be an honest assumption and they would accept the correction, and other times the legal forms and paperwork just haven’t caught up to real life yet, so it’s not really their fault.”

Christina did the same, and she encourages others to do what feels best for them. That could mean not correcting people when you don’t feel comfortable with it. She adds, “I do think it’s important that no one should have to say they are gay all the time, if they don’t feel it’s safe.”

Ask for a Second Opinion

Remember that it’s perfectly okay to switch doctors or to see someone else. “If you feel you’re not receiving the right care, ask to speak to a supervisor or get a second opinion,” McElligott says. “Everyone has the right to do so.”

Look for Role Models

LGBTQ+ organizations and the internet can be ideal for finding others who’ve been through this experience. Christina shares her story on Instagram and TikTok, which can be great places to find LGBTQ+ pregnancy and parenting advocates, along with people you can relate to.

“Other people with similar experiences can share their stories, give advice, and inspire you when you need it most,” McElligott says.

The Importance of Having a Pregnancy Advocate

You don’t have to go it alone. It’s important to have people who support you throughout your pregnancy and after you give birth.

A pregnancy advocate can be:

• A support partner. This could be your romantic partner, a friend, family member, or someone else you trust to go with you to doctor’s appointments and support you during birth.
• A pregnancy justice advocate. A pregnancy justice advocate can inform you of local laws and culture that may affect your care. For instance, they can talk with you about states that allow a religious exemption for medical professionals to decline serving LGBTQ+ clients or that don’t require them to recognize unmarried LGBTQ+ people as parents. You can find one with help from organizations like Pregnancy Justice.
• A doula. These people know important questions to ask, can share your birthing preferences, provide emotional and physical support during labor, help with breastfeeding/chestfeeding techniques, and more. The Queer Doula Network directory may be a good place to start to find a doula who’s sensitive to your needs. A resource like this can help you narrow down your choices, but ultimately, you should check a doula’s qualifications and references, and interview candidates to find the right one for you.
• Your healthcare team. If you’ve found an ob-gyn, midwife, nurse, or other provider who’s understanding and supportive, they can help advocate for you to others on your care team.

“Having someone else to advocate on their behalf means less pressure to stay vigilant and more people paying attention,” McElligott says. Pregnancy itself is stressful, and you may find that it’s a bit easier if you have more people looking out for you.

Recommended Pregnancy Resources for LGBTQ+ People

These resources can help you find providers, understand your rights, and more:

• The National LGBTQIA+ Health Education Center by the Fenway Institute
• LGBTQ+ Healthcare Directory
• RTZ HOPE
• Queer and Trans-Centered Resources for Families and Birth Workers
• Birthing Advocacy Doula Trainings Doula Directory
• Family Equality, including their resources Preparing for Pregnancy as a Non-Binary Person and Family Building for the Trans Community
• Queer Doula Network directory

You deserve equitable treatment inside and outside the doctor’s office. If or when you encounter barriers, remember that standing up for yourself is important, and it doesn’t make you difficult.