By Claire Campbell

It is increasingly evident that the words we choose to use matter, especially when speaking of something as sensitive as infertility. The language we use reflects our intentions and fosters inclusion 一 or exclusion. There are few places where words matter more, though, than in written legislature. That is why when the World Health Organization (WHO) defines infertility as, “the failure to achieve a clinical pregnancy after 12 months of regular unprotected sexual intercourse,” it matters 一 and has far reaching impacts. 

This definition does not include LGBTQ+ couples trying to build a family. There are many paths to parenthood that don’t include intercourse, so defining infertility without considering other methods of conception is exclusive and dangerous. Members of the LGBTQ+ community trying to conceive are not represented and are left without many of the resources heterosexual couples receive when diagnosed with infertility. 

What is social infertility?

An alternative definition is emerging to combat this exclusivity 一 and that is social infertility. Social infertility applies to people who are not able to reproduce due to factors associated with their sexual orientation rather than their own reproductive system. This definition includes LGBTQ+ people as well as individuals who are single and trying to conceive. Infertility is often related to the reproductive system itself, but social reasons can also be a factor.

Why is this wording so important?

Ultimately, definitions determine what your insurance will pay for. It is no secret that fertility treatments like intrauterine insemination (IUI) and in vitro fertilization (IVF) are expensive. So, insurance policies requiring LGBTQ+ people to pay out of pocket for six rounds of failed IUI before qualifying for an infertile diagnosis are discriminatory. Not to mention only 17 states require insurance policies to offer coverage for infertility diagnosis or treatment, but that’s a story for another day. 

Modern medicine has sophisticated ways of determining fertility without requiring failed sexual intercourse. Requiring this process is therefore inefficient and unnecessary, particularly for LGBTQ+ people who will require medical assistance to achieve parenthood regardless. 

What are the additional impacts of this wording?

Making the distinction of social infertility also impacts statistics reported regarding fertility. The so-called “invisible infertile” are those who are unable to conceive for reasons sometimes related to their bodies, but may also be because they are poor, single, or in a non-heterosexual relationship. Statistics often don’t include these individuals, hence the “invisible,” but as the definition changes we will be able to get a fuller picture of all who are faced with trouble conceiving.

A true working definition…

Using the term social infertility has created some discussions about the impact on fertility treatment distribution and who would qualify. Many ethics professionals suggest dropping the label entirely and treating infertility simply as a medical condition without worrying about the origin. That is why the definition is in the works, but any progress towards equal treatment with such a difficult diagnosis should be celebrated. 

Everyone deserves equal support on their journey to parenthood no matter what their experience looks like or who their partner is. 

While United States insurance companies do not currently recognize social infertility, bringing awareness to the flaws and limitations of policies can hopefully have lasting impacts in the near future. Social infertility is not a perfect definition and raises additional questions, but it is a step in the right direction. Each of us has a duty to choose the words we use wisely to make not only the joy of building a family inclusive and accessible, but all aspects of society equally as fair.