“Lesbians, Bisexual, non binary and Trans women couples are expected to demonstrate their infertility before the NHS will fund IVF – and to do so, must pay privately for up to 12 rounds of artificial insemination.”
This week in Westminster, Kate Osborne MP led a debate in Parliament on IVF provision and called on the Government to end the discrimination in IVF provision facing LGBTQ+ couples. Read her speech in full below.
I want to start by thanking everyone who came along to the briefing on this yesterday – in particular Meghan and Whitney, Laura Rose Thorogood from LGBT Mummies and Michael Johnson Ellis from Two Dads for sharing their deeply personal stories and the time they spent talking to MPs about this important issue.
As a mum of 2 wonderful boys, one of whom was conceived through IVF, this is a subject close to my heart. Everyone deserves the chance to start a family, no matter their sexuality or gender identity.
It was around 14/15 years ago that I started the IVF process as part of a same sex couple.
At that time we went through unnecessary procedures, a long waiting list and significant costs – but despite the hurdles it was achievable and my wonderful youngest son is now 13.
In the time he has been alive – for the past 13 years life for LGBTQ+ people in the UK has got progressively worse.
And not just in terms of IVF, in many ways life for LGBTQ+ people has gone backwards over the last decade.
Homophobic and transphobic bullying is on the rise, Trans Hate crime has risen, waiting lists for LGBTQ+ physical and mental health care are through the roof and virtually every day we see an attack on our community from this Government.
From attacks on LGBTQ+ refugees, to attacks on inclusive education in schools, to language outright denying Trans rights, this Government has ramped up its war on woke using divisive inflammatory rhetoric that is designed to stoke hate and distract from the mess they’ve made of this country ahead of the next General Election.
Ministers have failed to keep their promise to ban so called conversion therapy in full – allowing the barbaric practice to continue and in terms of IVF for same sex couples we are still waiting for them to keep their promise to remove the discriminatory practical and financial barriers LGBTQ+ couples face.
Since the IVF journey I was part of, NHS waiting lists are longer, the hurdles LGBTQ+ couples have to jump through have increased with a fragmented NHS meaning a postcode lottery in provision – and the financial cost is significantly higher.
If I were starting my journey to become a parent now – even on an MP’s salary, I doubt I would be able to afford to complete the process.
14/15 years later it is a disgrace that couples like Meghan and Whitney are still having to go through the same unnecessary fertility tests that we had to go through.
Speaking to people ahead of this debate it has been depressing to repeatedly hear from women who are giving up on their dream to become a parent because they have ran out of money, LGBTQ+ people being priced out of having a family.
Lesbians, Bisexual, non binary and Trans women couples are expected to demonstrate their infertility before the NHS will fund IVF – and to do so, must pay privately for up to 12 rounds of artificial insemination.
Yesterday MPs heard first hand from people who this is having a huge impact on – including Meghan and Whitney who are here again today to listen to the debate.
Meghan and Whitney spoke about their ICB requiring them to pay for 12 rounds of artificial insemination before they would be eligible for any treatment on the NHS which led to their decision to take their ICB to a judicial review.
I have spoken to couples who have paid up to so many couples who have spent 30/50/60,000 pounds on treatment, and many more who have just given up because they cannot afford to start the process – being priced out of having children.
Just last week the BBC referred to the situation as a ‘gay tax’ facing same-sex couples starting a family.
Megan and Whitneys legal case, more than a year ago now, helped prove that NHS England’s IVF policy discriminated against same-sex couples.
The National Institute for Clinical Excellence (NICE) recommends that couples who have been unsuccessful in conceiving after two years should be offered three full cycles of in-vitro fertilisation (IVF) for women under 40, and one cycle for women between 40 and 42.
The current requirement is that same-sex couples are expected to self-fund up to 12 Intrauterine (intra-uter-ine) Insemination cycles before they are eligible for NHS IVF treatment.
In comparison, opposite sex couples are not required to self-fund any treatments before being eligible for NHS IVF treatment.
These guidelines are due to be updated next year.
The Government has accepted this situation is unfair and discriminatory and in last year’s Women’s Health Strategy promised to remove these additional financial barriers to IVF for female same-sex couples in England, including removing the requirement to privately fund artificial insemination to prove fertility status before accessing NHS IVF services.
I’m pleased to see the Parliamentary Secretary for Mental Health and Women’s Health Strategy is the Minister responding today.
In May 2022 she said “We expect the removal of the additional financial burden faced by female same-sex couples when accessing IVF treatment to take effect during 2023.
And on the 11th September 2023 in response to a parliamentary question she told the house “We remain committed to remove the requirement for female same-sex couples to self-fund six rounds of artificial insemination before being able to access National Health Service-funded treatment. NHS England are intending to issue commissioning guidance to integrated care boards to support implementation, which is expected shortly.”
Minister we are still waiting for this guidance.
The response also failed to acknowledge that even now some ICB’s are still requiring self funding for up to 12 rounds.
With just 10 weeks left of 2023 – the promise to remove the additional financial burden in 2023 is obviously not going to be met.
Of the 42 Integrated Care Boards (ICBs) in England – only four offer fertility treatment to same-sex couples without the requirement to pay privately for artificial insemination.
10 more have said they are reviewing their policies but without the guidance from the Government or NHS England there is not even a timeline for ICB’s to make the changes needed.
The Minister must ensure the full implementation of the recommendations from the Women’s Health Strategy, and work with NHS England to set out a clear timeline to bring an end to the inequities experienced by LGBTQ+ couples when accessing fertility services.
In England, the NHS will fund in-vitro fertilisation (IVF) for heterosexual couples who have been trying for a baby unsuccessfully for at least two years and also meet certain other criteria such as age and weight.
Yet even here there is a postcode lottery for IVF – some ICB’s using outdated BMI as a way of measuring health – and refusing women IVF on the basis of their or their partners BMI.
Some ICB’s are setting their own criteria – and this happened to one of my constituents, refusing to offer IVF if either person in the couple already has a child with a previous partner.
Stonewall and DIVA’s 2021 LGBTQI+ Insight Survey found that 36% of LGBTQI+ women and non-binary respondents who had children, experienced barriers or challenges when starting their family.
One in five of those stated that the greatest barrier or challenge was the high cost of private fertility treatment.
Stonewall’s latest research shows us that 93% of ICBs are still falling short of the Women’s Health Strategy’s target.
The Govt and NHS England have said they have a ten year strategy to tackle this – most women cannot wait 10 years for the rules to change.
For the majority of people – raising tens of thousands of pounds is impossible – this policy is making them financially infertile
There have been so many organisations who have been in touch with concerns around IVF provision from the Royal College of Obstetricians and Gynaecologists, BPAS, Progress Educational Trust, National Aids Trust and many more
The National AIDS Trust has been challenging discriminatory legislation that prevents many people living with HIV from starting a family. Under UK law, people living with HIV don’t have the same rights as everyone else when it comes to accessing fertility treatment.
Scientific evidence has demonstrated that there is no risk of HIV transmission via gam-eet donation, due to advances in HIV treatment and this has been accepted for people in a heterosexual relationship.
Heterosexual couples are classified as being in an ‘intimate relationship’ by the Government’s Microbiological Safety Guidelines, and people living with HIV are allowed to donate gam-eet’s to their partner.
This ‘intimate relationship’ designation is not available to LGBTQ+ couples, creating yet another layer of discrimination on access to fertility treatment for LGBTQ+ people living with HIV.
Yesterday LGBT Mummies told MPs that in some cases when people are denied fertility funding access, they look to alternative routes like Home Insemination.
Going down this route comes with physical, psychological & legal implications that in turn cost the Government and the NHS more than if the treatment and chance of family creation were offered in the first place.
Laura-Rose told us that whilst home insemination has really worked for some people – and they have a great relationship with their donor, for others it can be dangerous.
It has led to inappropriate proposals to only donate if people have intercourse with the donor.
As well as health risks, if people do not use registered banks or clinics to obtain sperm, there is also the possibility a donor could later try to claim parental rights over a child.
Laura Rose spoke about how lucky she is to be a parent – but is still paying off a debt after incurring costs of more than £60k – so many families she is working with are simply priced out of having a family.
Two Dads UK also raised similar concerns in their briefings and contact with MPs, with Michael setting out that the inequality is pushing a community of people to take risks.
The Royal College of Obstetricians and Gynaecologist told me there is significant and unacceptable variation in the availability of NHS-funded fertility treatments in the UK and that they strongly believe there should be equal access to fertility treatment for samesex couples and called on the Government and NHS England to support Integrated Care Boards (ICBs) to ensure this commitment is realised as soon as possible.
I hope the minister has listened to all of the concerns and evidence from the very many organisations I’ve mentioned and no doubt the many others that will be referenced in the debate.
Ministers and NHS England can and should immediately end the discrimination in IVF provision facing LGBTQ+ couples.
It is unacceptable that the fertility treatment available for women via the NHS varies depending on where they live. The financial burden on same-sex couples is unacceptable – we cannot wait any longer.
The Government’s guidance and timetable for this to end should be published now.
The Minister has recognised this discrimination is unacceptable and I hope to hear in their response that immediate action will be taken to remove these unnecessary additional practical and financial burdens from LGBTQ+ couples.
- This article is a published version of the speech given by Kate Osborne during the debate she led on IVF provision on October 24th, 2023.
- Kate Osborne is the MP for Jarrow and a regular contributor to Labour Outlook. You can follow her on Facebook, twitter and Instagram.
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