Navigating Parenthood and Healthcare as a Same Sex Couple in the UK

By Philippa Oakley, Chiropractor and Member of the British Chiropractic Association.

My wife and I embarked on a journey to expand our family, a path that required us to navigate numerous challenges and systemic barriers within the UK’s healthcare system for same-sex couples. Our experience, marked by both personal loss and professional growth, highlighted significant gaps in understanding and inclusivity within healthcare services, particularly for same-sex parents.

A void of understanding and inclusivity

During our pursuit of parenthood through IVF, we encountered several challenges. Despite the changing societal landscape, many IVF clinics still use outdated forms asking for “mother” and “father” details, instead of more inclusive terms like “parent 1” and “parent 2.” When we voiced our discomfort with one of us being labelled as the father, we were met with resistance and dismissive solutions such as “scrub it out” on the forms. We lost count of the number of times staff assumed my wife was my sister.

Moreover, we faced a lack of understanding from healthcare clinicians, who often asked intrusive questions out of curiosity rather than clinical necessity. As a same-sex couple, we incurred substantial financial costs which were upwards of £40,000 for IVF, while heterosexual couples can access various fertility tests through the NHS. As a same-sex couple, we had to be ‘demonstrably sub-fertile’ or try up to 10 cycles of self-funded treatment before becoming eligible for funded treatment. This varies depending on which area of the UK you live, leaving IVF for same-sex couples as a notorious ‘postcode lottery’, with a wide disparity in support and standardisation of treatment. Much of the LGBTQ+ inclusivity training offered to staff within the NHS is embedded within a wider EDI package which fails to offer the necessary degree of useful information, as it forms part of an online training programme which is ineffective and inadequate.

Legal and resource restrictions

Despite legal advancements, there are also still barriers to same-sex parenting rights in the UK. Fundamental arguments about our rights and challenges in care still exist, with recent data indicating that LGBTQ+ communities continue to face discrimination, inadequate healthcare, and major concerns about accessing necessary services. Our experience reinforced these findings, as we frequently felt that our specific health needs were not being met, and that our encounters with healthcare providers were marred by ignorance and insensitivity.

Once we had completed the process and I fell pregnant, our journey took a heartbreaking turn when we lost one of our twins during pregnancy. The COVID-19 pandemic further contributed to our isolation, as support groups were unavailable, and charities were ill-equipped to assist same-sex couples. Resources were often tailored to heterosexual couples, and support groups did not accommodate the unique needs of a non-biological bereaved mother, leaving myself and particularly my wife feeling isolated. This lack of tailored support underscored the need for more inclusive and culturally competent care, and the need for research into the impact of traumatic birth on same-sex couples.

Turning a tragedy into lasting change

After welcoming our daughter and saying goodbye to her twin sister, we felt particularly motivated to drive positive change from our experience. We wanted to honour our daughter’s memory and create lasting positive change within the healthcare system, ensuring that no one else has to face the same challenges we did. We initially focused on improving doctor-patient communication through running online CPD courses on motivational interviewing and health coaching. However, we soon wanted to expand on this, so, we collaborated with a trans-specialist advanced clinical massage therapist and developed an online training course in inclusive care for manual therapists. This initiative received an overwhelmingly positive response and led to further opportunities to provide training on inclusive care and communication skills for NHS trusts, with a specific focus on culturally competent care of LGBTQ+ people.

Our advocacy efforts have extended internationally. I have delivered training to NHS staff, informed LGBTQ+ Positive Action Plans, and worked with various healthcare organisations, including the Canadian Chiropractic Association and the British Columbia Chiropractic Association, to provide seminars on inclusive healthcare. Additionally, I have been involved in consultancy services with the General Chiropractic Council to improve EDI standards and have developed a lecture series on Equity, Diversity, and Inclusion for chiropractic students in the Philippines.

Our journey has allowed me to unite my experiences as an LGBTQ+ individual, a parent, and a practicing BCA chiropractor to advocate for inclusive healthcare. There is no legal requirement for many healthcare professionals working in private practice to undertake mandatory EDI training as part of their ongoing CPD requirements, which, in my opinion, leaves us vulnerable to patient complaints, and at risk of providing inappropriate care. As a member of the chiropractic profession, I am delighted so many of my colleagues have taken the opportunity to join us in setting the standard for the provision of LGBTQ+ inclusive care in manual therapy.

Chiropractors have the opportunity to be proactive and forward-thinking, addressing the needs of LGBTQ+ patients before issues arise. My hope is to leave the profession better than I found it, ensuring that LGBTQ+ individuals can seek chiropractic care without fear of assumptions, awkward questions, or misgendering. By creating an environment of inclusive care, we can ensure that all patients feel respected and understood.