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For same- and similar-gender couples and transgender individuals wanting to have genetically related children, there are multiple options due to reproductive medicine to choose from. One of the most popular choices is surrogacy for gay couples, where a couple’s biological father contributes their sperm to create an embryo, and a surrogate mother strives to carry the baby to term. Other options include adoption and foster care, though both may have additional legal and financial implications.

Moreover, gay men and transgender parents may have difficulty navigating the legal system, as outdated laws and regulations can make it difficult for them to start families. Fortunately, organizations, fertility clinics, and advocacy groups exist to provide guidance and support to those wishing to create families.

Can Two Men Have a Baby?

Sure! Two gay men may have a kid using a method known as reciprocal IVF. In this scenario, one guy provides sperm to fertilize the eggs of the other man, which are subsequently inserted into a surrogate's womb. The surrogate carries the baby to term and gives birth. Both dads will be legal parents and have a genetic connection to the child.

Biological Child

Many individuals wish to have a biological child. And surrogacy for gay couples makes that desire a reality. Here is a summary of crucial factors to consider if you are unfamiliar with surrogacy.

Types of Surrogates

Over the past few years, the number of gay men utilizing surrogate mothers has increased. Two types of procedures exist.

Traditional Surrogacy

In traditional surrogacy, the surrogate mother is both the gestational carrier and the biological mother of the baby. Fertilization using intrauterine insemination (IUI) or in vitro fertilization (IVF) made this arrangement possible.

Legally, traditional surrogacies are more high-risk than gestational surrogacies, as the surrogate mother could have a claim to custody or visitation should they wish to pursue it in court.

Gestational Surrogacy

In contrast, gestational surrogacy involves the implantation of a fertilized egg from another biological woman into the surrogate mother through in vitro fertilization (IVF).

The child is thus not biologically related to the surrogate mother, which makes it more attractive from a parental rights standpoint. If the surrogate mother changes her mind during the pregnancy, she will not have a solid legal claim against the child.

Egg Donor Options

The egg donors will have to be found in the case of gestational surrogacy, and the egg will then be fertilized with one gay man’s sperm through IVF. Here is a look at the different types of egg donors.

Known Donor

A "known donor" is an egg donor already known to the intended parents. They could be close friends or relatives. It may reduce overall surrogacy costs if the donor donates their egg to the couple for free. They typically remain in contact with the gay men and the baby but do not act as a parent.

You won't need to employ an agency or fertility clinic to find an egg since you already know this type of donor. For many gay parents, this route can help to reduce overall surrogacy costs, especially if their egg donation choice is made deliberately as an act of love or support.

Anonymous Donor

An anonymous donor is someone the gay men do not know personally, and they will not receive any identifying information about the embryo donor.

This type of donor is usually coordinated for you by the surrogacy agency or clinic. Once the baby is born, you will have no contact with the biologically related mother.

Semi-Open Donor

A "semi-open donor" is a kind of arrangement where only some information is shared between the egg donor and the intended parents.

They communicate through an intermediary, but if both parties agree, they can open up the arrangement in the future.

Open Donor

Lastly, an "open donor" arrangement allows both parties to communicate directly.

It is common for them to meet each other in person before or after birth, but besides, individual arrangements can vary.

Sperm Donor Insemination Process

Insemination is an assisted reproductive technology (ART) in which specially washed sperm is transferred to a person's cervix or uterus, typically to achieve a pregnancy. It is an option for same-sex couples, heterosexual couples where the intended parent is transgender, and some people assigned female at birth. Sperm donors may come from a sperm bank or be known donors.

Insemination can be performed at a fertility clinic, or a midwife can perform the procedure at home in some cases. However, it is vital to note certain legal and medical risks associated with home insemination.

Deciding On Roles

Same-sex couples often share parenting responsibilities more equally than many heterosexual couples due to the amount of planning and thought that typically goes into having a baby with a same-sex couple. Studies have shown that gay couples tend to be more prone to share domestic duties and childcare than heterosexual couples.

Gay male couples may be more involved in their children’s lives than heterosexual dads, and this can raise their self-esteem and provide a sense of fulfillment. Additionally, biological mothers or other women may be included in family life by introducing the children to them as female role models.

Legal Aspects

In the case of surrogacy, it is also necessary to work with a surrogacy agency that can provide an experienced attorney in reproductive law and offer guidance through the legal process. They can connect you with an experienced attorney and will be up-to-date on everything you need to do in advance to ensure a smooth legal process.

There are three key elements of the surrogacy legal process:

I. The surrogacy contracts: It is an outline of the financial and social responsibilities of each party.

II. The pre-birth order: It is the first step towards establishing the intended parents as legal parents.

III. The adoption/post-birth process: It involves the entire adoption paperwork after the child is born.

Social Aspects

There is growing support for same-sex families! Research has shown that children who grow up in same-sex families are just as emotionally, socially, and educationally well-adjusted as any other children.

However, these families still face certain stigmas and harassment, so it is important to surround them with a supportive network of friends, family, and organizations. It is essential to intervene immediately if a child is being bullied since schools and teachers are prepared to handle such situations.

Costs

Surrogacy can be an expensive process. Costs can vary depending on the type of surrogates, egg donors, and whether or not IVF is used. For surrogacy in the United States, an approximate total cost of $120,000 with IVF and $98,000 without it.

As intended parents, you must pay for all agency fees, legal fees, and medical costs, along with fairly compensating your gestational carrier.

Adoption

Another option for hopeful gay couples is adoption. Here’s a look at potential pathways and the legal & cost considerations.

Ways of Adoption

There are five distinct adoption procedures, as determined by the Children’s Bureau:

• Public domestic adoption is one of the possible pathways to consider, as it requires fewer restrictions due to the lack of a private agency involved.
• Private domestic adoption requires more restrictions and involves the participation of a private agency.
• Independent domestic adoption involves the direct interaction between the adoptive parents and the birth parents.
• Intercountry adoption with a Hague Convention country and with a Non-Hague Convention country are the two remaining pathways available.

Legal Issues

Similar to surrogacy, the legal nature of adoption is complex, and the laws can vary from state to state and country to country. In light of this, we always suggest working with a professional adoption agency in your region that can aid you with the process.

Costs

American Adoptions estimates that the average cost of private adoption in the United States is around $70,000. It encompasses all adoption agency fees, legal fees, medical costs, and potential living costs of the birth mother.

However, remember this cost is contingent on where you reside and where you are adopting from. The Child Welfare Information Gateway resource is a great place to get a better feel for the costs and processes associated with adoption in your area.

Foster Care

Foster care is another alternative for the two gay men who want to establish a family. To become a foster intended parent, you must first be licensed.

State-by-state variations in licensing requirements are feasible, but generally speaking, the following steps are involved:

• Training;
• Background checks;
• Home safety checks;
• Family assessment;
• Referencing.

After getting a license, prospective gay fathers can be called upon to foster a child at any time. Being a foster parent is challenging since you never know how long a child will be with you − it might be a week or several years. Adoption may lead from foster care in some circumstances; however, this is not always the case.

Co-Parenting

The term "co-parenting" is most frequently used concerning divorce; a separated spouse with joint custody of raising children. However, co-parenting is planned for before a baby is born in the context of LBGT family building. Note that planned co-parenting can apply to polyamorous families and also other family structures, not only LGBT families.

Co-parenting, which can apply to multiple family structures, involves two or more people coming together to create a child and raise it together. In this case, the two gay men or gay couple in question will be the genetic parents, and the egg donor, sperm donor, and gestational carrier may all be considered intended parents. It can be done without sharing a residence or even living close to each other. The goal is for all of them to share parental rights and responsibilities.

The Future of ART for Same-Sex Couples

While technology has advanced extensively since the first surrogacy birth in 1985, it is still not possible for LGBTQ families to have a child using DNA from both fathers.

However, the IVG (in vitro gametogenesis) process, which allows stem cells to be reprogrammed into both sperm and egg cells, is being studied in mice and may eventually lead to the ability to create an embryo from two males. Whether or not this will be a possibility for gay couples in the future is yet to be determined.

by Dr. Uliana Dorofeyeva

M.D., IVF specialist, gynecologist, reproductive endocrinologist, expert of ultrasound diagnostics.