Thinking about starting a family? Make sure you investigate all of your options.

Deciding to start a family can be an exciting and nerve-wracking decision. But for LGBTQ+ couples and individuals in particular, selecting the best path to parenthood can be overwhelming in light of the many available options. Below, we’ll sift through the pros and cons of each in order to help you make an informed decision.

Biological Routes to Starting an LGBT Family

Artificial Insemination

Artificial insemination is the process by which a donor’s sperm is inserted directly into a woman’s uterus, and is typically the most cost-effective option for lesbian couples interested in being biologically connected to their child. The acronyms ICI and IUI stand for the main methods of artificial insemination: IntraCervical Insemination and IntraUterine Insemination.

ICI uses a device to insert unwashed sperm — that is, sperm that is still mixed with seminal fluid — directly into a woman’s cervix. This procedure can be done at home or in a doctor’s office, and is typically the easiest and most affordable method of insemination. It also most closely replicates natural conception, where the chances of pregnancy are about 25% per cycle, depending on the woman’s fertility and quality of the sperm.

IUI uses a device to insert pre-washed sperm directly into the uterus, giving it a better chance of reaching the fallopian tubes. IUI-prepped vials of sperm from a sperm bank are typically more expensive, but increase the likelihood of pregnancy.

In Vitro Fertilization

In Vitro fertilization (IVF) is the process by which an egg is fertilized outside of the body and transferred to the uterus where the child is carried to term. For gay men interested in being biologically connected to their child, IVF is typically a necessary step in the surrogacy process. Lesbian couples, on the other hand, may arrive at IVF only after other methods of insemination have failed, or if either partner encounters other fertility issues.

The costs of IVF vary by clinic depending on whether you are using a surrogate, frozen eggs, and by how many cycles you purchase up front from the fertility clinic. That said, The American Society of Reproductive Medicine lists the average price of one IVF cycle in the U.S. to be $12,400. Both artificial insemination and IVF often come with complex insurance requirements attached, so be sure to thoroughly consult your healthcare provider if you’re considering either method to build your LGBT family.


For straight couples and lesbians, surrogacy is typically considered if a woman has experienced miscarriages or unsuccessful IVF attempts. For gay men, surrogacy is a way to conceive a child that is biologically connected to one or both partners through the process of artificial insemination or IVF. While less common, a lesbian couple may also use a surrogate mother if one or both partners are unable to produce an egg or unable to carry a child to term. Surrogate mothers can be someone the couple knows personally, or can be selected through a surrogate agency. Professionals recommend the latter, as agency surrogates are pre-screened to avoid medical or fertility-related complications.

If you live in a state that still does not allow same-sex adoption, using a surrogate has the added benefit of ensuring one partner is recognized as the child’s biological parent. It’s important to note that each state has its own laws concerning surrogacy, and some do not allow it at all or even recognize surrogacy contracts. That’s why it is essential to use an experienced surrogacy agency to assist in navigating the process and ensure your LGBT adoption following the surrogacy is successful.

Fertility Preservation

While anyone can engage in fertility preservation, an AMA Journal of Ethics article notes it can be especially valuable for transgender individuals who elect to begin hormone replacement therapy or seek surgical means of transition. These methods of transition almost invariably result in infertility, so many trans people preemptively freeze their eggs or sperm before medical or hormonal transition so that they may be accessed later on when they are ready to start their biological LGBT family.

Non-Biological Family Building Options

LGBT family building - Two gay men smiling at child


Not everyone wants to (or can) biologically conceive a child, and many individuals and couples turn instead to the legal process of adoption. For single people and LGBTQ couples especially, adoption is fraught with paperwork and often prohibitive costs. And while domestic adoption agencies have warmed to LGBT adoptions in recent years, state laws still vary regarding who can adopt and through what means.

For those considering this option, it’s essential to research the different types of adoptions available: agency adoption, independent adoption, international adoption, state or public agency adoption, and second parent adoption.


Foster parenting is a way of caring for a child of any age for a range of time, usually because the child has been removed from a prior familial situation deemed unfit. Fostering can, but doesn’t always, lead to permanent adoption.

Most states do not take a position on whether or not LGBTQ couples are able to foster. That decision is instead left to welfare agencies and family court judges. And while a handful of states deny the right of same-sex couples to act as foster parents, six states explicitly protect that right: California, Oregon, Wisconsin, Massachusetts, Rhode Island, and New Jersey.


Intentional co-parenting — as opposed to co-parenting as the result of a divorce — takes place when unpartnered parents set out to raise a child together. It’s essential for those considering co-parenting to receive financial counseling and legal advice to establish clear expectations regarding shared custody from the outset.

Leveraging LGBT Family Resources

LGBT family - Two gay men cradling an adopted child

Regardless of how you approach family planning, there are many valuable resources and organizations whose goal it is to assist LGBTQ couples and individuals on their journey to parenthood. LGBT-friendly fertility clinics can offer invaluable guidance for potential parents of any sexuality and gender identity as they work to identify their options and pursue the best fit for their growing LGBT family.

Adoption advocacy groups like the Adoptive and Foster Family Coalition in New York City or the Family Equality Council work to change prohibitive policies surrounding LGBT adoption. Organizations like and Gay Parents to Be even offer financial assistance and legal resources for couples who might otherwise be unable to afford the often costly process of adoption, surrogacy, and artificial insemination.

Raising a family is not cheap. Surrogate agencies and other third-party methods can cost tens of thousands of dollars, and according to the Huffington Post, only 15 states require fertility services to be covered on insurance plans. Before making any decisions, make sure you’ve thoroughly investigated every option and resource available to you. Many of our providers offer fertility options and necessary care for those looking to start a family; use our search engine to find the right LGBT-friendly doctor to start building your family.

The road to LGBT parenting can be a long one, but the result is more than worth it. Whichever route you choose, it’s important to establish honest and open communication with loved ones as you make decisions that will change the course of the future — for you, your partner, and your child.

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