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The Future of Reproduction for Queer Couples

While rights for certain people who identify as LGBTQ have grown over the past several years, there’s one particular area where many queer couples lack a particular privilege: reproduction. Options have traditionally included surrogacy or adoption, but even then, the right to parent has been a hard-fought battle for the LGBTQ community. While the queer community finally has the right to parent, however tenuous, certain couples are still missing the opportunity to procreate using their own DNA — and for some, combining genetic material with their partner would be a truly extraordinary experience. And this opportunity may soon become a reality.

Researchers are creating a way for queer couples to reproduce using both of their DNA. Known as in-vitro gametogenesis (IVG), this science takes cells that are easy to harvest, such as from the hair or skin, and turns them into pluripotent stem cells (iPS cells). These cells can then be reprogrammed to become any cells in the human body. In essence, cells could be transformed into egg cells or sperm cells, making it possible for queer couples to conceive with only their genetic material.

This research has been spearheaded by scientist Shinya Yamanaka, MD, PhD, a professor at Japan’s Kyoto University who received the 2012 Nobel Prize in Physiology or Medicine along with the scientist Sir John B. Gurdon for their work in iPS. Based on this foundational work, in 2016 a group of researchers at Kyoto University were able to do what was previously perceived as unthinkable. Using cells from a mouse’s tail, the scientists created eggs from iPS cells. These eggs were then fertilized and implanted into female mice, which went on to generate baby mice. In their paper on this research, the scientists wrote: “The reconstitution of these events in vitro using pluripotent stem cells is a key achievement in reproductive biology and regenerative medicine.” Indeed, this research is groundbreaking in terms of reproduction as well as the treatment of infertility and chronic illnesses.

While this research proved to be a breakthrough in reproductive biology, there’s still a great deal of research ahead for creating sex cells that could work in humans. However, scientists around the world are looking to replicate the research performed on mice in order to reprogram human iPS cells into sex cells, or gametes. (A gamete is a mature haploid male or female germ cell, which forms a zygote by uniting with a cell from the opposite sex). One of the forerunners in this research is the Clark Lab at UCLA. Led by Amander Clark, PhD, the lab seeks to use cellular research to improve human reproductive and child health as well as creating stem cell models to recreate tissues and address infertility in cancer patients.

As of now, the closest option queer couples have to IVG is reciprocal in-vitro fertilization. But this intensive process is only viable for a couple where both individuals have uteri. During reciprocal in-vitro fertilization, one of the individuals provides an egg that is inseminated, and the other individual carries it to term. While this is a useful option for some in the LGBTQ community, reciprocal in-vitro fertilization remains accessible only to those with certain financial resources. Insurance doesn’t cover this procedure, which can cost upwards of $30,000. Other parenting methods available to other queer couples, such as surrogacy or international adoptions, also often come with a hefty price tag.

Being on the cutting edge of science, IVG may also come at a cost that’s affordable only for the privileged. With IVG, more couples would have the opportunity to procreate — but only those who could clear a steep financial hurdle. This would automatically eliminate anyone in the LGBTQ community with a lower income, a group disproportionately burdened with economic insecurity, especially among those who face marginalization on multiple fronts. IVG could perpetuate a problem that already exists: those with more means have more access to opportunities, reproductive and otherwise.

In addition to physical and economic constraints, there is recurring pushback against the methods for—and the very idea of — queer reproduction. Before the ability to create iPS cells, scientists were limited to the use of stem cells derived from frozen human embryos, which has long generated controversy. In addition to promising advances in fertility, stem cells may help treat diseases such as diabetes, spinal cord injury, Parkinson’s disease, and myocardial infarction. Still, ethical debates have surrounded stem cell research for decades, as the cells are harvested from oocytes and embryos. This touches on the debate on when human life begins — at conception or once a fetus is viable to live outside of the womb.

However, the debate may continue on with the use of IVG cells, as the anti-abortion movement is so often tied to anti-queer policies. In addition to the use of stem cells, the right for LGBTQ couples is heavily debated in conservative communities. For decades, adoption and foster care agencies — particularly those with a religious affiliation — discriminated against queer couples seeking to adopt. President Barack Obama enacted nondiscrimination policies across the nation to protect against such prejudiced practices. As of this writing, however, President Donald Trump is seeking to repeal these policies or add exemptions for religious organizations, as several have argued that the federal government is forcing them to contradict their beliefs.

By offering another option for queer couples to reproduce, one in which only the couple’s DNA is needed, the anti-LGBTQ advocates may find a new vantage for protest. The most commonly cited biblical passages opposing queer people include: “You shall not lie with a male as one lies with a female; it is an abomination” (Lev. 18:22) and “If there is a man who lies with a male as those who lie with a woman, both of them have committed a detestable act.” (Lev. 20:13). Certain religious groups, such as anti-LGBTQ Catholic and evangelical Christian denominations, take this as a literal interpretation to claim that homosexuality is a sin. With this interpretation, conservatives argue that it is “unnatural” for a queer couple to have a child together. But what if science provided a method to do just that? What becomes “unnatural”?

Political debates over the ethics of conception continue to rage on, especially in terms of stem cells. In addition, LGBTQ individuals still face daily homophobia, transphobia, queerphobia — as well as a conservative majority on the United States Supreme Court. This surging rightwing reaction makes LGBTQ civil rights appear tenuous at times. However obstinate our society may be, though, scientists are continuing to develop a method that may provide queer couples another option for making family.