Assisted reproduction and trends in parenthood among LGB people

Same-sex couples experience high levels of unmet parenthood desires and often depend on the availability of adoption and assisted reproduction techniques to become parents. In many countries, assisted reproduction techniques are not covered by public health or health insurance schemes for women in same-sex couples, even though they are covered for women in different-sex couples.

In this article, the importance of such restrictions for levels of parenthood is quantified by studying a policy reform in Spain. Women in same-sex couples were excluded from accessing assisted reproduction procedures free of charge through the Spanish public health system in 2013. Access was re-established in some areas in subsequent years, and ultimately in all of Spain in 2021.

Using data from the Spanish census and large household surveys, we show a decline in the share of women in same-sex couples living with newborn children following the reform of 2013. Co-residence with newborn children among women in same-sex couples dropped to very low levels in areas where public access was not re-established in the subsequent years, whereas its prevalence increased elsewhere. These results illustrate the importance of access to assisted reproduction to tackle unmet parenthood desires among women in same-sex couples.