Fertility Care for Queer People in the Bay Area
Why Bay Fertility Care Exists
Bay Fertility Care was created in response to a persistent gap in fertility care: most reproductive medicine in the U.S. is built for heterosexual couples experiencing infertility, even though many people seeking fertility support are not infertile in a medical sense at all.
Most traditional fertility care in the United States has been structured around one very narrow model: heterosexual couples experiencing infertility after a period of trying to conceive. For many queer and trans people, however, “trying to conceive” isn’t just a clinical question — it’s a social, emotional, and logistical one. Many queer and trans individuals come to Bay Fertility Care not because they experiencing physiological fertility issues, but because their bodies, relationships, and identities fall outside of hetero norms. And yet, clinical pathways, intake forms, insurance language, and treatment protocols frequently assume otherwise
At BFC, we saw how often queer and trans people were:
treated as “exceptions” rather than anticipated patients
forced to translate their lives into heteronormative frameworks
offered care models that prioritized intervention over fit
excluded from nuanced conversations about physiological fertility because they did not meet the clinical definition of infertility
BFC was created to offer a different starting point: fertility care that assumes queerness, affirms gender diversity, and centers people with presumptively healthy fertility who need access — not escalation.
When Fertility Care Isn’t About Infertility
Much of queer fertility care exists in the space of social infertility: the absence of a sperm-producing partner, a uterus-bearing partner, or a biologically reciprocal pathway — rather than a diagnosis of impaired fertility.
This includes:
single queer people
lesbian and queer couples
trans and non-binary people
any relationship in which no one produces sperm or carries a uterus
Traditional definitions of infertility — typically framed as 12 months of unprotected heterosexual intercourse without conception — simply do not apply. Yet those definitions continue to structure how care is delivered, what is reimbursed, and who is taken seriously in medical settings.
A midwifery-led model allows fertility care to begin where many queer people actually are: with bodies that may be functioning as expected, but lives that require intentional support, timing, and access. Bay Fertility Care is founded and led by a queer midwife, so we get it!
Specific Fertility Needs in the Queer and Trans Community
1. Gender-Affirming, Non-Pathologizing Care
For trans and non-binary people, fertility care often intersects with gender affirmation. This may include:
prior or current hormone therapy
decisions about fertility preservation before medical transition
navigating dysphoria during pelvic care, pregnancy, or chestfeeding
Affirming fertility care understands that gender identity is not incidental to reproduction — it is central to how people experience their bodies, make decisions, and engage with care.
2. Diverse and Intentional Family-Building Pathways
Queer family building often involves paths that are less commonly discussed — or poorly explained — in mainstream fertility clinics, including:
donor sperm IUI outside of a clinic setting
reciprocal IVF
fertility preservation for trans people prior to medical transition
gestational surrogacy
adoption and foster-to-adopt as primary, intentional paths
Each of these routes carries unique medical, legal, emotional, and financial considerations that require attuned support from providers.
3. Early-Stage, Low-Intervention Support
Many queer people benefit most from care that:
starts before pathology is assumed
respects physiological fertility
avoids unnecessary testing or medication
offers continuity across cycles
For people with regular ovulation and no known fertility concerns, midwifery-led home IUI can be an appropriate and effective— particularly when supported by careful screening and clear pathways to co-care when needed.
4. Legal, Financial, and Social Context Matters
Queer fertility journeys are shaped not just by biology, but by:
legal parentage considerations
donor agreements
insurance exclusions
the emotional challenges of navigating systems not designed for them
Fertility care that ignores these realities risks being incomplete.
Our Model: Fertility Care That Fits Real Lives
At Bay Fertility Care, we offer fertility support that:
assumes queerness as part of the patient population
centers continuity and informed consent
practices in a trauma-informed framework
respects physiology while remaining clinically up to date on evidence.
collaborates with physicians when medical care is indicated
honors the reality that there is no single “right” way to build a family
We believe queer and trans people deserve fertility care that feels thoughtful, competent, and affirming — not like a workaround or an afterthought.
Queer-Specific Fertility & Family-Building Resources
Below is a curated list of queer- and trans-centered resources that many clients find helpful alongside clinical care:
Books & Education
Queer Conception by Kristin Kali
A comprehensive, trans-inclusive guide to conception, pregnancy, and family building written specifically for queer and trans parents-to-be.Baby Making for Everybody by Ray Rachlin and Marea Goodman
A guidebook for queer/trans and alternative family building.
An extensive resource library of articles and videos related to trans conception.
Seahorses: Trans, Nonbinary, and Gender-Expansive Pregnancy Edited by Simon Knaphus
An anthology by and for trans people about queer family building, including conception, at the intersections of legal, political, and cultural contexts.
Community & Support
Parent Together
Membership-based community offering support and education for LGBTQ+ parents and those planning families.Queer Conception Support Groups
Support groups facilitated by midwife and author Kristin Kali, offering community for single people and queer and trans people navigating conception and pregnancy. Various group offering available.
Advocacy & Information Hubs
RESOLVE – LGBTQ+ Family Building
Clear explanations of assisted reproduction, donor conception, and legal considerations.Family Equality
Education, advocacy, and peer support spaces for LGBTQ+ parents and those planning families.