It feels, sometimes, as though the path to equality is not just rocky or steep but, instead, a Mario-style platform game where there are crocodiles lurking in the gaps and certain blocks are designed to explode when you step on them. An example: for all this country’s smiling efforts at inclusivity, for all its rainbows hurriedly printed on hoardings and coffee cups, the barriers preventing female same-sex couples from having a family are as high and wide as ever.
For those who have avoided the haunted rollercoaster that is fertility treatment in the UK, either by luck or choice, here are the facts: the National Institute for Health and Care Excellence (Nice) guidelines state that funded access to IVF in England is available to women “who have not conceived after two years of regular unprotected intercourse or 12 cycles of artificial insemination (where six or more are by intrauterine insemination)”.
So, if a woman in an opposite-sex relationship tells her GP they have been “trying” for a baby for two years they can access NHS-funded IVF treatment immediately. If a woman in a same-sex relationship tells her GP they have been “trying”, through whatever turkey baster means necessary, 80% of local clinical commissioning groups (CCGs choose how to delegate NHS funding in England) still require them to have up to 12 rounds of IUI to prove they can’t get pregnant (an irony traditionally glossed over politely).
IUI costs anywhere up to £1,600 per cycle at a private clinic, meaning that with fees it’s not unusual for a same-sex couple to have to spend £20,000 and a year in clinical care, monthly excuses to your boss so you can slip away mid-morning to lie dreadfully in terribly lit clinics, nurses asking you to, “Just pop your clothes on the chair,” before being eligible for NHS treatment. The money – which represents two-thirds of the average UK salary, cash that straight couples might be using to buy a flat, or a car, or a series of marvellous “babymoons” in advance of the birth of the child they conceived on the sofa after watching Normal People – is boggling and disturbing, and inhibitory for most.
It’s not the same everywhere in the UK – . Throughout Scotland, which is centrally funded, all same-sex couples can have six donor insemination cycles followed by three full IVF cycles if needed. But in England, all 106 CCGs ration access to NHS-funded fertility treatment, with more than a quarter (the Fertility Network revealed) denying access to same-sex couples altogether. Just eight allow same-sex couples to have NHS-funded fertility treatment directly.
Fairness is so often an unhelpful word – a plate of dry meat, picked to the gristle. Especially when it comes to childbearing and rearing, when so many of us are in danger of breaking our necks looking over a shoulder at what our peers have got, and how, and how much, and how happily, and with what ease. But it is a fact that people are restricted from fertility treatments depending on who they love and where they live, their postcode deciding whether or not a child will be born. These details, flagged by the Fertility Network and Stonewall, and couples like Megan and Whitney Bacon-Evans who plan to sue their local NHS over what they claim is “IVF discrimination”, is not just unfair, but darkly telling.
Treatments that aren’t seen as life-saving are all rationed on the NHS, but the arbitrary criteria at play here inevitably shows us something, something about who is seen to matter more. The wild costs of conceiving a child, the £20,000 investment required before they’ve even stepped foot in John Lewis’s buggy department, means it’s ruled out as an option for many same-sex couples. Which means fewer queer families, more discrimination for LGBTQ+ people, and less change. IVF is an opportunity to help people who want children but are having trouble conceiving; an opportunity that has the potential to promote equality and refocus our too-narrow ideas of what a family can be.
And wouldn’t that improve all of our lives? Wouldn’t it improve the lives of everybody, gay or straight, who has lived in a family, or is creating a new one of their own, or is deep in the slimy weeds of somebody else’s; a move to broaden the image and expectations of what a family looks like? Its shape, its genders, the way it got here, the home it made.
Surely the traditional family unit has damaged as many people as it has supported – surely now is the time to invest in and celebrate families who are helping to show that the walls of that structure were not load bearing. That they can be knocked through and rearranged without the house falling down.
Email Eva at [email protected] or follow her on Twitter @EvaWiseman