Discrimination against same-sex couples starting a family must end

As Australians start their families later, more people are needing to turn to assisted reproductive technology.

This is a good news story. IVF is providing would-be parents with opportunities not available to older generations. The technology is also becoming much safer, with fewer risky multiple births as clinicians move towards single embryo transfers.

But, as Angus Thomson reports in today’s Sun-Herald, a sweeping review of Australia’s fertility policy by former health minister Greg Hunt and embryologist Rachel Swift has found the IVF sector will not cope with the forecast rise in demand without significant changes to funding, access and regulation in the sector.

Among the review’s recommendations is expanding the definition of infertility for Medicare-funded IVF treatment to include any prospective parents who would need donor eggs, sperm or embryos to achieve a successful pregnancy, expanding access to same-sex couples and single women.

According to UNSW’s annual perinatal epidemiology report, released on Friday, single women and same-sex female couples now account for 17 per cent of people using IVF.

But access to government-funded fertility services turns on whether a person is in a heterosexual relationship.

Single people and LGBTQ couples often have to pay thousands of dollars for failed IVF treatment before they can be deemed “medically infertile” and receive Medicare rebates.

As reported by the Sun-Herald last month, a coalition of Australian fertility and healthcare organisations are seeking to change this. They have updated their definition of infertility to mean “the inability to achieve a successful pregnancy based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing or any combination of these factors” or the need for “medical intervention … to achieve a successful pregnancy either as an individual or with a partner”.

The groups hoped the move would encourage the Commonwealth ombudsman to expand its own definition, which restricts Medicare funding of infertility treatments to people unable to conceive after one year of regular, unprotected intercourse.

In a country that legalised same-sex marriage almost eight years ago, the fact same-sex families are not being offered the same access to assisted reproductive technology as heterosexual ones does not make sense.

As is noted in Hunt’s report, the most significant factor driving the number of people seeking to use IVF to start a family is increasing maternal age.

These women may meet the ombudsman’s definition of infertility, but here the distinction between medical infertility due to age and social infertility seems fraught.

The average age of a woman giving birth in NSW is now 31.4 years. That didn’t happen due to a plague rendering women medically incapable of having children before their 30th birthday: social factors and policy failings mean most Australians cannot have a child at the same age their grandparents did.

Women – fairly – want to be established in their careers before starting a family. Men too. The average Australian woman marries at 31.2 years, while the average man is almost 33.

In Sydney, buying a “family home” is financially impossible for many, and the precariousness of the rental market is pushing out the time at which Millennials, and now Gen Z, can settle down without worrying their future children’s school catchments may change at the end of each lease.

In turn, it seems unfair to describe the inability of same-sex couples to have a baby naturally as an entirely social phenomenon, given the well established body of evidence that people do not choose to be LGBTQ.

The benefits of increasingly safe and widely used assisted reproductive technologies should be available to all families.

The Opinion newsletter is a weekly wrap of views that will challenge, champion and inform. Sign up here.