Expanding the Clinical Definition of Infertility to Include Socially Infertile Individuals and Couples

Abstract

In the United States, single individuals and LGBTQ couples who wish to conceive biological children are considered to be “socially infertile” due to their relationship status. Due to the high cost of infertility treatments and inadequate insurance coverage, the socially infertile has minimal access to assisted reproductive technology (ART). Under the current medical definitions of infertility, even in states with infertility insurance mandates, only heterosexual couples with physiological infertility are covered for ART. It is well documented that infertility interferes with many aspects of the human experience and reduces the quality of life for involuntarily childless individuals regardless of whether the infertility is physiologically or socially based. Physiological infertility was initially considered to be a private issue before being recognized as a medical diagnosis and has since legitimized heterosexual couples’ access to ARTs. The medical diagnosis of infertility not only affirms that their intention to conceive biological children is justifiable but also confirms that it is a condition that can and should be treated with current medical interventions. Expanding the current definition of infertility to include social infertility will elevate it to a treatable medical condition, justifying the use of ART for such individuals and potentially alleviating the negative impacts of infertility. Thus, states with infertility insurance mandates should provide the same infertility coverage to socially infertile individuals as physiologically infertile heterosexual couples.