Yesterday at CDC, I went to a panel discussion on infertility and reproductive health at the Tom Harkins Global Communications Center. As childbearing and starting a family are considered fundamental human rights, the World Health Organization defines infertility as a disease. Based upon estimates cited in the CDC Public Health Action Plan, 6% of married women in the U.S. from 15 to 44 years of age are infertile. When estimates are based upon the rate of successful pregnancy after 12 months of trying, 16% of married couples are infertile. Recently, CDC has begun expanding its studies into infertility as an indicator of overall health; For instance, both male and female infertility are associated with obesity, diabetes, and exposure to environmental contaminants. Aside from the incidence and causes of infertility, the medical complications of fertility treatments, such as in vitro fertilization (IVF), was a primary topic of discussion among panelists. There appears to be consensus among clinicians and researchers that IVF is safest when restricted to single-baby births (i.e., no twins, triplets, or more). Moreover, single-baby pregnancy has become the preferred practice in IVF clinics for its minimal health risks to mother and child. Unfortunately, IVF is seldom covered by health insurance, driving many couples towards outmoded or less-than-reputable fertility technologies. In summary, the panelists not only outlined the demographics of infertility but also voiced concerns regarding equality of access to safe reproductive technologies. This affirming, scientific view contrasts with the many institutions of American society which continue to insist that infertility is merely a “lifestyle choice” or a matter of “Gods will”.
Given my lifelong physiological barriers to fertility and my disheartening experiences with sperm banking, the issue of lack of equity in reproductive medicine caused me some emotional discomfort towards the end of the discussion. Moreover, from the panel discussion and reading of the Public Health Action Plan, I noted one serious source of bias. The incidence of infertility is counted only for married, heterosexual couples. Yet, my emotional distress weakened my resolve to broach the topic of GLBT reproductive equity. At the end of the panelists presentations, when my turn at the mike came, I voiced a question related to environmental health: “What role do endocrine-disrupting chemicals in the environment and food supply play in male infertility?” Yet, my voice nearly froze at the mike as I felt the deeply personal implications of my inquiry. It is possible that my transgender-intersexed condition could be attributable to environmental pollutant exposure in my place of birth, Metro Detroit. Fortunately, the people with whom I work, as well as the visiting physicians are a courteous bunch.
I continued to feel distressed for the remainder of the day, for my inability to have children is a major cause of grief and and sorrow in my life. Fortunately, my partner, Monica was waiting for me when I got home. She had just returned from her trip to Washington D.C. to present the transgender pride flag at the Smithsonian. She treated me out to dinner, where we shared jokes over chicken parmegiana sandwiches. Late into the evening, as she shared her trip, we could not stop making wisecracks about the many cultural idiosyncrasies of the people and artifacts at the Smithsonian. I am blessed beyond words to have a partner who brings such light and merriment into my life.