Bioethics Blogs

Why we should recognize social infertility: the exclusion of lesbian and gay couples and single individuals from definitions of infertility

The diagnosis of infertility is an anomaly among medical conditions because it requires two people, whereas almost all other medical conditions require just one person. For instance, if I break my leg, my diagnosis and treatment does not include or depend upon anyone else within my web of relationships. In contrast, when physicians are assessing a patient for infertility, they inquire about the person’s presumed heterosexual partner. This is because the majority of medical definitions of infertility rely upon heterosexual activity as a prerequisite to determine if an individual is infertile. For example, the World Health Organization (WHO) defines infertility as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.” 

One significant problem with this definition is that it cannot account for lesbian and gay couples and single heterosexual individuals. Lesbian and gay cisgender couples are not having sexual intercourse (i.e. vaginal penile sex), so they are automatically excluded from definitions of infertility. Single heterosexual individuals may be having intercourse, but it may not be “regular,” which we can presume to mean on a consistent basis, and they may not be having unprotected intercourse.  

Yet, lesbian and gay couples and single individuals, regardless of their sexual orientation, are all infertile in a sense because they are not able to sexually reproduce via intercourse. Some in the bioethics literature have used the term “social infertility” to refer to individuals who are unable to reproduce due to factors associated with their partner.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.