LGBTQ+ pregnancy deserves a bigger spotlight this Pride

Pride Month often brings renewed attention to LGBTQ+ health, but conversations rarely extend to reproductive care—despite the fact that queer and trans people are getting pregnant every day. From fertility to birth and beyond, many still encounter care models that weren’t built with them in mind.

And while access to affirming care remains inconsistent, it’s not nonexistent. New York-based providers like Calla Women’s Health, New Hope Fertility Center, and NYC Counseling’s Queer Pregnancy Support Group are helping bridge the gap for LGBTQ+ parents seeking specialized resources and community.

There’s also Millie, a modern maternity clinic grounded in equity and whole-person support. Its ethos centers on inclusive care that affirms all birthing people, challenges outdated norms, and reflects the realities queer families face when starting or growing a family.  (For more insight into the challenges queer parents navigate, particularly around gendered assumptions and second parent adoption, read our Getting Sticky features with Laura Chautin and Masami Hosono & Whitney Mixter) 

Below: A Q&A with Shalini Shah, Millie’s Lead Guide, Reproductive Wellness Practitioner, and Perinatal Educator on what truly supportive pregnancy care looks like, where LGBTQ+ parents can find resources, and how to navigate today’s shifting legal landscape.

Tell us a bit about Millie and its inception. 

Millie was born out of lived experience. Our founder, Anu Sharma, had a traumatic pregnancy and birth - she developed gestational hypertension, had an unplanned C-section, and nearly hemorrhaged delivering her child. Just 36 hours after discharge, she was on the verge of a stroke from postpartum preeclampsia and HELLP syndrome. Like so many new parents, she was told to “come back in six weeks,” when what she really needed was attentive, ongoing care. That experience revealed just how broken and fragmented the maternity care system can be - especially for people of color. So Anu partnered with her midwife, Talia, to reimagine what maternity care could look like.

Millie is a new kind of maternity clinic - one built by people who have personally experienced the gaps in our healthcare system. We provide inclusive, collaborative care that begins as early as a positive pregnancy test and continues through birth, postpartum, and beyond - with full-spectrum support for both maternity and gynecological needs. Patients can begin care with us as early as a positive pregnancy test, and we also offer full-spectrum GYN services.

What barriers do LGBTQ+ parents face in accessing affirming, inclusive pregnancy care? 

Queer parents are often navigating a system that wasn’t built with them in mind. From the moment they start seeking care, they run into barriers - some visible, others more subtle. Many intake forms still assume heterosexual, cisgender identities. Providers may use gendered language without realizing the impact, or make assumptions about who is pregnant, who’s parenting, and whose body is involved. These moments can create a sense of exclusion and invisibility. 

Beyond language, there’s a deeper gap in clinical understanding. Many providers aren’t trained in the full range of queer family-building experiences - from reciprocal IVF to donor coordination to co-lactation - and that lack of preparation can lead to fragmented or inappropriate care. LGBTQ+ families often find themselves in the position of educating their care team while also navigating the emotional and logistical demands of growing a family. 

For trans and nonbinary parents in particular, the clinical setting can be dysphoric or even traumatic. Many report avoiding care altogether after negative experiences, which puts their health and their baby’s health at risk.

And these challenges don’t exist in a vacuum. Queer families of color, those on public insurance, and those navigating immigration or legal systems often face even more layered barriers. 

Ultimately, the biggest obstacle is that most care models don’t fully recognize or reflect the realities of queer parenthood. That’s what we’re working to change. 

How does Millie support all birthing people, regardless of gender identity, family structure, or insurance status? 

At Millie, inclusivity isn’t a checkbox - it’s a foundational principle that shapes how we design care, hire staff, train our team, and build trust with patients. 

We start with language, making sure every touchpoint - from our intake forms to how we greet patients - is gender-affirming and non-assumptive. But we don’t stop there. Our clinical team is trained in trauma-informed care and cultural humility, with ongoing learning around how to serve patients across a wide range of identities and lived experiences. That includes trans and nonbinary birthing people, solo parents, poly families, surrogates, and intended parents - all of whom deserve to feel respected and understood. 

Financial access is another key piece. We accept a wide range of commercial and public insurance plans. We also work with patients to help them understand what their insurance covers and connect them to outside support when needed. 

And perhaps most importantly, we recognize that being inclusive means being flexible. No two families look the same, and no two pregnancies unfold the same way. Our job is to meet people where they are - and to stay curious, compassionate, and adaptable as we walk alongside them. 

With more queer families seeking fertility and prenatal services, what are they looking for in a provider? 

What queer families want is care that meets them with understanding from the start, not care that requires them to educate along the way. That begins with being called by the right name and pronouns, but it goes deeper - like understanding the logistics and emotional layers of reciprocal IVF, co-lactation, or how to support both partners during pregnancy and postpartum. 

They’re also looking for providers who practice transparency and shared decision-making. Many queer people have had difficult or invalidating medical experiences, so trust needs to be earned - not assumed. A collaborative approach helps rebuild that trust and allows families to feel like true partners in their care. 

Ultimately, queer families want to feel seen and supported - not just medically, but in the full context of their identities, relationships, and family-building journeys. 

Why are inclusive language, clinical training, and care models more important than ever in the face of rising anti-LGBTQ+ legislation? 

Healthcare should be a sanctuary – not a site of harm. Affirming care is evidence-based care, and we have a responsibility to protect it. Inclusive language isn’t just semantics - it’s a signal of safety. And in today’s climate, safety is essential. 

In moments like this, when rights are being rolled back and queer and trans people are being targeted in public policy, healthcare has a responsibility to take a stand. 

Affirming care isn’t a “nice-to-have” - it’s life-saving. When clinical environments use inclusive language, when care teams are trained to understand the experiences of LGBTQ+ patients, and when systems are designed to center safety and dignity, outcomes improve. People come to their appointments. They ask questions. They share things that matter. They return. 

But when care isn’t affirming, people delay or avoid it altogether. That leads to worse outcomes, especially during pregnancy and postpartum, when support is most critical. 

Inclusive care models also send a powerful message: that all people, regardless of identity, are worthy of compassion, safety, and expertise. And in a time when so many queer and trans families are feeling under threat, that message matters more than ever. 

What do surrogacy and adoption typically involve, and how do procedures like IUI and IVF fit in? 

Surrogacy and adoption are beautiful ways to grow a family, and they’re often logistically and emotionally complex. Surrogacy requires careful legal coordination between intended parents and gestational carriers, medical screening and embryo transfer, and often substantial financial resources. Adoption may involve navigating state or international systems, home studies, waitlists, and deeply personal decisions around open or closed processes. 

For those carrying a pregnancy, procedures like intrauterine insemination (IUI) or in vitro fertilization (IVF) are common, especially for families using donor sperm or donor eggs. Some choose reciprocal IVF, where one partner provides the egg and the other carries the pregnancy. These pathways can be empowering but also involve hormone treatments, fertility tracking, and navigating high emotional stakes. 

We believe fertility and family-building support should be integrated into the broader care model - not siloed or treated as a specialty service for “other” families. That’s why we’re building bridges between fertility support, pregnancy care, and postpartum services, so that families don’t have to keep starting over at each step. 

What resources are available to support queer families, from insurance and state-mandated programs to HSA/FSA-covered services and products? 

There are more resources available now than ever before, but knowing how to access them is a challenge in itself. Some states now mandate fertility coverage regardless of marital status or sexual orientation, and many private insurers have expanded what they cover. Procedures like IUI, IVF, and even egg or sperm storage may be partially reimbursed, depending on the plan. 

HSA and FSA funds can often be used for related expenses - including fertility treatments, lactation support, chest/breast pumps, mental health care, childbirth education, and more. Some patients also qualify for grants or nonprofit support for family-building, especially if they’re working with donors or surrogates. 

That said, a lot depends on the fine print and too many queer families are left to figure it out alone. We always recommend working with a provider or advocate who can help navigate coverage, connect the dots, and flag what’s actually available. Access shouldn't depend on how well someone can decode an insurance policy. 

How can queer families advocate for themselves with insurance companies, hospitals, and medical providers? 

Start by asking questions and don’t be afraid to push for clarity. If something feels off, say so. If a form is outdated or a provider is making assumptions, you have every right to speak up. 

It can also help to bring a support person to appointments, especially when you're navigating complex decisions or systems. Having someone there to take notes, ask follow-up questions, or simply witness the conversation can shift the dynamic. 

Where possible, choose care teams who already center LGBTQ+ patients. The burden shouldn’t always fall on families to explain who they are or what they need. And if you run into roadblocks, there are advocacy organizations, legal resources, and even some HR teams who can step in to help. 

No one should have to fight for basic respect or access, but when that happens it makes a difference to have community, resources, and language to lean on.