Reproductive rainbow: Exploring fertility intentions and family planning experiences within the 2SLGBTQ community

Abstract

Background: Normative beliefs around gender and sexuality place individuals in the Two Spirit, lesbian, gay, bisexual, trans, and queer (2SLGBTQ) community at risk for poorer health outcomes within the healthcare system compared with heterosexual and cisgender counterparts. Accessing healthcare in highly gender-specific areas – such as family planning and fertility intentions – can be particularly challenging for those within the 2SLGBTQ community. Methods: I used Stake’s case study methodology and arts-based research with a social-ecological model and intersectionality framework to explore experiences fertility intentions and family planning. Virtually, I retrieved data from reddit and completed nine in-depth semi-structured interviews with eleven participants. Results: Participants, with a mean age of 24.6, represented diversity in their genders and sexualities. In the imagining phase, ideals of normal, lived experiences and intersections of identities form the fertility intentions. When participants moved towards actioning fertility intentions, they experienced nuanced suppressive and supportive factors. Suppressive factors included financial, biological, and societal, while supportive factors were community. Factors that were both supportive and suppressive included family, seeking information and healthcare systems. Conclusion: Intersectionality allows further exploration of the effect that heteronormativity, cisnormativity and other aspects of identities like race, culture, and age overlap and interlock to create variations in ideals of normal, lived experience and suppressive factors. As nurses, moral and ethical responsibility is to use our privileged position within society to advocate for safe and inclusive nursing education, practice, and spaces for our patients. Nurses can call for action at the individual, community, and institutional levels.