Patti Thornewell, a 34-year-old pharmacist living in Madison, Wisconsin, is slowly getting her bearings as the haze of anesthesia wanes. She had just undergone a dilation and curettage (D&C)—a procedure to remove a non-viable pregnancy from her uterus—at her local hospital. The powerful drugs that had put her under during the operation made it difficult for her to find her bearings, though it wasn’t just the medications that left her feeling both within and without. After a round of intrauterine insemination (IUI), an ultrasound at seven weeks and an appointment with her midwife, Thornewell and her wife were faced with a somber reality that was still difficult to comprehend: Their very wanted pregnancy had failed to progress.
“We had to use a Catholic hospital,” Thornewell says. “And while they were very polite and nice to us, we were continuously mistaken for sisters instead of spouses. We had to remind the staff that she is my wife.”
The pain of the miscarriage and procedure kept Thornewell preoccupied, so to her, this mischaracterization was annoying. But to her wife, who had also suffered this loss, it was devastating.
“She felt overlooked and ignored. She likened it to being nothing more than my taxi driver, because the staff never appeared to care about her emotional or mental well-being,”Thornewell explains. “We often wondered if heterosexual couples experience a similar thing. Do would-be dads get better treatment, or are they ignored too?”
As a psychologist who specializes in reproductive and maternal mental health, I can safely say that Thornewell and her wife’s experience is far from uncommon for LGBTQ2 people who’ve experienced pregnancy or infant loss. From the erasure of trans men in conversations about a variety of reproductive outcomes—be it abortion, miscarriage or a pregnancy that results in a live birth—to loss communities that centre straight, white couples, LGBTQ2 loss parents are often felt left out, “othered” and sidelined by straight people and a heteronormative society that continues to view the world through a binary lens.
But when as many as one in four pregnancies end in miscarriage—a number that’s undoubtably higher, as many people will miscarry without even knowing they were at one time pregnant—it’s simply inaccurate to automatically believe only straight couples endure the loss of a pregnancy. And it’s undoubtably detrimental to all loss parents to allow that belief to permeate miscarriage and infant loss communities, forums and other support systems. Not only does it harm the mental health of people like Thornewell, it erases their experiences entirely.
“It would be nice if lesbian couples were more normalized in the loss community,” Elizabeth S., a 34-year-old educator living in Washington, D.C., says. After her fifth IUI attempt, Elizabeth found out she was pregnant and had that pregnancy confirmed at her eight-week ultrasound appointment. But at 10 weeks, she was told she had experienced a “missed miscarriage,” and would need a D&C to remove the unviable pregnancy. Her experience at her OB/GYN’s office during this time was horrendous—her doctor did not take her pregnancy concerns seriously, and downplayed not only her fears but her physical symptoms—likely making it possible for the miscarriage to go undetected. Ultimately, she stopped going and had her fertility clinic take over her care and perform the necessary procedure.
And while Elizabeth doesn’t believe her sexuality was the reason her OB/GYN did not care for her adequately (“I suppose I could be naive to some systemic discrimination towards LGBTQ+ couples in the fertility/pregnancy world,” she says), and never felt overt discrimination during her fertility treatments, she was not immune to the generalizations and assumptions made by the staff.
“During different monitoring appointments during the five IUI cycles, there were a handful of times when my ‘husband’ was referenced, or they asked if I needed a collection cup for sperm, in which case I would have to remind them that I had a wife and we were using donor sperm,” she explains. “It happened maybe three to four times over 20-plus appointments, and each time I felt comfortable reminding the staff and was met with sincere apologies. Hopefully it reminded those people to think twice or double-check files before making comments or asking questions.”
But it’s not just random assumptions or haphazard mentions of a person’s “husband” that LGBTQ2 people facing pregnancy loss have to endure during these vital medical appointments. A reported 56 percent of LGBTQ2 patients have faced blatant discrimination while seeking medical care, and one in five trans people have been flat-out denied health care due to their gender identity. Of course, denying someone health care can have devastating effects. In the case of miscarriage, if any remaining pregnancy tissue is not passed naturally and remains in the body, an infection—what is known as a septic miscarriage—can occur. Left untreated, the infection can progress to the bloodstream and lead to septic shock.
And in the wake of the Trump administration’s barbaric decision to roll back Obama-era protections for trans people, allowing health care workers to deny care to trans people under the guise of “religious freedom,” seeking medical care before, during or after a miscarriage is all the more perilous for members of the LGBTQ2 community. It is not hyperbolic to conclude that people will die. (Earlier this year, the U.S. Supreme Court ruled the Civil Rights Act of 1964, which prohibits sex discrimination, applies to sexual orientation and gender identity. While the ruling focused specifically on workplace discrimination, the language used by the Supreme Court Justices could be used to expand LGBTQ+ protections to education, housing and health care, undermining the Trump administration’s anti-LGBTQ+ policies.)
There are also the mental health ramifications of discrimination and exclusion to consider. As the founder of #IHadaMiscarriage, an online community for loss parents, I know all too well that many of these spaces—meant to foster community, solidarity and unyielding support—do not consider LGBTQ2 loss parents or the plights they have faced while enduring the same types of losses.
“We definitely felt like we were the odd-people out,” Thornewell says. “We’re the only same-sex couple in our area that we know has gone through this. And every single book, journal, card, etc. uses gendered language talking about dads and fathers.
“Fertility in general is completely gendered and heterosexually focused,” she continues. “I’ve been lucky to find Etsy stores that will customize journals to change language to either ‘wife’ or ‘mom’ for us. None of the resources were specifically for same-sex/lesbian couples.”
Research has shown how devastating miscarriage can be to one’s mental health. A study earlier this year found that one in six women (trans men and non-binary folks were not included in the study, though one could hazard same or similar numbers) experience post-traumatic stress disorder following a miscarriage.
Another study found that nearly 20 percent of people who experience early pregnancy loss develop depression and anxiety, with symptoms lasting anywhere from one to three years. And since discrimination against those in the LGBTQ2 community has been associated with high rates of psychiatric disorders, substance abuse and suicide, the mental health ramifications of pregnancy loss can be compounded by the systemic bigotry, blatant intolerance and exclusion LGBTQ2 people can (and often do) face within loss communities.
“I think it would just feel better if I knew there were other 30-something lesbian couples going through what we have gone through, and seeing how it has all played out,” Elizabeth says. “[We need] representation and the normalization of our experience.”
As for Thornewell, she is preparing to undergo her second round of IUI—an undertaking, she says, that makes her nervous, especially since it’s happening in the middle of a pandemic. And like so many straight couples that have been profiled in legacy magazines detailing the difficulties those trying to get pregnant (or remain pregnant) are facing as hospitals enforce strict no-visitor policies, Thornewell is doing her best to remain hopeful.
“I had a procedure in May that had to be done at the clinic and my wife couldn’t come in with me. I felt so alone,” she says. “And when you’re going through fertility you already feel very alone. It also causes stress between my wife and I, because she feels bad that she can’t physically be there for me. I’m bringing along items that remind me of my wife.
“I’ll be wearing one of her shirts and her wedding ring so that I have something to comfort me while I’m in the room without her.”