Queer Tax: Examining 2SLGBTQ+ Black, Indigenous, and People of Colour's experiences of accessing assisted reproductive technologies

The use of assisted reproductive technologies (ART) has risen steadily over the past two decades. In Canada, up to 25 % of assisted reproductive technologies (ART) users identify as Two-Spirit, lesbian, gay, bisexual, trans, and/or queer (2SLGBTQ+). Despite evidence of inequitable ART access for 2SLGBTQ+ communities, scant research has explored the intersectional experiences of 2SLGBTQ+ Black, Indigenous, and People of Colour (BIPOC). Theoretically grounded in reproductive justice and critical political economy, this study examines ART access and clinical experiences for 2SLGBTQ+ BIPOC communities. Interviews were conducted with BIPOC and 2SLGBTQ+ people who had undergone or were seeking ART in Ontario, Canada. Data analysis, guided by constructivist grounded theory and situational analysis, was coded using MAXQDA. The findings reveal structural powers and systemic inequalities shaping the ART process and parenthood. Participants identified four key barriers faced by 2SLGBTQ+ BIPOC families: (1) normative practices (re)produced through ART; (2) mandatory counselling as gatekeeping and disciplining; (3) regulation of known donor sperm augmenting legal, financial, and timeliness barriers; and (4) limited availability of Black, Indigenous, and People of Colour donor sperm. These intersectional barriers highlight the urgent need for ART providers to offer competent and inclusive care. Additionally, the study underscores the necessity for clinical policy reforms to challenge heteronormative and racist practices, ensuring equitable access and improving availability of BIPOC donor sperm for diverse family structures.