The Most Important Surrogacy Questions for LGBTQ+ Couples Answered 

The path to parenthood for LGBTQ+ couples is more accessible than ever before. While there are multiple options for same-sex couples looking to expand their family, surrogacy stands out as a transformative and life-affirming journey that allows you to have a child who is biologically yours. However, navigating surrogacy can be tricky and emotionally fraught, so it’s vital that you begin your journey informed and empowered. 

What Is Surrogacy? 

Essentially, the act of surrogacy is outsourcing your pregnancy to a volunteer. In this arrangement, the surrogate mother agrees to carry and give birth to a child on behalf of the intended parents. Surrogacy is a unique and personalized solution for those unable to conceive or carry a child.

However, surrogacy is also a heavily regulated endeavor. Contracts are typically drawn up detailing the rights, responsibilities, and expectations of the intended parents and the surrogate. It is crucial to work closely with experienced professionals – such as fertility clinics, attorneys, and surrogacy agencies – who specialize in guiding individuals and couples through surrogacy. 

What is the Difference Between a Gestational Carrier and a Surrogate? 

There are two main types of surrogacy: traditional surrogacy and gestational surrogacy. The critical distinction between the two is the genetic relationship between the surrogate and the child. 

In traditional surrogacy, the surrogate uses her own eggs, making her genetically related to the child she carries. This method typically involves artificial insemination, where the surrogate’s eggs are fertilized with the intended father’s sperm or donor sperm. As a result, the surrogate carries the pregnancy and contributes genetically to the child’s makeup. 

Traditional surrogacy is less common due to ethical, legal, and emotional complexities. Determining legal parentage can be challenging, as the surrogate may have legal rights as the biological mother. Additionally, the ethical implications of the power dynamics between parents and surrogates come into play; traditional surrogacy arrangements may leave the surrogate mother more susceptible to coercion or exploitation. 

Some states outright ban traditional surrogacy due to these factors; others have stringent rules and regulations around conventional surrogacy. If you decide to pursue traditional surrogacy, ensure you know your state’s laws, have comprehensive legal counsel and have a strong relationship with your potential surrogate mother. 

Many couples opt for a gestational surrogacy arrangement. In this method, the intended parents’ eggs and/or sperm create embryos through in vitro fertilization (IVF). These embryos are transferred to the surrogate’s uterus, where she carries the pregnancy to term. 

As the surrogate does not have a genetic connection to the child, gestational surrogacy is a more legally straightforward approach. It allows the intended parents to have a biological connection to the child and benefit from the gestational support of the surrogate without as much legal red tape. 

In general, gestational surrogacy tends to be more expensive than traditional surrogacy. IVF implantation can be hugely expensive, but in addition to the procedure, there are expenses for medications, egg retrieval, laboratory procedures, and embryo transfer. You will also have to use a gestational carrier agency to screen and find a suitable surrogate and donor DNA to combine with your own. 

Deciding which form of surrogacy is best for your family is a profoundly personal choice. Either way, research and contact legal experts to ensure you are within regulations while starting your family.

How Does a Person Become a Surrogate? 

The first step to becoming a surrogate involves extensive screening and evaluation. Surrogacy agencies have rigorous criteria to ensure the physical and emotional well-being of the surrogate mother. Common criteria include: 

  • Age: most surrogates are 21 to 37 years old 
  • Healthy weight and BMI 
  • Past successful pregnancies 
  • Pre-existing health conditions 
  • Medication history (must be one year free of anti-depressants and other drugs) ● Smoking history 

These criteria can vary between agencies. Once a potential surrogate meets these base qualifications, they enter a comprehensive screening process. This screening process may include interviews with the agency and psychological and medical evaluations. 

After the screening, potential surrogates are matched with intended parents based on various factors, including personal preferences, medical history, and shared values. Legal contracts are drawn up once a match is made to establish the rights, responsibilities, and expectations of all parties involved. 

These thorough screenings and stringent criteria ensure the potential surrogate can happily and healthily carry your child to term. When looking at surrogate agencies, make sure you become deeply familiar with their screening processes and criteria. 

How are Egg/Sperm Donors Screened in the Surrogacy Process? 

If you are a same-sex couple considering gestational surrogacy, you will need an egg or sperm donor to create the embryos. Just like for surrogate mothers, rigorous screening procedures are in place to ensure donors’ health, genetic suitability, and overall well-being. 

The screening process for egg and sperm donors typically begins with an extensive application that includes detailed personal and medical history. Donors must provide information about their family medical history, physical health, psychological well-being, lifestyle choices, and any previous pregnancies or donations. If donors pass the initial screening, they move on to a more thorough vetting process. 

Medical evaluations are the most integral part of the screening process. Donors undergo comprehensive physical examinations, including blood tests, genetic testing, and infectious disease screenings. These tests aim to detect any underlying medical conditions or congenital abnormalities that may affect the health of the resulting child.

When selecting the donor sperm or egg, you will be given a quick overview of their medical and personal history before choosing (or rejecting!) their genetic material. Donors can opt to either be kept anonymous or have an “open donation” arrangement in which they can contact the intended parents. 

Is Surrogacy Legal In My State? 

While surrogacy is legal in many states, the specific regulations and requirements can vary significantly. 

If you live in Michigan, Nebraska, or Louisiana, compensated surrogacy is illegal, which means you can only pay for your surrogate mother’s medical expenses. New York recently legalized compensated surrogacy but still has many stringent regulations. 

There are currently no federal legal restrictions on LGBTQ+ couples who want to hire a surrogate. Historically, preventing same-sex couples from hiring a surrogate has proven unconstitutional. 

To ensure you stay compliant with your state’s laws during your journey, enlist an experienced reproductive law attorney specializing in surrogacy. These professionals have a comprehensive understanding of the legal landscape. They can provide you with accurate information tailored to your state. 

What is the Cost of Surrogacy for LGBTQ Couples? 

Surrogacy is a significant financial commitment. While the expenses can vary depending on factors such as location, chosen agency, and individual circumstances, there’s no doubt that finances are a vital aspect to consider. 

How To Budget for Surrogacy 

It’s spreadsheet time! The first step to planning your surrogacy finances is by drafting a budget based on your research. Experts claim that the total costs of surrogacy can balloon into six-figure pricetags, so make sure you have a plan. 

There are four main categories of expenses you will be responsible for: 

  • Agency fees: These fees are what you will pay the surrogacy agency. They will cover surrogate screening, matching, and case management services. 
  • Legal fees: Plan to pay an attorney or two to ensure the proper establishment of parental rights and the drafting of surrogacy contracts. 
  • Medical bills: As the intended parents, it is your responsibility to pay for the surrogate mother’s medical bills, including fertility treatments, IVF procedures, prenatal care, and potential complications during the pregnancy.
  • Surrogate Compensation: Your surrogacy agreement may include compensation unless you live in Nebraska, Louisiana, or Michigan. Payments are often made in monthly installments. On average, surrogate mothers are compensated between $50,000 and $60,000. 

Does Health Insurance Cover Surrogacy? 

Health insurance coverage for surrogacy can vary depending on the insurance provider and policy. In many cases, health insurance policies do not cover the specific costs associated with surrogacy, such as the surrogate’s medical expenses or the IVF procedures. However, some plans may provide coverage for certain aspects of prenatal care or complications during the pregnancy. 

Consult with your insurance provider to understand the extent of coverage for surrogacy-related expenses. Exploring your insurance options and considering supplemental insurance or specific surrogacy insurance policies can help mitigate potential financial risks. 

The Costs of Parenting 

We all know that raising children is expensive. But surrogacy can be a financially unique situation. 

Any costs incurred during the birth of your child will be your responsibility. Depending on your surrogacy contract, you will likely be responsible for the surrogate mother’s postpartum medical care. These costs can include OBGYN check-ups, prescriptions, postpartum supplies, and psychiatric care if needed. 

In addition, you’ll have to take care of a new baby – and new babies are not cheap! You’ll need diapers, wipes, bottles (or a breast pump for the surrogate mother), toys, doctor’s visits, cute outfits, and more. If you decide to put your child in daycare or hire in-home childcare, that will also add to your expenses. 

Experts say the average child costs between $9,000 and $23,000 a year – so make sure you’re financially planning for the long haul! 

In an LGBTQ+ Surrogacy, Which Parent Will Be the Biological Parent? 

Deciding which parent in a same-sex couple will be the biological parent is a deeply personal and individual choice. Discuss with your partner the importance of your child being genetically related to you. Let that guide your decision-making process. Always talk to your doctor or fertility clinic about your decisions as well. 

Some couples “mix” their sperm donations so the child could conceivably be related to either of them. Others decide to use both an egg donor and a sperm donor, deciding that biological

connection isn’t a priority. Discuss all your options with your partner and doctor to determine what best suits your wants and needs. 

Another option some couples choose is to have one embryo of each partner’s DNA carried to term, allowing them to have a child they are genetically related to. This route may be your best option if you want twins on the first try. 

Should You Consider Having Multiples When Going Through The Surrogacy Process? 

Some couples may choose to have their surrogate mother carry twins or even triplets. The choice to have multiples is profoundly personal and should be discussed with your doctor, surrogate mother, and fertility clinic. 

While having multiple children at once may appeal to some intended parents, it is crucial to weigh the advantages and disadvantages before deciding. Multiple pregnancies are considered high-risk, and the surrogate and babies’ health and well-being will require close monitoring and specialized medical care. Twins are also more likely to be born premature and may require neonatal intensive care. 

Remember that fertility clinics will choose the healthiest embryos when beginning a pregnancy; there are not always enough viable embryos for twins or triplets. The healthiest and most successful pregnancies utilize the most viable embryo, but discuss all options with your doctor and spouse to see what is right for you. 

If you want multiple children, but not necessarily at the same time, some agencies allow you to re-hire the same surrogate or utilize the same donor DNA. Maintain a relationship with your chosen surrogacy agency to expand your family at a pace that’s right for you. 

What are Birth Certificates Like for New LGBTQ Parents? 

What your child’s birth certificate looks like will depend on your state and local jurisdiction. In most situations where surrogacy is legally recognized, the birth certificate will have the intended parents’ names. If you use a traditional surrogacy arrangement, your surrogate may be listed as the biological mother until the child is adopted. 

Some U.S. states require an adoption or parentage order to establish legal parentage for the intended parents. You and your spouse may also have to sign a pre-birth adoption agreement to have your names on the birth certificate when the child is born. Talk with your attorney to see what requirements are in place for your state.

What Factors Should I Consider When Choosing a Surrogate? 

So, you know that all the surrogates you’re leafing through have been vetted and approved by a surrogate agency, but how do you decide which one is right for you? 

Take your time when choosing a surrogate; you want to ensure that you can trust this woman with your child’s life. Take time to look over the documents provided by your surrogacy agency; carefully review each woman’s medical and psychological history. Talk with your spouse about what you each want from a surrogate and what your dealbreakers are. 

It’s vital that you take time to interview your potential surrogates and get to know them as people. You will be in close contact for the next nine months—possibly longer—and you must be sure that you can maintain a healthy and happy relationship for the sake of your child. Don’t avoid difficult conversations with potential surrogates; you and your spouse should feel comfortable discussing complex topics with the surrogate mother. 

When choosing a surrogate, remember that she will be crucial to your family’s story. Do your due diligence to ensure she is someone you are happy to share the journey to parenthood with. 

What if My Surrogate (or Their Family) Isn’t Supportive of the LGBTQ+ Community? 

In addition to ensuring your surrogate is healthy in mind and body, you must know that you and your surrogate share the same values. As a same-sex couple, you know better than anyone that not everybody is as accepting of gay marriage and adoption as they may seem. These complicated dynamics are why you have to have a challenging conversation early on about your surrogate’s opinions regarding LGBTQ+ partnerships. 

In many cases, your agency has already noted or screened for this and would not match an LGTBQ+ couple with an anti-gay surrogate mother. But in case this hasn’t happened, don’t hesitate to ask your potential surrogates how they feel about carrying a child for a same-sex couple. You may also want to ask about their parents, partners, and loved ones; anyone who would know they are participating in a surrogacy arrangement. 

These considerations are also why having a trusted attorney specializing in family law is vital. They will be able to draw up firm legal documents that protect the rights of both you and the surrogate mother. If a pattern of questionable or offensive behavior begins, you can ensure it is correctly documented and take action. 

Should I Use a Surrogacy Agency? 

Finding a vetted and trustworthy surrogate on your own can be difficult, time-consuming, and expensive. The time commitment and knowledge it takes to have a successful and smooth surrogacy often drive LGBTQ couples to use a surrogacy agency.

Agencies have expertise and experience in facilitating surrogacy journeys, streamlining the process, and providing valuable guidance at each stage. They handle screening and matching potential surrogates, coordinating medical and legal operations, and providing ongoing support and counseling. Surrogacy agencies also often have relationships with reputable fertility clinics and legal professionals, taking those logistics off your plate. 

Agencies charge fees for their services, but it’s worth it to have the support of experts at every step of your journey! 

What Should My Relationship With My Surrogate Be Like After Birth? 

Your relationship with your surrogate after the baby is born is entirely up to you, your partner, and your surrogate. You and your surrogate should discuss your expectations throughout the pregnancy so that no one is caught off-guard by the shift in the relationship after the baby arrives. 

Expressing gratitude and appreciation for the surrogate’s selfless act is crucial to the post-birth relationship. Demonstrating genuine appreciation for your birth mother’s role in helping you achieve your dream of parenthood fosters a positive and respectful connection. 

Keeping the lines of communication open is beneficial for all parties involved. Regular check-ins or occasional updates can maintain a sense of connection and provide updates on the child’s well-being. However, respect the surrogate’s boundaries when she sets them; some surrogates may want to be involved in the baby’s life, while others prefer distance. 

Recognize that transitioning from the surrogacy journey to the post-birth relationship can take time. Approach the relationship flexibly, allowing it to evolve independently innately. Some intended parents and surrogates may develop lifelong friendships. In contrast, others may maintain a more cordial and emotionally distant connection. 


Surrogacy offers same-sex couples a remarkable opportunity to fulfill their dreams of parenthood. By understanding the various aspects of surrogacy, LGBTQ+ couples can make informed decisions and navigate the surrogacy process with confidence and knowledge. With the support of experienced professionals, you can embark on a surrogacy journey that brings you closer to your dreams of parenthood. 

Ready to take the next step toward fulfilling your dreams of parenthood? Look no further! Our surrogacy agency is here to provide you with the answers to the most important surrogacy questions for LGBTQ+ couples. We understand that the journey to parenthood can sometimes feel overwhelming, especially when navigating the complexities of surrogacy.

That’s why our team of experts is dedicated to guiding you through every step of the process, addressing your concerns, and ensuring that you have the knowledge and support you need to embark on this incredible adventure. Don’t let unanswered questions stand in the way of your happiness. Contact us today and let us help you turn your dreams of building a family into a beautiful reality.