Fertility services for gay men: A website content analysis of US fertility clinics and sperm banks
Bibliographic record
Abstract
BACKGROUND: Fertility preservation and subsequent third-party reproduction represents a principal pathway by which gay and bisexual cisgender men may have biologically related children. Previous studies of a similar design have commented on the availability of fertility services for sexually and gender diverse communities, but none have investigated access to the aforementioned services for this specific population. OBJECTIVES: To assess the availability of fertility preservation and third-party reproduction services for gay and bisexual cisgender men across US fertility clinics and sperm banks. MATERIALS AND METHODS: A content analysis was performed on a sample of fertility clinic and sperm bank websites compiled from three online sources. Sample construction and analysis were completed in 2023. Each website was systematically examined by two separate coders with a third coder deciding any discrepancies. Website coding followed a pre-constructed standardized questionnaire. Logistic regression analysis was used to identify statistically significant differences. RESULTS: A total of 675 clinic and sperm bank websites (136 academic and 539 private) were analyzed. Five hundred and two (74.4%) offered third-party reproduction and 326 (48.3%) offered fertility preservation for gay and bisexual cisgender men. Furthermore, 248 websites (36.7%) featured some form of disqualifying language either directly communicating or implying exclusion of gay and bisexual cisgender men from these services. Private facilities were more likely to offer third-party reproduction (odds ratio [OR] = 1.88, p < 0.01) but less likely to offer fertility preservation (OR = 0.68, p < 0.05) compared with academic affiliated facilities. Lastly, states in the highest Human Rights Campaign Equality Index tier were significantly more likely to offer third-party reproduction (OR = 2.50, p < 0.01) than the lowest tier. DISCUSSION AND CONCLUSION: These findings demonstrate great variability in access to fertility preservation and third-party reproduction services. Geography and ambiguity in facility-specific policies represent persistent barriers to family building for gay and bisexual cisgender men.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".