Reproductive Journeys: A Comparative Analysis of Patient-Centered Care and Well-Being in 2S/LGBTQIA+ and Mixed-Sex/Gender Couples Undergoing Medically Assisted Reproduction
Bibliographic record
Abstract
Quantitative studies on mixed-sex/gender couples show that infertility and medically assisted reproduction (MAR) impact psychological and relational well-being, emphasizing the need for patient-centered care. However, little is known about the experiences of 2S/LGBTQIA+ couples who primarily seek MAR due to social infertility. While qualitative findings suggest unique barriers to sensitive care, quantitative comparisons remain limited. This study compared personal and relational well-being, along with perceptions of patient-centered care, between 2S/LGBTQIA+ and mixed-sex/gender couples undergoing MAR. The sample included 345 Canadian and American couples (80 2S/LGBTQIA+, 265 mixed-sex/gender) recruited from fertility clinics and online platforms. Participants completed the Patient-Centredness Questionnaire-Infertility, Hospital Anxiety and Depression Scale, Brief Dyadic Adjustment Scale, and Dyadic Coping Inventory. Mixed-effect models adjusted for sociodemographic factors revealed no group differences in anxiety or perceived patient-centered care. However, mixed-sex/gender couples reported significantly higher depressive symptoms (p = .008, d = 0.33), while 2S/LGBTQIA+ couples showed higher relationship satisfaction (p = .004, d = -0.33) and greater use of common dyadic coping strategies (p = .016, d = -0.31). These findings highlight relational strengths among 2S/LGBTQIA+ couples despite potential access barriers. Future research should further explore diverse MAR experiences to inform inclusive, sensitive, and equitable fertility care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".