Racial and Sexual Minority Women's Receipt of Medical Assistance to Become Pregnant

Objective: This study aimed to determine rates at which racial minority (i.e., non-White) and sexual minority (i.e., lesbian and bisexual-identified) women in the United States receive medical help to become pregnant. Income and insurance coverage discrepancies were hypothesized to mediate differences in receipt of medical help as a function of race and sexual orientation. Method: Two studies compared rates at which adult women ages 21-44 reported receiving medical help to become pregnant as a function of race and sexual orientation, using data from 2 cycles of the National Survey of Family Growth (the 2002 wave in Study 1, and the 2006-2010 wave in Study 2). Mediation analyses controlling for age and education level evaluated whether race and sexual orientation were positively associated with receipt of medical pregnancy help, as mediated by insurance coverage and income. Results: Heterosexual White women reported receiving medical fertility assistance at nearly double the rates of women who identified as non-White, sexual minority, or both. Differences in rates of help received by White and non-White groups were only partially mediated by insurance coverage and income in both studies. Insurance and income discrepancies accounted for all differences between sexual minority and heterosexual women's receipt of pregnancy help in Study 1; insurance coverage alone explained differences in Study 2. Conclusions: Researchers often indicate that economic differences are responsible for health disparities between minority and majority groups, but this may not be the case for all women pursuing medical fertility assistance. Possible origins of these disparities are discussed.