Reproductive Journeys: A Comparative Analysis of Patient-Centered Care and Well-Being in 2S/LGBTQIA+ and Mixed-Sex/Gender Couples Undergoing Medically Assisted Reproduction

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.