Subject(s)
Fertility Preservation , Infertility, Female/prevention & control , Leiomyoma/surgery , Leiomyomatosis/surgery , Minimally Invasive Surgical Procedures , Uterine Neoplasms/surgery , Combined Modality Therapy/adverse effects , Combined Modality Therapy/trends , Female , Fertility Preservation/adverse effects , Fertility Preservation/instrumentation , Fertility Preservation/trends , Humans , Infertility, Female/etiology , Intraoperative Complications/etiology , Intraoperative Complications/prevention & control , Laparoscopy/adverse effects , Laparoscopy/instrumentation , Laparoscopy/trends , Leiomyoma/diagnostic imaging , Leiomyoma/pathology , Leiomyoma/physiopathology , Leiomyomatosis/diagnostic imaging , Leiomyomatosis/pathology , Leiomyomatosis/physiopathology , Minimally Invasive Surgical Procedures/adverse effects , Minimally Invasive Surgical Procedures/instrumentation , Minimally Invasive Surgical Procedures/trends , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Preoperative Care/adverse effects , Preoperative Care/trends , Robotic Surgical Procedures/adverse effects , Robotic Surgical Procedures/instrumentation , Robotic Surgical Procedures/trends , Tumor Burden , Uterine Neoplasms/diagnostic imaging , Uterine Neoplasms/pathology , Uterine Neoplasms/physiopathologyABSTRACT
OBJECTIVE: To assess geographical distribution and practice characteristics of fertility clinics inclusive of lesbian, gay, bisexual, and transgender (LGBT) patients. DESIGN: Cross-sectional analysis. SETTING: Not applicable. PATIENT(S): None. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Prevalence and geographical distribution of fertility clinic websites with LGBT-specific content, indicated by keywords and home page cues specific to the LGBT patient population. Assessment of relationship between LGBT-specific content and clinic characteristics, including U.S. region, clinic size, private versus academic setting, and state-mandated fertility insurance coverage. RESULT(S): Of 379 websites analyzed, 201 (53%) contained LGBT content. Clinics with the highest proportion of LGBT website content were in the Northeast (59/82, 72%) and West (63/96, 66%), while the lowest proportion was in the Midwest (29/74, 39%) and South (50/127, 39%). Most frequently used terms included lesbian (72%), LGBT/LGBTQ (69%), and gay (68%), while less used terms included trans/transgender (32%) and bisexual (15%). Larger clinic size was associated with LGBT-specific website content (odds ratio, 4.42; 95% confidence interval, 2.07-9.67). Practice type and state-mandated fertility insurance coverage were not associated with a clinic website having LGBT content. CONCLUSION(S): Over half of Society for Assisted Reproductive Technology member fertility clinics included LGBT content on their websites, yet those in the Midwest and South were significantly less likely to do so. Predictive factors for having LGBT website content included location in northeastern and western regions and increasing clinic size. Further studies are needed to evaluate whether inclusion of LGBT content on clinic websites impacts use of reproductive services by the LGBT patient population.
