LGBTQ+ individuals and pregnancy outcomes: a commentary

Lesbian, gay, bisexual, transgender, queer, ‘plus’ (LGBTQ+) individuals who are pregnant or want to become pregnant face worse pregnancy outcomes than heterosexual patients.1, 2 This is especially relevant because in the USA and elsewhere, sexually diverse and gender-expansive populations have steadily risen, pushing LGBTQ+ pregnancy from niche into the mainstream.3, 4 The American College of Obstetricians and Gynecologists (ACOG) endorses quality care to all people regardless of sexual orientation or gender identity.5, 6 This includes providing gender-affirming care throughout a patient's pregnancy, acknowledging risk factors for LGBTQ+ populations that affect reproductive outcomes, and using appropriate evidence-based clinical recommendations to tailor care.5, 6 Despite these criteria, these patients still encounter many barriers to health care and have limited access to obstetric care and fertility clinics.5, 7 As clinicians and scientists, it is crucial that we continue to promote equitable care to pregnant individuals of any background.