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LGBTQ+ Competency in Birth and Beyond reviewed by Kirsten Killoran

Did you know that in a 2018 survey, 1 in 2 young adults (18-24 years) did not identify as 100% heterosexual?  (https://yougov.co.uk/topics/lifestyle/articles-reports/2015/08/16/half-young-not-heterosexual). As lactation consultants we are called on to support a diverse range of family types, whether in hospital settings, in the community, or in private practice.  How does your workplace or your practice reflect this diversity… or does it?  That is what we set out to explore with AJ Silver of the Queer Birth Club (https://queerbirthclub.co.uk) : the barriers and challenges faced by LGBTQ+ families in antenatal and postnatal care, how we as lactation consultants and healthcare workers can help our clients/patients to navigate an historically cisgender, patriarchal system, and how we can work to support the cause by becoming meaningful allies.


The day began with a run-down of common terms used within the LGBTQ+ community; for example, transgender, cisgender, nonbinary, gay, lesbian, heterosexual, and many more.  While these terms may be useful in box-ticking exercises, it is up to us to listen to our families and respect the pronouns (she/her, they/them, etc) and terminology they wish to use for themselves, and should not make assumptions.


Just as we value all our clients and patients equally, so too do we have to respect and value their lived experiences.  Historically (and even to this day) the LGBTQ+ community has been over-medicalised; in particular, the transgender community.  Assumptions about a client’s gender or sexuality can often lead to lack of trust and disengagement with healthcare professionals, as well as mental health issues.  As AJ noted: “The words you use can have lasting effects on families”.


Have you considered how your workplace or private practice might appear to an LGBTQ+ family?  As a simple exercise, AJ suggested walking through your system as a potential LGBTQ+ client.  Does your website and social media include images of a diverse range of families, or only mums, dads and babies?  Do your forms and charts use gendered terms like mother/father, or instead do you use birth parent/parent 2?  Are there inherent assumptions that everyone in the family is related by blood, or is there room for donor/surrogate information?


While these may seem like small, nit-picky things, representation and inclusion not only matter, but in some cases can be of huge medical importance.  In the afternoon we were presented with several case studies to consider.  In each example, couples and families were subjected to unnecessary procedures, incorrect tests, delays and red tape, simply because they were LGBTQ+ families and the traditional maternity system procedures were not set up to cater for them.


Finally, we looked at what we can do to become better allies.  The first is to acknowledge and examine your own biases.  Explore where they come from, and try to learn more about issues you’re not familiar with – ideally from LGBTQ+ sources.  Consider changes to your website, social media and forms/charts to be more inclusive.  Demonstrate your allyship not just during pride month in June (also known as rainbow-washing), but as a natural part of your practice.  Post photos of LGBTQ+ families in “boring”, everyday social media posts, rather than as special “good news” stories. Allyship should be normal and natural, not forced or demonstrative.


Ultimately, while we all provide the same caring, compassionate support to our clients regardless of family type, it never hurts to consider a few small changes to show that we do “walk the talk”.  After all, as Marian Wright Edelman once said: “You can’t be what you can’t see”… can LGBTQ+ families see themselves as your clients..?


Kirsten Killoran, November 2021.

Kirsten received a bursary of €100 from ALCI to attend  LGBTQ+ Competency in Birth and Beyond.

Further Reading


Presenting at the ILCA 2023 In-person Conference in Las Vegas:  A Personal Account


ILCA 2023 Conference Presentation: Building Policy Coalitions


WHO/Unicef Congress