(672) Factors contributing to delay in family building among sexual/gender minority people in the COVID-19 pandemic

Objective: Sexual and/or gender minority (SGM) people confront disparities in reproductive health care. Studies among non-SGM people have shown concerns about and delays in parenthood due to the COVID-19 pandemic. We aimed to describe factors among SGM people influencing the delay and return to family building in the COVID-19 pandemic.

Study Design: Data from participants in The PRIDE Study—a national, online, longitudinal cohort study of SGM people—who completed the 2022 COVID Family Building Survey, self-reported sexual orientation and gender identity and reported impact from COVID-19 on family building plans were included.  We used chi-square and Fisher’s exact tests to compare family building decision making factors among SGM (cisgender, transgender, and gender expansive) groups.

Results: Our study included a total of 401 SGM participants with a median age of 32 years. A total of 233 (58%) participants identified as gender expansive (e.g., non-binary, transgender, genderqueer) and 396 (99%) participants identified their sexual orientation outside of straight/heterosexual. 41% of participants reported delaying family building due to the COVID-19 pandemic. Of those participants, a majority (55%) reported that national COVID-19 positivity rates were a concern prior to returning to family building (Table 1). Further, 20% of respondents delaying family building cited wanting more COVID-19 pregnancy safety data and 13% wanted more COVID-19 safety data in breast/chest feeding prior to returning to starting or growing a family (Table 1). When comparing response proportions between SGM groups, no significant differences were found.

Conclusion: Our study found that national COVID-19 positivity rates were a major factor prior to returning to family building among all SGM groups. Many respondents reported needing more COVID-19 safety data in pregnancy and breast/chest feeding prior to returning to family building. Our study highlights the importance of pregnancy safety research and public health messaging, particularly to vulnerable populations.