Lesbians denied fertility treatment: discrimination or spending cuts?

Two lesbians denied fertility treatment by their regional health authority are threatening legal action, claiming that they are being discriminated against on the grounds of their sexual orientation. The health authorities in the northern region of Asturias argue that the 2006 law outlining fertility treatment available under the national health service, and passed by the current Socialist Party administration, applies only to heterosexual couples, and specifically refers to cases where the male partner is sterile.

"A lesbian couple is by definition sterile, because they cannot reproduce without the aid of a third party, so therefore, even if the regional government doesn't say so explicitly, what it is effectively saying is that we find a man," says Silvia García, one of the women who say they have been discriminated against in Asturias.

"A lesbian couple is by definition sterile, because they cannot reproduce without the aid of a third party"

"The national health service is there to solve health problems; not to guarantee the right to motherhood"

At least two other regional governments, Catalonia and Murcia, also refuse to provide assisted reproduction to lesbians. But other regions, among them Valencia, Andalusia and the Basque Country, do offer such services to lesbians. So far, Spain's other regional governments have yet to publicly state their position. Indeed, policy regarding free treatment seems less about party politics, and more about saving money. Asturias is controlled by the Socialist Party, while Valencia's regional government is run by the conservative Popular Party (PP).

Health Minister Leire Pajín admitted last week that the law was open to interpretation. "The law on assisted human reproduction does not discriminate against any type of woman, but neither does it establish whether treatment should be free."

A spokeswoman for the ministry was unequivocal however: "The national health service is there to solve health problems; not to guarantee the right to motherhood, which is a much wider remit." The spokeswoman said she saw no contradiction between the current legislation on assisted reproduction - which stipulates against discrimination on the grounds of sexual orientation or marital status - and the wider law on health services, which makes it clear that only heterosexual couples are eligible for free treatment through its reference to sterility.

The head of the health service in Asturias, Ramón Quirós, denies discriminating against Silvia García and another woman, Andrea Muñiz, saying that the hospital report said neither was sterile, and therefore were not eligible for treatment. "The health service in Asturias is not interested in people's sexual orientation: we offer the same service to everybody," he added.

Quirós referred to legislation from 2006 outlining free medical care, allowing for "human assisted reproduction when there is a diagnosis of sterility or an established clinical status." He added: "When somebody is healthy or the medical report says that they are not infertile, the system does not finance them." But legislation from the same year on human assisted reproduction states: "The woman may receive the techniques outlined in this law independent of her marital status and sexual orientation."

Gay and lesbian organizations in Catalonia say the health authorities there discriminate against lesbians. "The law is being misinterpreted. At the moment we know of three cases of discrimination," says María José Ariza, deputy head of the Catalan Association of Lesbian and Gay Families. She accuses the health authorities in the northeastern region of "not giving priority to lesbians," and that most couples give up in the face of long waiting lists and use the private sector. But she adds that a working group has been set up to find ways to widen access to fertility treatment. Private treatment costs between 6,000 and 12,000 euros. Each year some 30,000 couples, of which around 1,500 are single women or lesbians, take this path.

In Murcia, a health authority spokeswoman said that its assisted reproduction facilities "are directed exclusively at heterosexual couples with sterility issues." Manuel Lucas, head of the Spanish Society for Intervention in Sexology, says that interpretation of the law "needs to adapt to the times we live in." He suggests replacing the criteria of sterile with "impossibility to reproduce."