Lesbians, single women refused public-funded assisted reproduction

Lesbian couples and single women will be excluded from the right to assisted reproduction techniques such as artificial insemination and in vitro fertilization, according to proposals on new basic services offered under the public health system sent to regional health departments by the Health Ministry.

However, ministry sources insisted such techniques would be offered to anyone with fertility problems under the public health system and not only to "couples comprising of a man and a woman." The sources insisted there were no ideological motives behind its recommendations, which are aimed at providing the regional authorities with criteria on which to "prioritize" cases of assisted reproduction. They said cases "will be treated strictly on therapeutic and preventive grounds."

Current rules contained in a decree approved in 2006 indicate that the public health system will only fund assisted reproduction in cases of "clinically established" sterility. It is on that basis that some regions such as Andalusia, the Balearic Islands, the Basque Country and certain hospitals in Madrid offer such treatment to single women and lesbians. In other regions that adhere strictly to the letter of the decree, it is difficult for single women and lesbians to receive this treatment at public hospitals.

Responsibility for healthcare in Spain lies with individual regions, with funding provided by the central government. The proposals sent by the Health Ministry to the regions leave the door open for such services to be offered if they can demonstrate they have the resources to do so. The public health system is already suffering from the impact of draconian spending cuts imposed by the central government to rein in the public deficit.

The proposals on assisted reproduction, to which EL PAÍS has had access, are due to be presented at a meeting of the Inter-territorial Health Council next Tuesday. They establish that such treatment can be offered to "couples" that meet certain criteria, which state that the woman cannot be older than 40 years old and no more than 38 in cases of with artificial insemination from a male partner. The male partner cannot be more than 50 years old. Couples in which either partner has voluntarily undergone sterilization or cannot complete the treatment through reasons of health or social factors will be excluded from receiving assisted reproduction.

These criteria would seem to exclude single women and lesbians with fertility problems from receiving treatment, although the Health Ministry insists that this is not the case.

The text on basic services sent by the Health Ministry to the regions defines sterility as "the failure to achieve pregnancy during 12 months of sexual relations with vaginal intercourse and without using contraceptive methods." This indicates that lesbians would be required to maintain sexual relations with men or for single women to find a male partner.

Isabel Gómez, a member of the State Federation of Lesbian, Gays, Bisexuals and Transexuals (FELGTB) considers the ministry's proposals on assisted reproduction to be ideologically motivated. "The government is sticking to a monolithic idea of what constitutes a family," she said. "If the Health Ministry revises the criteria for funding this service it should do so to eliminate differences and discrimination. It appears it is doing quite the opposite."

The criteria, she insisted, adhere to the idea that the government has of the family, which is that "formed by a man and a woman."

Gerardo Ruiz Rico, a professor of Constitutional Law at the University of Jaén, also believes the restrictions on access to assisted reproduction proposed by the ministry are discriminatory. "They are making a limited interpretation of the legislation," he said. "It establishes a series of conditions that return to the definition of a couple to that formed by a man and woman. This is not in line with the doctrine of the Constitutional Court, which has backed same-sex marriages."