The subject of kids is one that’s hard to talk about in chronic illness and disability communities. Part of it is the infantilization we as adults experience due to our conditions. Part of it is due to how difficult it may be to date. A lot of it has to do, though, with fertility and the ability to carry a fetus to term.

We disabled and ill are judged for trying to have children – and we are judged if we cannot.

Infertility is simply an umbrella term. What it means is that a heterosexual couple has been unable to conceive over the course of 6-12 months (depending on ages involved). It affects one of every eight couples.

Conditions that can affect fertility range from Endometriosis and Polycystic Ovary Syndrome (PCOS) to physical and hormonal issues to medication-related issues. Medications can make it difficult to conceive, whether for a specific time or longer. Many medications haven’t been observed in pregnancy and therefore have unknown risks to both parent and fetus in utero. Others, such as methotrexate, are known to be toxic for fetuses.

Forced sterilization is a reality that too many of us have lived through, from New Zealand to the US and beyond.

There are many ways to deal with infertility ranging from adoption and surrogacy to IVF and other fertility medications to living child-free. If people choose to go through IVF and other fertility treatments, these aren’t always covered by insurance. In fact, only 15 states mandate some sort of infertility treatment coverage. The ACA didn’t expand coverage requirements in this case – which is, frankly, a disappointment.

Living with infertility is costly.

If someone aims to have kids, they have to deal with medical appointments and the charges associated with IVF/infertility treatments.

Surrogacy is expensive, especially as it generally means the family pays for medical care for the surrogate.

Adoption is also incredibly expensive. Depending on illness/disability, socioeconomic status, race/ethnicity, relationship status, gender identity, or sexual orientation, it may be impossible to adopt. Denials are not rare, again especially for those of us with illnesses or disabilities.

Adoption is also incredibly expensive. Depending on illness or disability, socioeconomic status, race/ethnicity, relationship status, gender identity, or sexual orientation, it may be impossible to adopt. Denials are not rare, again especially for those of us with illnesses or disabilities.

The emotional toll infertility takes is horrendous. When we can’t conceive, it can make interacting with family difficult, whether that’s being asked when you’ll have kids or interacting with kiddos you may never have on your own. Hell, even being on social media can be taxing. Everyone posts cute pictures of their children. They don’t mean to trigger reminders of pain but inevitably do.

This can all take a terrible toll on our intimate relationships as well.

This week, Chronic Sex will focus on sharing resources and experiences of people dealing with infertility.

If you struggle with fertility issues, know that you aren’t alone. There are many resources that exist, such as RESOLVE: The National Infertility Awareness Association.