Deborah Law 0:03 Good morning. You are listening to the new J 96 and this is Deborah Law today's host of Lambda Reports, a program by and for the lesbian and gay community in St. Louis. And this morning, I'm speaking with Jennifer Firestone, who is coordinator of the family and parenting program at the Fenway Community Health Center in Boston, Massachusetts. And for any of you who might not know, Jennifer is an ex St. Louisan, and this is the first of a series planned on, where are they now and what are they doing? A look at St. Louis lesbians who have gone to other places. Good morning, Jennifer. And thank you for joining us. Jennifer Firestone 0:33 Good morning. Thanks for having me. Deborah Law 0:36 Why don't you tell us a little bit about the family and parenting program at Fenway and maybe also a little bit about the Fenway Community Health Center. Jennifer Firestone 0:42 Okay, well, I'll start with the center. Fenway Community Health Center is primarily a gay and lesbian identified community based health center here in Boston, and we're actually celebrating our 20th anniversary this year, so the Center has been around for quite some time. (Happy birthday), thank you, and it's grown actually substantially. There's now about between 80 and 100 people working here, goodness. So there's really a lot going on here at the Center. And the family and parenting Services Program has been evolving since about 1985 when some local lesbians who were very interested in having children biologically became frustrated with the lack of access to artificial insemination that lesbians and single heterosexual women had. There were very few, if any, providers in the area who would perform artificial insemination with women who weren't married, straight, married, and in a married relationship. So there were some sympathetic people here at Fenway Community Health Center. This was many years ago, and between the lesbians in the community who wanted to see this happen. I think there were probably about five of them at the time, got together with some providers here and began to set up our own program, which we sort of changed the terminology a little bit to be alternative insemination, as opposed to artificial, because it's, it's very real. It's not, it's not artificial at all. So we sort of used some different words for it. So that's pretty much how it started. I think there were probably five women in the program when it first began in 1985. Now, when we have an orientation, which we do every two months, we have an orientation to this program. We have approximately 35 and 40 women who come so it's really sort of taken off as a program that many, many women, mostly lesbians, mostly in couples, some who are not in couples, and also some single heterosexual women, as well as a few married couples who now participate in the program, we have about 40 active clients, and we've got 41 babies and about seven more on the way at the moment. So that's a little bit about how that program began, but it's really there's actually gotten to be a lot more to it. Originally, it was founded to give lesbians and single heterosexual women access to this technology. I think it's really gathered a lot of steam as a reproductive rights issue in terms of the rights of single women and lesbian women to bear children and to create family and to be parents. So it's really kind of an issue of self determination as well. I think another reason that a lot of people come to our program now, actually, in Boston, there are several providers who will do AI with single women and with lesbians, but we still are Sperm Bank's largest client, and I think it has something to do with the kind of feminist self-health model in which this program was founded and continues to operate, that in as much as it is possible, I think the women in the program control the process, that they we don't have a lot of screening or requirements. There's a there is some medical screening that we require, but there's no other sort of psychosocial screening. There are no age or marital status or financial status kinds of requirements. And I think that our program is also kind of unique in that it really encourages and requires, actually very active client involvement, both in terms of the ovulation prediction process, as well as that us is a sort of, ours is a home-based insemination program. In other words, we teach the women how to do the inseminations themselves, and they pick up the sperm and take it home with them when they're ready to use it and actually do the inseminations themselves. So ours is kind of the least medical, least technical model and and so I think for a lot of women, obviously, this is the way they they would like to do it, and we're finding actually, a lot of straight women would prefer to do it this way as well. So that's pretty much how the AI program has has operated. It also involves a lot. We like to try to take a more holistic approach, in that we have three different support groups that women can participate in, that meet monthly for women who are both thinking about doing AI. And then there's other groups, one for women who are who have inseminated between one and eight times. And the third group is for women who have inseminated nine times or more. And it sort of recognizes the fact that that alternative insemination is really a difficult process. Emotionally. It's very it can be very draining on the individual, on the relationship, if there's a relationship involved, and, you know, recognizes that women really need and can provide each other with a lot of support while they're going through it. So I think those are things that are kind of unique to this, as opposed to doing it in a doctor's office. Deborah Law 6:30 Excellent. Well, I have to say, when I looked at the information that you had sent to me, clearly, from my background in women's health, seeing all of the self help literature and perspective and sensibility was very exciting to me, because I think that's the soundest way that our healthcare can be both available to us and that we can take on some of the tougher issues that are involved in things like artificial or alternate insemination. Artificial has never been a word, actually, that I have used, and in fact, it was a question that I had for you, and maybe I can jump to that one right away. Your program does use alternative insemination. For years, we had aggressively called the process "donor" insemination, again in this effort to get rid of the term artificial insemination, and I wondered if there was a conscious change from donor to alternative or Jennifer Firestone 7:19 I don't know. (Okay), I don't I've been here for the past couple of years, and so I met some I don't know. It hasn't been really a controversy while I've been here. It was just always that way. So I've led it alone. I'm not sure what the … Deborah Law 7:36 it makes sense. I just wondered if there was a had been some thought in terms of that. But let me kind of back to the you brought up many, many issues, and in fact, answered many questions that I had, but was wondering, in terms of who comes to the program, and you've answered that in terms of who comes, if you have seen in the years that you have been there, from the information that's been kept, some discernible patterns in terms of who is using the service, or changes in that pattern, the kinds of things that you've learned about let, the lesbian community and the women's community in Boston that then can be extrapolated to other communities, possibly. Jennifer Firestone 8:12 Well, I'm afraid I haven't been around long enough to see major changes, but there, There are some recognizable kinds of things going on now. As I said before, most of our clients are lesbians, and I think that's obviously because we are so clearly geared towards lesbians. And so I would say, probably, at least I don't know, 95% of the women in our program are lesbians. And I also think that it has something to do with lesbians just being more comfortable in a more sort of women-centered kind of place, both in terms of the health center, as well as the program itself. One thing that's really noticeable to me is the age of the women in our program. I think that probably the average age of the women in the program is about 37 or 38 years old. We have very few young, you know, I mean younger women, women under 30 even. And I think that's kind of different from a lot of places, and I think it has to do with the whole process that lesbians go through in deciding to have children. It's really very extensive that it's not uncommon. At the beginning of an orientation, I'll ask people sort of how long they've been thinking about it. By a show of hands, you know, how many people you know have been thinking about this for less than a year or more? And generally speaking, people have been thinking about this for more than four years. That, I think that is one of the most obvious distinctions between lesbians having children, and I think most married couples having children is that is the level of deliberation that goes. Into it. I think it takes lesbians a long time to get to a place where they feel comfortable enough with all the different aspects of their life, their relationships, their their work and financial situation, their comfort with being lesbians and being lesbian mothers. Women come to our support group around, you know, considering AI for quite a long time. And so I think that's a really obvious and unique distinction in our program, is that it really takes a lot. It's taken women a lot of time to think about it and come to this place where they're ready to do it. So that's something that I think is pretty significant. And I think in terms of the straight women that come to the program, and straight married couples, I think a lot of them come here because they feel more accepted. I just spoke with a woman, actually this morning, for a long time who felt very bizarre that she was 40 years old and only now getting around to having a child. Well, that's not uncommon in my program. I have tons of women who are 40 years old, but, you know, for a straight married woman, she felt very freakish in her community, and really came here so that she could be in a support group. First of all, she needed support. She knew that, and she needed to be somewhere where there was support, and I think where it would be more acceptable that she was older and wanting to have a child. And I think a lot of people come here because they're very put off by the high tech, high medical models that you know, some of the more sophisticated and mainstream high tech reproductive facilities that they find in this area. Deborah Law 11:55 … which generally tend to be very alienating. Yeah, well, you know, I kind of say that the lesbian baby boom sort of started in the mid to the late 70s. And I'm wondering, from your program, have you seen an increase or more of us interested in having kids? Are you really just seeing that as we reach that age, and of you know, our mid 30s, late 30s, that that's sort of the magic moment, based on all the factors that you've said. More kids, fewer kids, anything discerning? Jennifer Firestone 12:26 I think so, I mean, I think it must be, because the numbers of people coming to orientations has grown enormously. You know, it started out with five, and now there's more like 45 and so I think the program has really grown from a very small program with no paid staff to a very large program with one full time staff and one part time staff person involved in it. So I think that that's that's some indication of the numbers growing. And I think it's about a lot of things. Part of it is about the things I mentioned before, and I think part of it, I think I do think some of it has to do with our evolution in terms of gay and lesbian, like, liberation. And I think that for a long time, people felt so marginalized and felt like if you were you know that being a lesbian and being a mother were mutually exclusive. And I think that that is that has changed. And I think the degree to which it's changed, I think, has a lot to do with our movement and the gay liberation movement, and as people feeling better and feeling more, quote, unquote, normal, you know, sort of rejecting this whole notion that gay people and children are a bad combination or an unsafe combination. I think that people really are just rejecting that idea. Certainly, a lot of women in the support group still struggle with it. I think we still deal with, you know, is despair to the child in our support groups. But these days, it's maybe one or two people who say that, and there's 10 others in the room who feel very differently, who feel very confident about what we have to offer children as lesbians and as you know, lesbian mothers and lesbian-headed families. So I think that there is a real difference. Another real difference that's happening. It sort of is a little different from the AI program, but that gets more into our other gay and lesbian family and parenting services is the number of men who are interested in being fathers. And I think that has partly to do, again, with our evolution as a movement, and it has partly to do with changes in AIDS- and HIV-related testing that I think, you know, years ago, where before there was an HIV test that people had any faith in it, it seemed like being biological parents was an impossibility. And I think that has really changed. We have run two eight week groups for gay men considering parenting, both of which were oversubscribed. The first orientation we had for gay men considering parenting, there were 50 men packed into a room that we, you know, had no idea that many men would show up. And now we run this game, this eight week group for gay men considering parenting twice a year, and it fills up every time. And so I think that's a whole other issue is gay men sort of coming into their own around this and starting to recognize, you know, what we have to offer children, and rejecting all these myths about our appropriateness to be with children, much less to be parents. Deborah Law 16:06 Right. Well, I think some of this baby boom actually started before AIDS impacted our community. I also think that has an effect in terms of how we begin to how we have developed a politic about our relationships and definition of families and carrying on families. You look at heavy losses on one side, and sometimes it begins to evolve into a need to be creating at the at the same point. And I would like to talk more about the men in the program and sort of that evolution. But maybe we could step to a couple of other things. First, which is, I was wondering, if you have many couples returning for the other partner to inseminate, this is something that … Jennifer Firestone 16:50 Yeah, it's not uncommon. It's possible when, if either a couple or an individual does get pregnant and can see through a particular donor, it's possible, generally, for them to purchase and reserve sperm from that same donor for siblings later on. And that's actually quite common, that that after a woman makes it through her first trimester and is feeling pretty good that she'll go ahead and put aside some sperm from that same donor so that in two or three or however many years, she or her partner, if she has one, can inseminate with that same donor. So that's that's pretty common. We're actually there's one family who's having their third going for their third sibling. But yeah, there are actually quite a few. Deborah Law 17:48 I was going to say, probably more common in my experiences, that it tends if one is in if a woman is part of a couple, that the other woman gets very interested and very active about getting pregnant and having a kid shortly after the birth. And I just wondered if you've noticed any butch/femme pattern. I have to say, from my experience, it seems like the butches are tend to be more aggressive. And I have a limited study group, I will admit, go for the first time, and then very quickly, the fem in the relationship is ready to get pregnant, and not necessarily that, you know, I don't know what the pattern proves, but that's been my experience at this point. Jennifer Firestone 18:26 Oh, no, maybe I should, like pay more attention. Hmm. Deborah Law 18:32 Okay, well, can you tell us a typical experience a woman or a couple comes calls Fenway says, you know, I would assume first their support groups, but kind of, what is, what's the typical, very quickly experience. Jennifer Firestone 18:47 Well, the way it generally works, is somebody will call and say, you know, they're they want information about the AI program, and I take their name and address and I send them literature in the mail, and that includes a brochure that sort of describes, step by step how the program works. And I'll send them information about the next orientation session, which is a three hour, very extensive program that we have every two months. And I send them information about the three different support groups. And I also send them a copy of our newsletter. We have a newsletter that comes out a few times a year, whenever we can get it out. It's called Conceptions, and it's a newsletter about family and parenting issues in the gay and lesbian community, and about our program that's become a really good sort of networking and communication tool. So that's what I send people, and they check that out, and then a lot of times, people will show up to the support groups. We have people coming to the support groups from all over New England, from Rhode Island and Connecticut and New Hampshire and Vermont. People come all the way down here on Tuesday nights for support groups. And sometimes people will come back over and over again. And other times, people sort of show up once and don't and they don't see them again. But. But eventually, usually, people will come to the orientation, and I haven't had a chance yet to see how many people that come to the orientation actually go on to participate in the program. For some people, it's right away. For some people, they'll go to the orientation, they'll take the medical forms, they get their exams, and boom, they're like back in here a few months later, after charting their cycles for a couple of months, they're ready to go. Other people, it takes years. There's people who you know were at an orientation, like a year and a half ago, and it took them this long to get to a place where they were ready to go ahead with it. So after they go to the orientation and they they have to get a medical exam, either here or with their own provider, using forms that we have, and we ask them to chart their cycles. A lot of what we do during the orientation is teach people how to do self-cervical exams so they can observe changes in their cervical mucus and the opening to their cervix and and to you know how to do their basal body temperature accurately. And so we spend a lot of time on that. And it's very interesting, because I know when I was in St. Louis and talked with you about this kind of stuff that was really common, I have vivid memories of us putting sheets up at the Women's Eye bookstore around the windows while we looked at each other's services, and that was such a long time ago, but it's really funny how removed that is from people's experience these days, which is a little disturbing to me, actually. You know that I say that during these orientations, and I can't tell whether or not I've just gotten older and the women in the room are so much younger than me, or just that it was such a fleeting thing that that whole sort of women's self-help era, and I feel very connected to it, and feel like it's what enabled me to sort of slide so easily into this fairly unique position at running this program. But for most women, this is the first time they will ever look at theirs or anybody else, sort of I always think that's so odd, but the women are fascinated by it and are really excited to learn this stuff. And so that feels really good that we don't just rely on ovulation predictor kits, which is what doctors use mostly these days. I think doctors are of the opinion now, women don't want to, women aren't capable or to really, women won't want to bother with all this. They don't want to dirty their fingers, you know, trying to check out their own cervical mucus. And so they use these kits, which are very expensive and not they don't work with everybody. I have very mixed reviews on them. And so I feel like there again, is this thing where the regular doctors go to the whatever is the highest tech thing, whereas I think these more manual methods continue to actually be, you know, I think more accurate for a lot of people. So anyway, we do that. They chart their cycles for a few months, and then they make an appointment to come in and see me, and we go over their charts, and, you know, fill out the necessary paperwork. And then at that point, if they're ready to move ahead, they can start looking at donor profiles. And there are two banks that we work with in California, one in LA and one in Oakland, and what I generally have 16 page profiles on most of the donors, which is something else that women don't usually get at a doctor's office, that because we're so big and we deal in such high volume, the banks are more willing to sort of send me these profiles, which I keep on hand here, so that women can really spend as many hours as they want looking, you know, at who all the different donors are and what they're like. And they select, they give me a list of at least 10 donors that they're that they would be comfortable using in their order of preference, and that's what I submit to the bank each month, and the bank gives them the first donor that's available on their list. So that's usually kind of the progression that people go through. I order for everybody all at once. I order for everyone in my program the middle of every month. And the bank ships. Both banks ship the sperm to me in large tanks of liquid nitrogen vapor. And I have a large tank of liquid nitrogen here in my office, and I transfer it from their tanks into my tank, and then it can stay here, cryo preserved for an indefinite period of time. But so that way, the women can be, you know, observing, observing their, you know, their cycles. And when they think they're ovulating and they're ready to use it, they come in. And they pick up a little cooler full of 10 tons of dry ice, and we give them their two vials, and they pay for them and take them home with them. And then they do the insemination themselves, which they've also learned during the orientation. And, you know, we go over that a few times, so they know what they're doing when they leave here. So that's generally kind of the progression, and that's usually the way it goes. Sometimes people get hung up. There are those relationships that fall apart during the process, and then that usually means some some change in the course that the woman was on. But that's generally the way it goes. The problem that we run into, I think, since we do have an older population, is that it is a lot harder to get pregnant when you're you know over 35. I don't think I ever knew that to the extent I know that now. And so that's a situation where I usually suggest that women inseminate a couple times, and if they think they're really getting it at the right time and they're still not getting pregnant after a few inseminations, then I usually refer them to some to get some infertility work done, which they can either done, get done here or with their own provider. And that I think is different too, that I think other doctors will usually, and some of the HMOs require women to wait a year they have them inseminate for like, a year before they do infertility work. And I really disagree with that, because I feel like older women don't have the time, and also don't have the money to do that for so long, so I I have actually become more aggressive about doing infertility work earlier on. Deborah Law 26:49 What is the average length of time that one usually spends in terms of insemination before … Jennifer Firestone 26:54 It's really hard to say. I mean, anybody should plan on at least six months. And you really plenty of women who get pregnant on their first try, but it depends. It's such a hard thing to say because it depends so much on the age of the woman, the regularity and predictability of her cycle. There are some people who know exactly when they're ovulating. There's other people who we look at those charts month after month, and we can never tell when they're ovulating. And so it really depends a lot on your your own cycle and … Deborah Law 27:25 And you really do find a big difference when a woman is over 35m huh? Jennifer Firestone 27:29 Which is really very irritating to me, that our biology, our biological evolution, has not like kept in sync with our sort of social, (yeah), social evolution that I think women are are having children later in life, but reproductively speaking, our bodies aren't being as cooperative as I think we'd like them to be, Deborah Law 27:51 Huh? Because it kind of runs counter to some of the early women's health stuff, too, where we talk so much about nutrition and the things that we did to our bodies as women aged. And, you know, there's the pPregnancy After 40 Workbook and things where it was really something that we could correct, that a lot of it was culturally in, you know, induced in a way. So this is interesting in terms of what you're … Jennifer Firestone 28:16 I don't know what to say about it, except that it just feels so common that people's like different hormonal thing will be off. That, you know, when people do get fertility stuff checked out after they've been inseminating for a few months, … Deborah Law 28:32 There is a difference. Jennifer Firestone 28:33 I'm amazed at how common it is for something to be off, not necessarily something that's irrevocable, but different hormonal things. I think the most common thing is known as luteal phase defect, which is that period of time between the time you you ovulate and the time you get your period where conception that is a time when conception would occur and implantation would occur. And it seems like that's a time when people run into problems, or that people do conceive and they have these really early miscarriages, which I think straight people who are having intercourse wouldn't necessarily even know, but because these women know exactly when they inseminated, they're very aware of what's going on, and I think so we we tend to be more aware of those early miscarriages that other people wouldn't necessarily recognize. Deborah Law 29:28 Right. Well, I have to say I don't know where this half hour has gone, but we have used it up, and we haven't even got to talk about about our legal issues and the other stuff that you do and what kinds of things are happening for women who have had kids and now we're dealing with issues in terms of childcare and schooling and education. Transcribed by https://otter.ai