Are Fertility & Femininity Inseparable?
The physical, emotional and social impact of fertility struggles
This week I will focus on family, fertility and forging our identity within a family tree.
Today’s newsletter is about the medical and mental health implications of infertility.
Today’s podcast is an interview with a woman who discovered later in life that she has dozens—if not hundreds—of siblings. Take a listen HERE. More details below!
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I recently saw a woman in her late 30s for her check-up. She has been trying to become pregnant for three years. As we re-reviewed her extensive medical evaluation for root causes of infertility, she welled up with tears.
We have decided to stop trying, she told me.
After multiple unsuccessful rounds of IVF, she and her husband had given up hope for having a baby on their own. She was exhausted. Between hormone injections, feelings of inadequacy, and haphazard sleeping and eating habits over the last 36 months, she was worn down, mentally and physically.
I’m just done, she reported through quiet sobs.
It turns out she is not alone. According to the World Health Organization, approximately 10% to 15% of couples worldwide experience infertility. The American Society for Reproductive Medicine estimates that in the U.S., about 1 in 8 couples (or 12% of married women) have trouble getting pregnant or sustaining a pregnancy.
Unsurprisingly, research has shown that individuals and couples experiencing infertility have higher rates of depression, anxiety, and other emotional challenges compared to those who are not experiencing infertility. In addition to the stress of infertility itself, the treatment process can also be emotionally challenging. Fertility treatments may be expensive, time-consuming, and physically demanding, and can take a toll on mental health.
So when my patient asked me for advice on next steps, I had a few thoughts.
Thank you for supporting this work! Together we’re changing the conversation about what it means to be healthy.
Health is about more than fertility and failed IVF. Women are not defined by their ability to reproduce. We are the integrated sum of complex parts. Health is about having awareness about the stories we tell ourselves, acceptance over the things we can't control, and more agency over our life. It starts with having access to fact-based information to care for our body and mind.
Together, my patient and I started to reframe her fertility “journey” not as a talent competition but as a process of self-discovery. She began to see that by drowning herself in work, mindlessly noshing on sweets, and isolating from friends, she was successfully avoiding disquieting thoughts—and disallowing the natural process of grief.
To validate her own feelings and to give herself permission to be human. “You’re more normal than you think.” I told her.
To work on the painful process of accepting that she and her husband may never conceive on their own. I explained that acceptance is not about giving up; it’s about honoring the truth and having the courage to face it. It’s about holding space to grieve. We discussed healthy coping strategies, such as couples therapy and mindfulness techniques. She laughed, My only therapy right now is ice cream.
To lean into the areas where she has agency.
Fertility-wise, we discussed other assisted reproductive technologies from intrauterine insemination (IUI), and the use of donor eggs or sperm. We talked about surrogacy and adoption, options she had been afraid to discuss for fear it meant “giving up.”
Self-esteem-wise, we discussed how to re-write her internal narrative about worthiness and how she might begin to measure her life less by external validation and more on her own terms.
Health habit-wise, we mapped out a plan to gradually put herself back in the driver’s seat of her routines (ice cream included).
When I asked her what she needed from people around her, she looked at me soberly. “I wish someone would say ‘No matter what happens, I love you.’”
“How about making that wish known?” I suggested.
It hadn’t even occurred to ask for what I need, she smiled back. I guess the little girl inside me just needs to hear I’m okay.
Family dynamics are complicated, but what happens when you learn that you have dozens—and possibly hundreds—of siblings?
When writer Chrysta Bilton’s mom decided to build a family as a gay woman in the early 80s, she employed a sperm donor. This man also played a role in Chrysta and her sister’s life as “dad.” But he continued to donate to other women—in secret—for almost 10 years. Chrysta learned this shocking truth from an article in the New York Times. On this episode, Chrysta joins Dr. McBride to discuss family secrets, shame, her unconventional coming-of-age story, and how all of this affected her mental and physical health.
Chrysta’s critically acclaimed memoir “Normal Family: On Truth, Love, and How I Met My 35 Siblings,” is available now.
Please be sure to like, rate, review — and enjoy — the show!
What are your thoughts about fertility, femininity, and the definition of family? I welcome your thoughts, as always.