If the military wanted you to have a family…
Is having a family in the military a right or a luxury? This is a question one group seeks to answer in its pursuit of advocating for family building, the idea that a family is not always just made, but it is built, through adoption and assisted reproductive technology (ART).
To scan the crowd at a welcome home event, you might think that the military “issues” children the way they do equipment. But for some, attending these functions is more painful than the deployment itself because they are forced to come face to face with the picture-perfect family they don’t have and can’t make.
What’s the Problem?
According to the CDC, infertility is a struggle faced by 16.2% of married females aged 15-49. Infertility is a global issue. The UN has said that all humans have the right to procreate. The World Health Organization goes a step further and believes that addressing infertility can “mitigate gender inequality” as globally females are more likely to suffer from infertility-related shame, stress and stigma.
“It’s a disease,” said Ellen Gustafson, co-founder of the Military Family Building Coalition (MFBC), the group that is at the forefront of this family building conversation. “It’s not something we challenge in literally any other disease. I mean, you have people that are given care for a lot of things that another person might question, but if they have a disease, their care is fully assumed.”
But although infertility is considered a disease in America, it is not “covered” like a disease. It is “cared for” like a symptom. What does that mean in reality?
“Getting access to controlling your reproductive health is not an issue, getting access to enhancing your reproductive health is not a problem,” said Katy Bell Hendrickson, co-founder of MFBC. “But troubleshooting the problems you’re having in your reproductive health, that’s 100 percent DIY.” Tricare does not currently cover infertility care or ART. It does cover some diagnostic testing costs, but if a female is struggling with infertility in the military, it is up to her to find her own solution.
Gender Disparity in Infertility Coverage
According to MFBC, for some female service members there is added pressure to reproduce at convenient times that align with career progression. In the Navy, this may be during a two to three-year “shore tour.” Females who are unable to align their family building within these schedules can be derailed by pregnancies that fall during less “convenient” tours of duty.
When juxtaposed with the availability and ease with which male service members can receive a prescription for Viagra, the gender divide seems to widen. The DoD is aware of the connection between sexual health and mental health. A study conducted by the National Institutes of Health (NIH) said that 85% of veterans diagnosed with PTSD also suffered from erectile dysfunction. The VA quotes the study stating that “sexual health is a state of physical, emotional, mental, and social well-being in relation to sexuality. [It] is a significant predictor of physical and emotional health and overall quality of life.”
We know the stigma surrounding virility and fertility impacts mental health. Despite this knowledge, there is a hesitation to cover ART, largely due to the associated price tag.
The Cost
Conceptually, the general public may be supportive of alternative forms of building a family. However, this support generally stops short of a congressional payday in the form of TRICARE coverage, which is what may be required to transform would-be parents into a family bursting at the seams.
For one round of In Vitro Fertilization (IVF) a family can expect to pay $25,000, with average success rates ranging from 11-39 percent depending on maternal age. By contrast, the cost of a generic form of Viagra is roughly $40 per pill without insurance. Family building is a huge expense for an insurance provider that is always on the lookout for ways to cut costs. This does not factor in the additional costs paid out by the DoD for these new dependents, like birth-related hospital stays and medical coverage for roughly 18 years.
What Is Next?
According to MFBC, instead of framing “family building” as an issue of personal choice, it must be framed as an essential medical service. Just as the average citizen may not want their tax dollars to pay for the treatment of a smoker’s lung cancer, their treatment is not going to be denied because of their personal choice to smoke. The conversation needs to be less about what “choices” the DoD should or should not cover, but rather how to anticipate what diseases should be covered in order to keep up with advances in available treatments.“I come from a military family, as do many others who also have an uncle, a brother, a dad, a sister, a mother who have served,” Bell Hendrickson emphasized. “In building these families, you’re actually building the future.” Η
