title: Disparities between online assisted reproduction patient education for same-sex and heterosexual couples.
abstract: Does the prevalence of online education in fertility center websites differ for lesbian, gay, bisexual, transgender (LGBT) couples compared to online education for heterosexual couples?
  
  
  
  This review of fertility center websites showed that the majority of websites with patient education for heterosexual couples do not have similar materials for LGBT couples.
  
  
  
  In order to have biologically related children, LGBT individuals or couples utilize assisted reproductive technologies (ART). Fertility clinic websites provide online education to familiarize patients with the different ART procedures; however, no studies have examined the prevalence of educational information for LGBT couples compared to information for heterosexual couples utilizing ART.
  
  
  
  This website review evaluated Centers for Disease Control and Prevention (CDC)-reported fertility center websites. Websites were reviewed in 2014 using the latest 2011 CDC report, and reviewed again in 2015 with the latest 2013 CDC report.
  
  
  
  Patient education information was coded using categories determined after a sample review, and differences were analyzed with χ(2) tests, with P-values calculated with Fisher's exact test.
  
  
  
  In 2014, 31.1% (121) of 389 websites with information for heterosexual couples also contained information for LGBT couples. In 2015, the number of fertility centers with information for LGBT couples increased by 52.9% to 185 (P < 0.001) of 407 (45.5%) fertility center websites. However, the majority of fertility clinic websites (54.5%) with information for heterosexual couples still do not include information specific to LGBT couples.
  
  
  
  The lack of online information on fertility center websites may not directly reflect the quality of care LGBT individuals or couples receive in the clinic, and the effect of this absence of online information on the clinical experiences of LGBT patients is unknown.
  
  
  
  These findings add to the growing body of work showing disparities in the treatment of LGBT persons compared to the overall population. To overcome these discrepancies, healthcare providers should adapt their practice to include this growing and underserved patient population.
  
  
  
  Funding was provided by the Medical Student Summer Research Scholarship, Barbur Khalique Foundation. There are no competing interests.
authors.affiliation: Boston University School of Medicine, Boston, MA 02118, USA.
authors.forename: Helen
authors.initials: H
authors.lastname: Jin
authors.affiliation: Biomedical Genetics Section, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA dasgupta@bu.edu.
authors.forename: Shoumita
authors.initials: S
authors.lastname: Dasgupta
mesh_terms: D005191:Family Characteristics; D005260:Female; D005298:Fertility; D020010:Heterosexuality; D006801:Humans; D020407:Internet; D008297:Male; D010353:Patient Education as Topic; D027724:Reproductive Techniques, Assisted; D000072339:Sexual and Gender Minorities
keywords: assisted reproduction technologies; bisexuality; cultural competency; healthcare disparities; homosexuality; patient education; transgender persons