by Dr. Elliott Kronenfeld

In this exciting age where families look different and are being built by all types of people, the ways to parenthood are many.  For LGBTQ+ folx, there are options for fertility preservation, adoption, foster care, Big Brother/Big Sister, co-parenting, and more.  The path to parenthood requires intentionality, support, and the need to involve others.  These opportunities also bring challenges to the intended parent(s) as they navigate through the reality that parenthood does not “just happen” after a night of sex. Very often LGBTQ+ intended parents enter the process with the assumption that “we just need the right parts and plumbing”.  Even if that is true, issues of medicalization take on a new meaning for bodies that are already socially scrutinized.  The issues of intimacy, connection, and sexual citizenship are challenged when fertility concerns are raised, especially if it requires changing expected stories of who and how conception, gestation, and biology is managed.

However, heteronormative adults are taught that baby making is a natural and organic process.  When we are young, we are cautioned about having sex because someone will get pregnant, so be careful!  For many of us, we enter our early adulthoods excited about the concept of finding love, having sex, and eventually having a family of our own.  We have a fantasy of how that will happen.  There is a script for it.  Fall in love, get married, maybe set up a home and get a career started, and then have a baby.   It all seems so idealistic and natural.

For those who decide to be in a partnership and follow a more traditional journey, the expectation is that sex will be fun, easy, and spontaneous.  Then reality sets in.  Life gets complicated and sex can often be something that starts to slow down, and the menu becomes a bit predictable – but still a good menu.

When the decision to start having children is made, sex starts to take on new meanings and the first major shift in intimacy takes place.  It is no longer about carnal cravings, exploration, and connection.  There is a goal.  Cycles are tracked. Temperatures are taken.  Ovulations are predicted.  Sex starts to become scheduled and on demand.  When conception does not happen as predicted, anxieties rise, and self-doubt begins to form.  The longer the process takes, the more challenging the emotions become.

Eventually there comes a time when the doubt and dismay become concerning and a medical appointment is made.  This creates the second major shift in intimacy.  Tests are run.  Answers are sought.  Diagnoses are given.  Blame is felt.  For all intended parents in the assisted reproduction process, new identities as patients are formed.  When our bodies become medicalized, we become a collection of our parts.  We are broken down into organs and functions.    Sex and intimacy leave the equation as other people begin directing sex and reproduction.

Perhaps some meds are given, sperm samples are left, masturbation is regulated, and paper gowns are worn.  Ovulation is stimulated. Endometrial linings are measured. Sperm count, motility, shape are all measured.  Jerking off in a cup.  Legs up in stirrups.  This is all sexy.  Welcome to the third shift in intimacy.  We begin to give the entire process over to someone else.  Secrecy and emotional dysregulation set in when there is a baby shower at work, a pregnancy announcement, a Facebook post of little Rae’s first cupcake.  Hoping.  Getting disappointed.  Hoping again.  Will it work this time?  How many?  How come?  What does that mean?  Getting pregnant went from not getting into the backseat of a Chrysler to having to learn a new language.  Buckle up, you are on the emotional rollercoaster, and it does not always feel like you and your partner are riding in the same car.

If, joy of joys has happened and a baby arrives, welcome to the fourth shift.  We are exhausted.  Overprotective.  No one knows what this journey was really like.  All focus on this miracle baby.  We did it!  But, we aren’t “doing it”.  We have fought long and hard to have this baby and parenting is the most important job right now.   I do not take it lightly!  But, after midnight feedings, diapers, balancing the external expectations, and how could this little baby create so much laundry???  Sex and intimacy slip further to the back burner.

So, while this is not the journey everyone takes, it is common enough for us to talk about.  If this story sounds vaguely familiar, it is time to talk about how to make the fifth shift:  Prioritizing the marriage and getting back to being a connected, intentional, and intimate couple.  This shift is the one in your control.  It is important to communicate, prioritize, and reengage in this commitment you made to each other.

I do not think this is easy.  Not by any stretch.  But, now that you are parents, it is critical to model for your children what a healthy, loving, intimate relationship looks like.  You have gone through so much to have this baby.  What are the lessons that you want to pass down about connection, love, intimacy, and relationship?  Time to start modeling!

If you want to talk more about the shifts in intimacy and connection during family building, reach out to Dr. Elliott Kronenfeld at or check out his book, Couples by Intention: Creating and Cultivating Relationships that Matter! at


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