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In instances of infertility caused by medical intervention or an underlying medical condition, this procedure is often sought by affected patient populations. U.S. Title 21 regulations have produced disparities in access, disproportionately restricting services for sexually and gender diverse subpopulations capable of producing sperm. This article examines policies contributing to these disparities, explores how these policies may translate to real-world health care delivery, and proposes policy changes that would increase equitable access to care.<\/jats:p>","DOI":"10.1089\/lgbt.2023.0317","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T13:47:39Z","timestamp":1711979259000},"page":"415-418","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Systemic Barriers to Fertility Preservation for Sexually and Gender Diverse Populations"],"prefix":"10.1177","volume":"11","author":[{"given":"Andrew","family":"Shin","sequence":"first","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin N.","family":"Kathrins","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Department of Urology, Brigham and Women's Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6624-8354","authenticated-orcid":false,"given":"Alex S.","family":"Keuroghlian","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA."},{"name":"The National LGBTQIA+ Health Education Center at The Fenway Institute, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,5]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0564"},{"key":"e_1_3_5_3_2","unstructured":"World Health Organization. Infertility. Geneva Switzerland; 2023. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/infertility [Last accessed: October25 2023]."},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2019.11.025"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11040550"},{"key":"e_1_3_5_6_2","unstructured":"National Archives. Title 21 of the CFR\u2014Food and Drugs. Electronic Code of Federal Regulations. 2023. Available from: https:\/\/www.ecfr.gov\/current\/title-21 [Last accessed: May25 2023]."},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2022.02.032"},{"key":"e_1_3_5_8_2","unstructured":"Fertility Center of California Sperm Bank Inc. List of Available Services & Fees. San Diego and Tustin CA. Available from: https:\/\/www.spermbankcalifornia.com\/sperm-bank-cost.html#Directed [Last accessed: May 25 2023]."},{"key":"e_1_3_5_9_2","doi-asserted-by":"crossref","unstructured":"Goldberg AE. LGBTQ Family Building: A Guide for Prospective Parents. American Psychological Association: Washington DC; 2022.","DOI":"10.1037\/0000291-000"},{"issue":"2","key":"e_1_3_5_10_2","first-page":"91","article-title":"Pathways to fatherhood: Evaluating the priorities of self-identified gay and bisexual men pursuing family building options","volume":"3","author":"Hanson BM","year":"2022","unstructured":"Hanson BM, , Leondires MP, , Glatthorn HN, et al. Pathways to fatherhood: Evaluating the priorities of self-identified gay and bisexual men pursuing family building options. 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Available from: https:\/\/www.brighamandwomens.org\/pathology\/clinical-pathology\/reproductive-endocrinology [Last accessed: July 1 2023]."},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2010.06.037"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/03009734.2020.1725935"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/09564624221077785"},{"key":"e_1_3_5_19_2","unstructured":"U.S. Food and Drug Administration. FDA Proposes Individual Risk Assessment for Blood Donations While Continuing to Safeguard U.S. Blood Supply. Silver Spring MD; 2023. 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