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How to Navigate Gender Disappointment After Fertility Treatment

A fertility counselor explores the concept of gender disappointment and offers ways to reframe your feelings.

May 21st, 2025 | 15 min. read

By Melissa Kelleher, LCSW

You’ve endured so many appointments, injections, side effects, bills, and the emotional rollercoaster of fertility treatment — all for the chance to have a baby. So why, when you learn the sex of your future child, are you sometimes left with a sense of...disappointment?

In this article:

What is Gender Disappointment?

You've likely come across at least one "gender reveal" video while scrolling on social media, where expecting parents show off a blue or pink slice of cake or pop a cannon of colored confetti. In many of these videos (particularly those that go viral online), one parent will immediately show signs of disappointment after the big reveal. 

But most parents-to-be who have this experience aren't being filmed.

Instead, they may see an 'XX' or 'XY' on a genetic testing report or receive the news during a pregnancy ultrasound. While some people feel excited to learn the sex of their baby, others are surprised to experience feelings of disappointment, especially if they've gone through the intense emotional and physical demands of fertility treatment.

When Expectations Don't Match Reality

Whether you've always dreamed of having a daughter or imagined raising a son, discovering that your baby’s sex (often referred to as gender) doesn't match your expectations can bring up unexpected emotions like sadness, grief, or guilt.

This emotional experience is known as gender disappointment, and it can affect anyone — including LGBTQ+ individuals and couples, single mothers by choice, and those who have faced pregnancy loss or long fertility journeys.

While it's a valid response (and more common than you might think), it's often misunderstood and not openly discussed, due to parents developing a deep sense of shame or confusion around these feelings. 

In this guide, we’ll explore:

  • What gender disappointment is (and what it’s not)
  • Why it may show up after fertility treatment
  • How gender, sex, and societal expectations play a role
  • What support is available for those experiencing these feelings

Understanding Gender Disappointment

Gender disappointment is a form of emotional distress that occurs when a parent feels sadness, grief, or disconnection upon learning that the sex (often referred to as “gender”) of their baby is different from what they had hoped or envisioned.

It can arise from deeply personal desires, cultural norms, or family expectations — and often coexists with love and joy for the child. This experience is common and valid across all types of families, including LGBTQ+ parents and those who needed fertility treatment to bring a baby into the world.

It doesn’t mean you won’t love your child. It doesn’t make you ungrateful or a bad parent. But it can feel like a loss — of dreams, family names you planned to pass down, imagined futures, or experiences you’d associated with a particular gender.

Let’s unpack why gender disappointment occurs, how to validate and process it, and how expanding your understanding of gender can help shift your perspective.

Why Fertility Patients Might Experience It Differently

For those who conceive with medical assistance, whether through IUI, IVF, egg or sperm donation, surrogacy, or other pathways, the journey to parenthood is often long, exhausting, and expensive.

So when fertility patients experience disappointment around gender, it can feel “wrong,” or even shameful. But emotions don’t follow logic. And fertility treatment often intensifies the sense of investment — not just financially, but emotionally.

It’s normal to build a clear vision and dream about your future child, and it’s okay to mourn the version of that story that won’t come true.

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● “I know people who would give anything to have any baby at all.”
● “I fought so hard for this — how can I be upset?”

Root Causes of Gender Disappointment

Gender disappointment rarely stems from surface-level preferences. It's often deeply tied to our identities, relationships, and life histories. Here are some common underlying reasons:

1. Cultural or Familial Pressures

In some families or cultures, there may be clear preferences for children of a certain sex.

This can show up in traditions, inheritance expectations, gender roles, or comments from family members. Even if you don’t agree with these preferences, internalized pressure can still impact your emotions.

2. Personal Experiences or Childhood Desires

You may have always dreamed of raising a daughter because of a close relationship with your own mother. Or perhaps you longed for a son after losing a male figure in your life. These desires can go back decades and carry significant emotional weight.

3. Family Balancing

Parents may hope for a specific gender to "balance out" their existing family — for example, after having two daughters, you may long for a boy. When those expectations aren’t met, disappointment can set in, even when love for your child is never in question.

4. Unresolved Trauma or Unmet Needs

Sometimes, gender disappointment is tied to deeper wounds.

If you experienced emotional neglect, abuse, or strained parental relationships tied to a certain gender, it may shape the way you envision connecting with a future child. These associations may be subconscious - but powerful.

Understanding why you're feeling disappointed is the first step toward compassionately addressing those feelings.

Gender Identity vs. Biological Sex

In Western culture, gender and sex have historically been conflated. But it's important to understand that sex is assigned at birth based on anatomy, while gender is a social and psychological construct, often shaped by cultural norms and personal identity.

As trans dad and LGBTQ+ family-building advocate Trystan Reese explains:

"The evidence shows us that gender is comprised of a constellation of factors—there is no one singular thing that makes any of us feel more like a man, a woman, or something else entirely."

This science-based view underscores the reality that gender identity and expression are not binary or fixed, but fluid and individual.

Desires for a boy or a girl often stem from societal ideas about what those identities mean — not the individual child you'll hold in your arms. If we unpack what we’re actually longing for, it’s usually qualities like gentleness, strength, creativity, or connection — all of which can be nurtured in any child, regardless of their sex assigned at birth.

The Evolution of Gender Identity

It's important to acknowledge that children born today are increasingly likely to grow up in a world where gender is understood as a spectrum, instead of a black and white concept.

According to research from UCLA's Williams Institute, about 1.2 million U.S. adults identify as nonbinary, representing 11% of the LGBTQ+ adult population. A 2022 Pew Research study noted that approximately 5% of people under 30 identify as transgender or nonbinary. 

Your child may grow into their assigned gender. They may not. But their worth, identity, and relationship with you won’t be determined by chromosomes or gender reveal balloons.

How to Process Gender Disappointment

If you’re experiencing gender disappointment, it’s important to know that your feelings are valid — and that you’re not alone. Naming and acknowledging these emotions is the first step toward healing.

While it can feel isolating or even shameful, there are healthy ways to process and move through it with support, compassion, and time.

Here are four important things to remember as you work through these feelings: 

1. Acknowledge It Without Shame

You’re allowed to feel whatever you feel. Give yourself space to acknowledge any feelings of disappointment or shifting expectations without judgment. 

2. Explore the Why Behind It

What dreams were tied to a particular gender? Where did those expectations come from? Was it about bonding, legacy, safety, or recreating something from your own childhood?

3. Seek Support

Talking to a therapist — especially one who specializes in reproductive or perinatal mental health — can help you effectively work through these emotions.

Expert Help is Available

Here at Illume, we can help connect you with a mental health professional who has experience helping clients navigate experiences like pregnancy loss, gender disappointment, or the stressors of fertility treatment.

  • If you're a current patient at our practice, please ask your Patient Navigator for access to our vetted network of licensed care providers.
  • New patients can schedule a consultation and request more information from their New Patient Liaison during the intake process.

4. Reconnect to the Bigger Picture

You’re growing or welcoming a child — a unique human being with their own personality and path. Try to slowly shift the focus from their gender to the special, lifetime relationship you’ll build together.

A Special Note for LGBTQ+ Parents

  • For queer, trans, and nonbinary parents, gender disappointment can carry distinct emotional layers — particularly when expectations about gender expression, societal norms, and biological limitations intersect.
  • Some trans men who choose to carry pregnancies may feel conflicted if their child is assigned female at birth (AFAB), especially if the experience amplifies gender dysphoria.
  • For same-sex female couples, there may be a longing to parent a boy after having daughters, or fear that their child won’t have a male role model.
  • For gay male couples building families with the help of egg donation and surrogacy, there may be anxiety around raising a daughter in a society that often presumes children need a mother to thrive.

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Get the facts about LGBTQ+ family building, including where to begin your journey and what to expect along the way.

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The Impact of Societal Pressure 

Some LGBTQ+ families face subtle (or even overt) pressure to present as a "balanced" or "typical" nuclear family. LGBTQ+ parents may feel pressured to meet traditional parenting expectations, including gender norms for both themselves and their children.

These emotional pressures are compounded by the fact that many LGBTQ+ parents must use assisted reproduction, adoption, or surrogacy to build their families — adding layers of financial, legal, and emotional complexity.

Gender disappointment in LGBTQ+ families isn’t just about the child’s sex — it’s often rooted in how the outside world might perceive, judge, or try to define your family based on that information.

The Good News

It’s also important to acknowledge that children of LGBTQ+ parents are more likely to grow up in environments that actually affirm gender diversity. Research indicates that children raised in LGBTQ+ households often exhibit greater openness to diverse gender roles and identities.

A 2023 study published in the Journal of Marriage and Family found that individuals with LGBTQ+ parents reported being more open to people of diverse genders and sexualities,

Recognizing that gender is not destiny — and that your family gets to define itself on its own terms — can be a powerful, grounding truth.

Gender Disappointment FAQs

Why does gender disappointment sometimes occur after IVF?

Fertility treatment involves a high emotional and financial investment, which can lead to strong hopes about what your future child will be like. For some, this includes imagining a specific gender or even starting to plan a themed nursery.

When the outcome doesn’t match those hopes, it can trigger grief, guilt, or confusion — especially if the child’s gender feels symbolically tied to their journey or loss.

Can LGBTQ+ parents experience gender disappointment?

Absolutely. LGBTQ+ parents may experience gender disappointment for many reasons, including pressure to create a "balanced" family, navigating cultural norms, or concern over how a child’s gender may impact their personal identity, dysphoria, or societal perception.

Is gender disappointment the same as gender dysphoria?

No. Gender disappointment is a parent’s emotional response to their child’s biological sex not reflecting their expectations. Gender dysphoria is the psychological distress someone may experience when their own gender identity differs from the sex assigned to them at birth.

What are some reasons people experience gender disappointment?

  • Personal childhood experiences or traumas
  • Cultural or religious expectations
  • Desire to "balance" the family (e.g. one boy, one girl)
  • A strong connection to a specific parent-child dynamic
  • Belief that one gender may be easier to raise or relate to
  • Pressure from family members or society

What if my feelings are intense or won't go away?

If your emotions feel overwhelming or persistent, working with a fertility-informed therapist can help. Processing these feelings in a safe, nonjudgmental space can reduce guilt and help you build a healthy bond with your child.

How can I talk to others about gender disappointment without feeling judged?

It’s okay to be selective about who you share these feelings with. Not everyone will understand, especially if they haven't faced infertility or loss.

Try saying: "I’m grateful for this pregnancy, but I’ve also had some unexpected emotions come up — and I’m working through them."

Talking with a therapist, joining a support group, or connecting with other parents who have experienced gender disappointment can be more helpful than sharing widely.

Can gender disappointment show up even after a baby is born?

Yes. While some people begin to feel better (developing feelings of excitement or acceptance) during pregnancy, others don’t fully process their emotions until after birth — especially if external pressures or unhealed grief resurface.

Remember: That’s okay! Emotional healing is never linear.

You’re Allowed to Feel Everything

If you're struggling with feelings of gender disappointment, know this: you are not alone, and there is nothing wrong with you. These emotions do not make you a bad parent.

They make you human.

Whether your feelings stem from past losses, personal expectations, or the emotional weight of fertility treatment, they are real and valid. You can be deeply grateful for your baby while still grieving the child you imagined. Both experiences can coexist.

Need a safe space to talk?

At Illume Fertility, we care for the whole person, not just your medical needs. That includes helping you navigate complex emotions like grief, anxiety, and gender disappointment at any stage of your journey.

Our network of licensed mental health professionals are here to support you with compassion, understanding, and personalized care. Many of them have walked this path themselves and understand how difficult it can be.

If you’d like to hear from others who have faced similar emotional challenges during their fertility journeys, we encourage you to explore our extensive collection of patient stories.

No matter how you're feeling in this moment, know that support is available, and you don't have to navigate these challenging emotions on your own. We're here for you!

Melissa Kelleher, LCSW

Melissa Kelleher is a licensed clinical social worker and fertility counselor who has worked with Illume Fertility patients for many years, in addition to her work in private practice. She facilitates sessions with individuals and couples during their fertility journey, helping them navigate loss and disappointments, as well as giving them the tools to make decisions related to their specific challenges. She currently provides an extra layer of one-on-one support for Illume patients who have recently experienced a loss.

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