What the Human Rights Campaign's highest designation means for LGBTQ+ patients building their families, and why this year's recognition lands at a particularly important moment.
June 8th, 2026 | 8 min. read
At a Glance
→ Illume Fertility has been named a 2026 LGBTQ+ Healthcare Equality Leader by the Human Rights Campaign Foundation, the eighth consecutive year earning the designation.
→ Only 255 of 741 participating healthcare facilities are publicly listed as Leaders in this year's directory, a notable drop from prior years given current legal and political pressures.
→ The recognition arrives during a year of significant pressure on LGBTQ+ healthcare access, making publicly identifiable inclusive providers harder to find and more important to patients.
→ For LGBTQ+ intended parents, inclusive care goes beyond welcoming language: it means a clinical team that understands donor conception, reciprocal IVF, gestational surrogacy, and the legal and financial landscape that comes with each path.
The Human Rights Campaign Foundation (HRC) released its 2026 Healthcare Equality Index on June 5, 2026, and Illume Fertility has been named a Leader for the eighth year in a row.
This year's report arrives in a healthcare landscape where LGBTQ+ care access is being actively debated and, in many states, restricted, which shaped both how facilities participated and how their results are being shared publicly.
In this article:
What is the Healthcare Equality Index?
The Human Rights Campaign Foundation's Healthcare Equality Index (HEI) is the national benchmark for LGBTQ+ inclusion in healthcare settings.
For close to two decades, it has given hospitals, clinics, and health systems a structured way to assess and improve their policies on inclusive care, and it has given patients a way to identify providers that have done the work.
The HEI evaluates participating facilities across four core areas:
- Non-discrimination protections and staff training
- Patient services and support
- Employee benefits and policies
- Patient and community engagement
In the 2026 cycle, 741 healthcare organizations participated, and 44% earned the highest designation of Healthcare Equality Leader.
The HRC introduced an option this year for facilities to keep their individual scorecards out of the public directory, recognizing the varied legal and operational pressures institutions are navigating. As a result, only 255 facilities are publicly listed as Leaders.
Illume Fertility is proud to be one of those 255 and remains the only free-standing fertility center with Healthcare Equality Leader status in the Northeast.
Practicing in Connecticut and New York, where state protections for LGBTQ+ healthcare remain strong, we're able to stay publicly listed and easy to find for the many patients searching for inclusive care.
Illume Fertility's 2026 Leader Designation
Earning Healthcare Equality Leader status for an eighth consecutive year reflects how LGBTQ+ inclusion functions inside our practice day to day, from how intake forms are written to how financial coordinators review coverage, how staff are trained to talk with intended parents, and how we coordinate care for donors and gestational carriers.
Our Founder and Medical Director, Dr. Mark Leondires, built his own family through surrogacy and egg donation, and that experience led him to create Gay Parents To Be, Illume's dedicated resource hub for LGBTQ+ family building. He built the broader practice on the same principle: inclusive care should be part of how it works from the ground up.
"When I was navigating my own family-building journey, I learned just how much it matters to work with people who already understand the path you're on," said Dr. Leondires. "That's the environment we've worked to create at Illume for the last 24 years, and it's what this recognition from the Human Rights Campaign Foundation reflects."
LGBTQ+ Inclusivity Matters More Than Ever
The 2026 Healthcare Equality Index arrives during a difficult year for LGBTQ+ healthcare access. As the Human Rights Campaign Foundation notes in this year's report, healthcare organizations across the country are working under shifting legal requirements, anti-DEI efforts, and active restrictions on gender-affirming care.
All of this has real consequences for patients: LGBTQ+ adults are still twice as likely as non-LGBTQ+ adults to report being treated unfairly or with disrespect by a healthcare provider, and when patients see their care debated in legislatures, the result is often delayed care, skipped screenings, and worse health outcomes.
What the Research Says
Two recent studies show why HEI participation matters beyond the designation itself.
A 2025 longitudinal study in BMJ Quality & Safety found that hospitals consistently participating in the HEI received higher patient ratings and recommendation scores than those that didn't, with stronger HEI performance linked to higher patient satisfaction overall.
A separate 2025 study in JAMA Network Open found that nurses in hospitals with high LGBTQ+ inclusion reported lower burnout, less job dissatisfaction, and a greater willingness to recommend their workplace.
The research shows us that fostering an inclusive healthcare practice isn't symbolic. It correlates with better outcomes for patients and more stable teams for staff.
What will insurance cover?
Don't let confusing policies delay your family-building journey. Whether you're exploring IUI, IVF, donor conception, or surrogacy, this guide breaks down what to expect as an LGBTQ+ patient.
Challenges LGBTQ+ Patients Still Face
While LGBTQ+ visibility and representation have improved over the past decade, the structural barriers haven't disappeared. A few ongoing issues:
The Definition of Infertility
Most insurance plans still rely on the older definition of infertility, which requires 12 months of unprotected heterosexual intercourse. That definition structurally excludes same-sex couples, single parents by choice, and many transgender and non-binary individuals from accessing the very coverage they're paying premiums for.
In 2023, the American Society for Reproductive Medicine updated its definition to recognize the inability to achieve pregnancy based on a patient's medical, sexual, and reproductive history, with explicit inclusion of LGBTQ+ patients and single parents by choice.
However, insurance companies aren't bound by ASRM guidelines, and many plans still haven't adopted the updated definition, which is why coverage denials for LGBTQ+ family building services remain so common.
Cost & Accessibility
Even with coverage, family-building paths like donor conception, reciprocal IVF, fertility preservation, and gestational surrogacy carry substantial out-of-pocket costs. Donor gametes, surrogate compensation, agency fees, and the legal work to secure parentage are almost universally excluded from insurance, regardless of state.
Finding Qualified Providers
The clinical and legal landscape for LGBTQ+ family building is its own subspecialty.
Reciprocal IVF, split-cycle IVF, third-party reproduction, pre-transition fertility preservation, second-parent adoption, and the variations in laws across states all require working knowledge, not goodwill alone.
Patients shouldn't have to teach their care team the basics before getting started.
What to Look for in a Fertility Clinic
If you're an LGBTQ+ patient evaluating fertility clinics, success rates are an important factor, but they're not the only one. A clinic that is genuinely built to serve LGBTQ+ families will have specific capabilities, not just rainbow flags in June or inclusive language on its website.
A useful checklist when comparing clinics:
- How many LGBTQ+ patients has the clinic actually treated, and across which pathways (IUI with donor sperm, reciprocal IVF, surrogacy, fertility preservation)?
- Are donor conception and third-party reproduction coordination handled in-house, or referred out to external providers?
- Are reciprocal IVF and split-cycle IVF offered?
- Are intake forms, patient portals, and educational materials inclusive by design?
- Is there a financial coordinator who knows how to work fully-insured vs. self-funded plans, and how to push back on coverage denials tied to the older definition of infertility?
- Are mental health counseling and community resources part of the patient experience?
If the answers are provided quickly and transparently, that tells you something valuable about how integrated LGBTQ+ family building is into the practice.
How Illume Supports LGBTQ+ Family Building
Gay Parents To Be is Illume's dedicated resource hub for LGBTQ+ family building, created to close the gap in support that intended parents have historically faced. It exists alongside Illume's clinical practice, and it continues to shape how the team works with every intended parent who walks through the door.
All patients pursuing LGBTQ+ family building at Illume have access to:
- An experienced third-party reproduction team to coordinate donor and gestational carrier arrangements
- Reciprocal IVF and split-cycle IVF
- In-house genetic counseling and PGT testing
- Pre-transition fertility preservation for transgender patients
- Financial coordinators who understand the specific challenges LGBTQ+ patients face
- Mental health counseling, fertility acupuncture, nutrition services, and support groups
- Free educational resources and community through Gay Parents To Be
No two paths to parenthood look the same, and our goal is to help each family make informed decisions with the support of a care team that already knows the terrain.
Ready to take the next step?
Illume's LGBTQ+ family-building team can walk you through your options, from reciprocal IVF to surrogacy to fertility preservation, and help you understand what each pathway involves.
Our Promise to LGBTQ+ Families
The Human Rights Campaign Foundation frames HEI recognition as a roadmap, not a finish line. That framing matches our perspective here at Illume. The designation is meaningful, especially this year, but the real measure is what patients experience in the consult room, the financial review, the procedure suite, and the follow-up call after a transfer.
Everyone who wants to build a family deserves a fertility team that knows what they need, what's possible, and how to get them there. If you're an LGBTQ+ individual or couple at the start of that conversation, we invite you to schedule a free 30-minute consult with one of Illume's family-building specialists to explore your options.
Not sure where to begin?
Our complete guide to LGBTQ+ family building: choosing a clinic, fertility testing, treatment paths, insurance, and more.
