The last several decades have witnessed a dramatic change in how our society conceives of family, parenthood, pregnancy, childbirth, and gender roles. One issue at the heart of this change was the successful uncoupling of intercourse from reproduction via assisted reproductive technology (ART). 1 ART has made it possible for a wealth of individuals, who would otherwise be unable, to create families and become parents. 2 Traditionally, most people think of infertile couples as the beneficiaries of such technology, but ART has special and important implications for gay and/or unmarried persons as well. 3 Dubbed the" structurally infertile," this latter group, if desirous of reproducing," must do so through means other than sexual intercourse because of the social structure in which they self-identify." 4

Despite the growth in popularity of ART for both the medically and structurally infertile, ART continues to be a mainly private-payer enterprise, reserved for those individuals who have the expendable income to pay for these expensive technologies. 5 Given both the high demand for ART as well as the astronomically high cost for some ART procedures, some states have begun mandating insurance coverage as a means of ensuring that a wider range of people are able to access reproductive technologies. 6 While much focus has been on whether insurance should be mandated for such procedures, little attention has been paid to the unusual consequences of mandated insurance for consumers of ART, particularly gay and unmarried persons. Of the fourteen states with some form of insurance mandate, none explicitly excludes gay or