Breaking The Silence: Infertility and the Asian American Experience

Growing up in a Taiwanese American household meant that the topic of fertility was never touched on. I never truly grew curious about the field until middle school sex education. I was lucky to be raised in Southern California, where the public schools, like mine, didn’t shy away from these topics. There, I was introduced to all the intricate biological processes of fertilization and birth. I admired the molecular detail of the process, the merging of genetics, and the incredible anatomy of the female reproductive system to produce life. Yet, I never shared this interest at home — it felt taboo, like crossing an invisible line. My mother and I had a close relationship, but when it came to the topic of sex, we were practically strangers.

Later in high school, I experienced my first true conversation on this topic with a person I looked up to — my lifelong piano teacher, a brave Taiwanese woman who endured a decades-long fight with infertility. As I listened to her detail the pain that came with each failed treatment and her diminishing hope, her story resonated most because of the embarrassment she felt, the shame and stigma that she could never seem to escape. At the time, I couldn’t understand why it was such a burden, but years later, I realized that my piano teacher had to brave the realities of social stigma and shame.

Infertility continues to be a glaring issue, impacting millions of families across the United States and disproportionately affecting minority populations. And in Asian American communities, there’s an added layer of psychosocial and cultural factors that exacerbate the struggle.

A review of studies published in 2021 and earlier found that Asian American women feel pressure to bear children, and if they are unsuccessful, they are often blamed for their inability to conceive. The women in the studies reported that the stigma often surfaced in conversations with elders, who would ask when they’d become grandparents or unfairly compare these women to others who had already given birth. The pressure from whispers around exactly when a woman would have a child resulted in an immense amount of pressure, and consequently, these infertile women experienced mental health issues, including depression, anxiety, and resentment.  

It’s disheartening to think that many of these Asian American women suffer at the hands of harsh patriarchal expectations. But unfortunately, many of these issues are deeply rooted in traditional Asian beliefs and social norms. Sons are seen to be more desirable, as they can pass down the family surname. Daughters have been readily given up in favor of a son, as seen in the effects of the One-Child Policy in China. The cultural standard from the very beginning instills a feeling of favoritism and bias toward men, leading women to grow up believing they can never measure up to the value of a man.

So how does this connect back to infertility? When women are taught that their value lies in motherhood, infertility becomes more than a medical diagnosis — it becomes a perceived failure to fulfill their purpose in life. The result is often isolation, guilt, and grief. Of course, the advancements in assisted reproductive technology, such as in vitro fertilization (IVF) or embryo freezing, have transformed people’s ability to conceive and have children. But nevertheless, Asian American women often shy away from enrolling in various infertility clinical trials. A 2008 study found they were less likely than non-Hispanic white patients to express interest in participating, further revealing the hesitation to seek care, possibly due to language barriers, medical mistrust, and time constraints.

Today, there is still minimal literature on what exactly is happening in Asian American communities regarding infertility and how to navigate it. Certain organizations such as FertilityIQ and the Center for Reproductive Medicine and Advanced Reproductive Technologies have begun to sound the alarm on Asian American infertility, a promising sign for future progress. But there is still a significant amount of work needed to ensure Asian American women can feel comfortable and confident in seeking reproductive health treatment. Whether this is through increased funding for more research or integrating more comprehensive sex education resources and curriculum for Asian communities, these efforts are imperative to reducing stigma surrounding infertility.

Now, I look back at my piano teacher with admiration for her story and her determination to conceive. She was eventually able to give birth to two beautiful, healthy twin babies following IVF treatment. And now, she attends conferences to share her empowering story, working to dismantle the shame so deeply embedded in Asian American women — an important first step in infertility advocacy. 

In order to provide a safe space for Asian American women to seek care, it is crucial to engage Asian Americans in fertility research and to explore how culture can play an integral role. This progress is fragile, especially as national conversations around reproductive health continue to face uncertainties. But real change starts through encouraging discourse and educating patients and families on how to navigate the struggles of infertility. It is my hope that more inclusive research and shifting perspectives can promote culturally competent care and protect the rights of women to pursue care freely and fearlessly.  

One day, I hope my future daughter can come to me with questions about fertility, sexuality, and reproductive concerns — and I’ll be ready to meet her with openness, honesty, and pride.

Illustration by Callie Ware.