Originally published October 9, 2016
John Riehs is the proud father of two beautiful young children, each of whom was born through surrogacy. Dallas readers may recognize John as a well-regarded pediatric dentist and the owner of Preston Center Pediatric Dentistry.
Coming out was a slow process for John. It wasn't until after dental school, in 1999 at age 27, when he first allowed himself to experience what he had thought about since he was a kid.
"I knew at a young age, probably around 11 or 12, that I had feelings for the same sex, but I was from rural Texas and this was not acceptable. Or even discussed," he said. "I think being sheltered in a small southern town, with a population of fewer than 5,000 people and a community where 'being gay was not allowed or accepted' contributed to my late coming out."
Because he never knew anyone who was gay, John said he thought his feelings were wrong and rare. "I had no clue that there were bars and communities where I could meet others who felt the same way I did," he added.
After dental school, John moved to Oklahoma to begin his career. He met a guy, and soon started traveling to Dallas, where a large gay community existed.
Being in Dallas allowed John to have a “second life" away from the social unacceptance of his childhood. Jump forward five years, and he had moved to Dallas permanently and came out to his family.
"First to my brother, then to my cousins, whom I consider sisters – all of whom where loving and supportive," he said. "Then to my Mom and Dad. This was a little more challenging, given their upbringing and the timing, early 2000. I think their reaction was understandable. They loved me, but did not understand or support my being gay."
For a few years John said his personal life was never discussed with his parents. But as time moved on and social norms evolved, his mom and dad began to realize that he was happy and that maybe their reluctance to support him had to do with their own insecurities about what others would think.
"Today my family is my greatest support system and they love me and my children unconditionally," John said. "Just as it took me time to accept my own sexuality, it took time for my family to accept and readjust their own expectations for my life. As a father, I understand that now."
Being gay in his mid-thirties, John said he never thought he would have the opportunity to have a family.
"It wasn't until I met a gay father through my dental practice that I realized this was a possibility," he said. "I was 35 at the time, and the dad had twin girls through surrogacy who were now my patients."
"I never asked many questions of this dad, but he opened my mind and allowed that first glimmer of hope that would one day come to fruition," he said. "I eventually came to be friends with other gay dads who had created families through surrogacy as well."
After many dinners with these friends, John had gained considerable insight into the surrogacy process. But just to make sure he was as fully prepared as possible, he even reached out to other families from the local LGBTQ community whom he did not know but had learned that they had children through surrogacy.
During this time of research, John convinced myself that “I can be a dad by myself – I don't need a partner to make this happen."
But by the time he turned 37, he realized that he had not moved beyond his initial stage of information gathering.
"My birthday stirred emotions about aging, and I believed that it was "now or never" to start my family," he said. "So as a next step, I picked a local surrogacy agency here in Dallas to learn about their program and services. I met with them in early Spring of 2012, and within a month I made the decision to proceed with them."
Before coming to that decision, however, John spent a great deal of time reviewing his finances and also thinking about how parenting could affect his future relationships with other men.
"At the time, I presumed the ability to have a relationship with another man would be extremely hindered if I had a family," he admitted. "But since then my thinking on this has changed considerably, and I no longer think that my kids somehow prevent me from finding love."
The moment he signed with the surrogacy agency, John's journey began. He said he found it helpful having the agency to guide him through the process, at least for the initial surrogacy.
"I think the biggest decision I had to make was to mentally be prepared to commit to something, someone, other than myself," John continued. "As a gay man, I never thought I could have a family, and my life centered around me. It was a little--no, a lot--egocentric, as I'm sure most gay men can relate."
Another important decision he made: John determined not to confide in family or friends about his decision to start a family until he was halfway through the process.
He said had made his mind up and he didn't want anyone to influence him to back out.
"Because of our background growing up in the conservative South, I expected my family might discourage me from my plans," he said. "As it turned out, I was correct. In the beginning my family did voice their opposition. But their feelings changed along with the birth of my son, Jacob. In fact, my dad recently told me (on Father's Day) that being grandparents to my two children was the greatest gift I could ever have possibly given to him and my mother. By way of apology for his initial reaction to my plans to become a dad, he also let me know that sometimes parents concern themselves with their own insecurities, which can make them selfish."
As with anything, John said going through a process once gives you plenty of insight for the next round. Having experienced every step during Jacob's eventual birth allowed him to ask better questions, more questions, during the process of having his daughter Hayden, his second child.
"Some of the trials and tribulations associated with the first surrogacy were also diminished with a better contract that incorporated items about hospital delivery, insurance, ob/gyn, etc," he said. "I found that open communication and discussing potential hurdles in advance helps out tremendously in case the pregnancy does not go as planned. For instance, during my first surrogacy, the surrogate became hypertensive during the first trimester and eventually pre-eclamptic (a potentially dangerous pregnancy complication characterized by high blood pressure). During this time, it was in the best interest of my child's health to minimize the surrogates stress, so essentially I felt a great deal of pressure to “follow her lead" in order to maintain my child's safety. Had we discussed expectations for an emergency delivery, difficulties may not have occurred."
On his second surrogacy journey, John made sure the following questions and requests, missing from his first surrogacy contract, were included in the second one.
- Please provide the last five years of your medical visits/history.
- Can we choose an OB/GYN was acceptable to us both? I'd like one with privileges at a level III NICU hospital.
- Delivery at a hospital I choose (one with level III NICU).
- If for some unforeseen reason the delivery occurs at a different hospital, the expenses for transport to the agreed-upon hospital would be adjusted from compensation.
- Verification of surrogate insurance at time of transfer.
- Agreement that the surrogate would not do any traveling during the third trimester.
- If surrogate chose to travel during the second trimester and a premature delivery occurred, surrogate would pay expenses associated with transportation and additional out-of-state hospital fees.
- I chose not to use breast milk from the surrogate, but made the request to obtain it if my child was born premature.
- If the surrogate had been a surrogate previously, ask to speak with EVERY family she has delivered for.
- The second surrogacy was an amazing experience. I think open communication and discussing all potential outcomes and expectations made for a smooth journey. My second surrogate maintains contact with me through Facebook. However, because of the difficulties with expectations and the emergency delivery, I do not have any contact with my first surrogate.
"I think the best advice I was given prior to the start of surrogacy was to be prepared for hurdles and not to get discouraged," John said. "There are so many moving pieces in the process from screenings, egg donation, surrogacy designation, fertilization, transfer, contracts, etc. It is a timely process and staying positive is important. For my first surrogacy, it took almost two years from the time I signed with the surrogacy agency until Jacob's birth."
Advice John wishes he had received for his first surrogacy was to ask more questions -- and to keep asking as many questions as possible. The more communication and potential outcomes discussed, the more likely hurdles would not turn into walls.
During his first surrogacy, full disclosure of the surrogate's health history was not received, and ultimately factored into his son Jacob being born at 29 weeks.
"I think it's a fair request to receive a potential surrogate's medical records," he said. "If the surrogate is willing to have full transparency with her health, that likely would set the pace for a much more positive experience for intended parent and surrogate alike."
One last piece of advice, which John said he considers extremely important: "While reviewing the surrogate's contract, be sure to address the choice of OB/GYN. Naturally, many surrogates want to use their own OB/GYN, which is understandable. However, if complications occur during the pregnancy, most OB/GYNs only have privileges to deliver at certain hospitals."
If your child, like John's, is delivered at a hospital with a minimal neonatal intensive care unit or "NICU" (hospitals have different levels of NICU), and needs a more sophisticated NICU, then you'd have to have him/her transported from one hospital to another. "Believe me, watching your child fight for his life, as I did with my son, is extremely stressful," John said. "Adding the burden of a transport only served to increase the stress!"
Furthermore, larger urban hospitals tend to have more experience with surrogacy and the “red tape" paperwork involved.
"Have a meeting with the hospital administrator prior to the birth to review the paperwork and have everyone on the same page," John said. "That process would have been invaluable for me for Jacob's birth. But the hospital my first surrogate chose was not at all familiar with the process or the documents. They required documentation to procure his birth certificate. I was eventually able to work everything out, but I can attest that it took a vast amount of time and I had to endure endless red tape."