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October 11 marks National Coming Out Day, an opportunity to celebrate all those who have come out as LGBTQ+ and recognize the courage they’ve demonstrated by choosing to be their authentic selves.

Celebrating National Coming Out Day at Alto

October 11 marks National Coming Out Day, an opportunity to celebrate all those who have come out as LGBTQ+ and recognize the courage they’ve demonstrated by choosing to be their authentic selves. In honor of this annual celebration, we sat down with two Alto team members — Ben Romero (he/they), Business Operations Manager for Health Plans and Travis White (he/him), Senior Software Engineer — who generously shared their experiences of coming out as bisexual/queer. Here are their stories, in their own words.

Ben: Like a lot of folks, I avoided coming out for most of my life. I grew up knowing that I wasn’t exactly straight and later recognized that I’m bisexual. I remember my entire experience around my sexuality being wrapped in shame. I would reluctantly conform to heteronormativity just to avoid the fear of being outed or questioned. It wasn't until college that I first felt like I could open myself up to the experience and validation that I deserved. By the time I graduated from college, I had a refreshed sense of my place in the world, but I was still hiding my sexuality from my family.

Five years after college, I was finally ready to be open with my family about being bisexual, and it was the first time I felt as if I had to “come out.” At the time I was engaged to my non-binary/queer partner. My family knew my partner as a woman, but my partner was also beginning to validate their nonbinary gender experience. All I could think about was how much of a disservice it would be to our identities as a queer couple if we started our marriage having to assume more invalidating heteronormative assumptions. I first told my closest family members — my younger brother and parents — who supported me unconditionally and showed me so much love. Not every family member was as accepting of my sexuality, which was really disappointing, but I had more than enough support from my chosen family to finally overcome the fear that I had held on to for so long. 

Travis: I realized I wasn’t completely straight at some point in high school. Growing up Catholic, I was always taught that men are attracted to women and that being gay was a sin. So when I found myself attracted to both girls and guys during high school, I wondered what was wrong with me. I brushed it off and ignored that aspect of my sexuality for a long time, which I would later come to regret since it definitely fed into ongoing anxiety and depression in college.

I first came out to my closest friends during my junior year of college. By that point, I had fully accepted that I wasn’t straight, but I had never acted on my bisexuality. I had only dated girls, so my friends saw me as completely straight. I couldn’t quite figure out how to tell them, and it ended up happening organically while hanging out on a Friday night. We were playing a game around the table that required everyone to share something no one else knew about them. Something came over me and I decided to throw caution to the wind with a, “by the way… I’m bi.”  

I came out to my parents several years later when I was working my first engineering job out of college, living in Silicon Valley and loving life. I knew that if they chose not to accept me, it was going to be their loss. After a night out (and an amazing prime rib dinner) when they were in town, I told them that there was something I wanted to tell them about myself - that I am bisexual. My dad’s first response was, “What does that mean?” I informed them that it means I am attracted to both men and women, though more recently, I’ve come to think of myself as being attracted to interesting people regardless of the gender they identify as. My parents were very supportive, but truthfully I had reached a point where I could be accepting of the worst-case scenario. 

Ben: I was most grateful for the sense of relief I experienced. Despite facing criticism and homophobia from some of my siblings after coming out, I couldn’t shake the sense of pride I felt from allowing myself to be unapologetically queer and visible. I’m finally allowing this part of me to flourish and grow. It’s liberating to be radically honest with yourself and others, regardless of what anyone else may think. I’ve now come to identify with the term queer in addition to bisexual. Part of the growth I’ve experienced involves unlearning so much of what I’ve been socialized to believe about the gender binary, and I’m just now starting to understand where I exist outside of it.  

Travis: When I came out to my friends during college, we stayed up talking until very late into the night. I left feeling a huge weight lifted off of my shoulders — and so full of love and support from some of the people I was closest to.

And later when I came out to my parents, they accepted me with open loving arms, for which I’m grateful, but I was also prepared to move forward with my life even if they did not accept me as my true authentic self.

What resources, support groups, or communities did you rely on when coming out? 

Ben: The isolation of being in the closet can sometimes lead to stories or expectations of yourself that aren’t necessarily helpful, or true. For me, as a bisexual, some of those expectations sounded like “I’m not queer enough,” “I don’t fit into the queer community,” or “people won’t believe I’m bi/queer.” I looked to my queer friends and even to LGBTQ+ advocates on social media and was relieved to find that they had many of the same fears about coming out as I did. I found that learning from other people’s experiences could help validate my own feelings, even if we had a different orientation or gender. As a queer Latinx, I also sought validation from people who shared similar intersections around my identity, which helped me navigate the concerns I had about coming out to my family.

Travis: My friends were very supportive so I was really able to lean on them. It was also helpful to just search online for other people’s coming out stories. Before I could tell my family, I knew I had to reach a point where I would be secure in my identity regardless of the outcome of that conversation. Part of the reason it’s so important to share coming out stories is because hearing other people’s experiences helps inspire you to do the same.

What advice would you give to others considering coming out? 

Ben: Above all, put your safety first. Try your best to not take on the burden of guilt for not being your authentic self — that is not a reflection of you, but a reflection of how our environment can fail to provide the validation we deserve. Take your time and build your comfort with folks who will validate your experience. There’s a whole community of people who will back you up and care for you if someone you come out to is hurtful or invalidating. 

Travis: Do it if, and when, you’re ready. You can never control how others will react, so just accept that other people’s responses have nothing to do with you. It took me years to reach that point with my family. It can be incredibly tough, and you can never know in advance how anyone will respond, but if they cannot accept you for your true authentic self, there are plenty others out there who will.

Do you have any suggestions for allies? 

Ben: I would stress the importance of familiarizing yourself with queer history and how our struggle for acceptence has evolved over the years. The LGBTQ+ community and allies have so much to be proud of today, like the repeal of “Don’t ask, don’t tell” (a former U.S. policy that directed military applicants to not disclose their sexual orientation), the legalization of gay marriage, and more queer representation on our screens — just to name a few.

At the same time, while all of those are certainly celebratory milestones, I ask that allies also recognize that our pride comes from so much more than a handful of legislative victories over the last decade. Our pride comes from the queer folks who came before us and fought for our visibility by rallying voices to speak out against injustice. Allies can research events such as the Compton’s Cafeteria riot, the Stonewall uprising, or the works of the Combahee River Collective. Understanding this historical context is important for also understanding the intersectional nature of the LGBTQ+ struggle for acceptance and restorative justice. Even though we have much to celebrate, our struggle continues as we fight for those who are still excluded or marginalized. 

Travis: Listen. The number one thing you can do is to listen and accept what someone in the LGBTQ+ community is telling you as their truth. It may change in the future — and that’s okay! Sexuality and gender are not a binary, and both can be incredibly fluid.

For parents: how you discuss sexual orientations and gender identities at home can leave a lasting impact on your children. I remember asking my mother about her thoughts on gay marriage, and she shared a more traditional view of marriage as a union between a man and a woman. That stuck with me for a long time and is a key reason I waited so long to tell them who I truly am. Read your toddler a book about a gay couple that gets married, teach your teens about prominent members of the LGBTQ+ community (and why they’re important), and if your LGBTQ+ child asks you to drive them to gay prom, treat the scenario as completely normal — because it is.

Why is it important for you to work at a company that values diversity in all forms? 

Ben: For me it’s a requirement that a company I work for prioritizes diversity and inclusion. I appreciate that Alto provides visibility into the progress that we’ve made towards building a diverse team that reflects the diversity of the patients we build solutions for. We also hold space to identify the work that still needs to be done. It’s really validating to have your background recognized at company celebrations and events or in spaces like employee resource groups (ERGs)*. It’s also important that we do all we can in our everyday actions to foster a collaborative and inclusive environment — one where people feel comfortable enough to be their authentic selves and not like they have to mask their gender, race, neurodivergence, or any other part of their identity. 

Travis: The U.S. — and the world — is made up of so many different people. There’s diversity of thought and beliefs, educational experiences, socioeconomic status, gender, race, A homogenous company that doesn’t mirror that diversity  will never be able to serve the entire population, and will miss out on a lot of opportunities. Alto’s mission is to fulfill medicine's true purpose — to improve quality of life — for everyone who needs it. The key word to me is everyone, and to truly fulfill the promise of that mission, we need a company as diverse as our customers. I personally find it rewarding to work at a company that values diversity and has strong representation of many identities, because that’s how the best ideas come to fruition and ultimately how the most positive impact is achieved.

At Alto, we believe in a world where every perspective matters. Diversity fosters creativity and creates innovation, and we welcome candidates of all backgrounds, skill sets, and experiences. To learn more, read Why We Prioritize Diversity at Alto. 

For more information on how to make your workplace safe and equitable for LGBTQ+ team members, read 11 Simple Ways You (Yes, You!) Can Make Your Workplace More LGBTQ Inclusive. 

If you or someone you know is considering coming out, we encourage you to review these resources:

Parents, Families, and Friends of Lesbians and Gays (PFLAG) Recommended Reading: Coming Out

*ERGs are meant to empower community groups within an organization by directly linking decision makers and implementing policies that support the group’s specific needs. The groups often center around a shared identity or experience and focus on building community, providing support, and contributing to its members’ personal and professional well-being. By creating an open forum for employees to come together, discuss challenges and opportunities, and foster a sense of belonging, ERGs help both individuals and organizations thrive.

We’re excited to welcome Christopher Tidball to the Alto team as Director of Product Management, Supply Chain & Fulfillment. Learn more about his passions both in and outside of work and what drew him to Alto.

Introducing Christopher Tidball, Director of Product Management - Supply Chain & Fulfillment

We’re excited to welcome Christopher Tidball to the Alto team as Director of Product Management, Supply Chain & Fulfillment. Most recently, Christopher led a large team of product managers, engineers and program managers at Amazon to power the company’s most complex fulfillment operations. 

As Alto continues to expand our geographic footprint and customer base, Christopher’s nearly 20 years of industry experience will support us in scaling our systems, so that we can continue to deliver the same high standards of care and service to even more communities.

We recently sat down with Christopher to learn more about his passions both in and outside of work, what drew him to Alto, and the operational opportunities he’s most excited about. 

Welcome to Alto! What inspired you to join the team?

Before a recruiter ever reached out to me about a role at Alto, my wife and I were very satisfied customers. We had been on a long journey of trying to start a family, and that ultimately led us to a fertility clinic that recommended Alto. We had a great experience from day one: the app was easy to use, the same-day deliveries from couriers were always on time, and Alto’s pharmacists walked us through the various medications in our delivery and answered all of our questions. 

Alto’s focus on the customer experience was immediately clear, and I made a mental note that this was the type of company I’d like to work for. Fast forward a few months later, a recruiter reached out and introduced me to the leadership team whose passion and experience sold me on leaving Amazon to come here.

As the Director of Product Management - Supply Chain and Fulfillment, I'll focus on the technology investments that can help us continue to grow and offer exceptional service to our customers. “Supply chain” covers a lot of ground: procurement, inventory, pharmacy operations, delivery, and more. There are tons of opportunities to automate processes to make it easier for Altoids to run the business, especially as we grow and expand. 

What areas of the business are you most excited about?

The operations side has always been exciting to me—it's where the magic happens. At the end of the day, if we don't have sustainable, efficient ways to fulfill the promises we make to our customers, we won't survive. 

Alto has a great business model, and many happy customers to show for it, but there’s always room to continue to innovate and improve the delivery experience. It's one of the few in-person interactions we have with the customer and we want to make it exceptional.

Tell us about life outside of Alto. Are you doing anything interesting at the moment?

I'm a pilot in training — I'm about 75% of the way to getting my single-engine license. I live in Seattle so the aerial views of the city, Puget Sound, and the Cascade Mountains are absolutely breathtaking. Flying gives you a sense of freedom that reminds me of when I first got my driver's license.

You can find more information about Christopher or connect with him directly on LinkedIn. If you have any questions about Alto, or are interested in joining our team, please visit alto.com/careers.

In celebration of Hispanic Heritage Month, which takes place from September 15 - October 15 every year, Alto is highlighting the important work of Alto Auténtico, our Latinx employee resource group (ERG).

Get to Know Alto Auténtico, our Latinx ERG

In celebration of Hispanic Heritage Month, which takes place from September 15 - October 15 every year, Alto is highlighting the important work of Alto Auténtico, our Latinx employee resource group (ERG)*. Below, Robert Barahona, Provider Success Specialist and co-leader of Alto Auténtico, shares more about the group’s origins, current initiatives, and plans for the future.

Robert: “Auténtico” means authentic in Spanish, and authenticity is central to the ERG’s mission. The group was created to ensure that Alto’s Latinx team members have a presence and a voice within our company culture, and that they are supported in their professional development with meaningful opportunities to grow at Alto.  

Robert: Our focus is both internal and external. In addition to developing a Latinx community at Alto, we also shape Alto’s product and services so that we’re better serving our Latinx users (more about that later). Much of that work involves building awareness of Latinx history and cultural contributions, as well as bringing attention to negative stereotypes that we want to dismantle.

We use holidays and events like Day of the Dead (November 1st and 2nd) and Cesar Chavez’ birthday (March 31) to share educational resources with our team members. On Cinco de Mayo, we hosted a Zoom happy hour and a taco lunch for all our pharmacies.

For last year’s Hispanic Heritage Month, we invited Dr. Robert Rodriguez, the president of diversity consulting firm DRR Advisors and a thought leader in Latinx talent management, to speak at Alto. He shared about his own journey of repressing his background to assimilate in the workplace to fully embracing his heritage and empowering other Latinx employees to be their authentic selves.

How are we celebrating Hispanic Heritage Month this year?

Robert: We’re focusing on celebrating Latinx intersectionality. It’s important to recognize the diversity within Latinx culture and the important perspectives of Latinx women, LGBTQ+ individuals, and those of mixed heritage, including our Black and Asian members who also identify as Hispanic or Latinx. Every week during Hispanic Heritage Month, we’re educating the full Alto team about a specific group within the broader Latinx community, with resources for additional learning.

What can team members look forward to from Alto Auténtico in the future? 

Robert: We’re really excited to continue to help shape Alto’s services and resources for customers, making our offerings as inclusive as possible. We’re currently working with the operations, product, and marketing teams to establish a bilingual team to support Spanish-speaking individuals using our pharmacy delivery services across all of our communities. 

We’re also launching a mentorship program in which Alto’s junior Latinx team members will be paired with senior Latinx team members for coaching sessions. This is another important step in continuing to invest in our Latinx team members’ professional development.

How can allies recognize Hispanic Heritage Month?

Robert: Great question! I think learning is key. Simply taking the time to educate yourself about the Hispanic and/or Latinx experience — particularly about our diversity as a group — goes a long way toward building trust, which is key to true allyship.

Interested in learning more about the Alto Auténtico employee resource group? Reach out to altoautentico@alto.com and visit alto.com/careers to learn more about our open roles. 

In celebration of Hispanic Heritage Month, which takes place from September 15 - October 15 every year, Alto is highlighting the important work of Alto Auténtico, our Latinx employee resource group (ERG)

Heart-healthy living is a lifelong practice. To help you get started, we’ve compiled a list of the top heart disease prevention actions to tackle during each decade of life.

How to Prevent Heart Disease at Any Age

You may associate heart disease with aging, and for good reason — individuals age 65 and older face a higher risk for the condition. This stems in part from how aging-related changes in your body overlap with risk factors for heart disease. For example, your arteries and heart muscle stiffen with age, making it more difficult to pump blood well during exercise.

Still, it’s never too early to prioritize a heart-healthy lifestyle. As heart disease-linked conditions like diabetes and high blood pressure grow increasingly common among young adults, many people are now becoming at risk for heart disease at an earlier age. 

And even if you are young and in good overall health, the choices you make today can affect your heart health for years to come. Cardiovascular health issues like heart attacks, strokes, and heart failure often stem from a lifetime’s worth of health choices, including many you have control over.

Since heart-healthy living is a lifelong practice, it may feel more manageable if you set specific goals and priorities impactful for your age group. To help you get started, we’ve compiled a list of the top heart disease prevention actions to tackle during each decade of life. This is intended to be a high-level guide to prevention, so consult with your healthcare provider about more targeted priorities based on your individual health needs.

2. Search for a primary care provider if you don’t have one

3. Find your favorite physical activity and develop a fitness routine

You’re out in the real world, exploring what you want your life to look like. It’s normal to experience some anxiety during this exciting but nerve-racking time. Your cardiovascular health may not be top of mind as you navigate a stressful job search, adjust to the pressure of beginning a career, or start a family, but taking several heart healthy actions during this decade of life will put you on the right track early on.

Focus on building a foundation for a healthy lifestyle. That means quitting smoking if you currently smoke, figuring out which physical activities work for you, and getting in the practice of staying up to date with yearly doctor’s appointments. If you don’t already have a primary care provider, now’s the time to search for one.

1. Create a weekly routine that makes time for exercise

2. Prioritize your mental health — whatever that looks like for you

3. Contact relatives to build your family medical tree

There’s a good chance your calendar’s looking pretty packed these days. Momentum in your career may come with more responsibilities and later nights in the virtual or physical office. And for those who already have a family, or are thinking of starting one, maintaining work-life balance may be a challenge.

As you continue to build on the foundation you set in your twenties, here are three new action items to add to your health routine. First, remember your favorite physical activity? Make sure there’s a block of time in your schedule for it each week.

Since your mental health can significantly impact your physical health — and your risk for heart disease in particular — be sure to give your emotional well-being some attention during what may be a hectic time. 

Some stress is to be expected when you have many responsibilities at work or home (or both), but if you’re concerned about your mental health, don’t be afraid to ask your doctor for suggestions or resources. You can also check out Moodfit, a free mood-tracking app, or Insight Timer, an app that offers free guided meditations.

Lastly, since your family’s health history is a big predictor of your own risk for cardiovascular disease, take some time to contact relatives and figure out if heart health issues run in your family tree.  

1. Continue to explore your exercise options

3. Stay current with annual check-ups and screenings

Does it feel like life has only gotten faster? Believe it or not, your metabolism has already begun to slow down. That means it’s time to amp up your workout routine, if you haven’t already. Enjoying your chosen exercise method is key to sticking with it in the long term, so if you haven’t found your go-to activity just yet, keep looking. If you’ve only ever worked out on your own, try a group class, online or in person.

It’s time to check in on your sleep hygiene, too. Regular sleepless nights have been linked to heart attacks, high blood pressure, and diabetes, so if you’re getting in less than an average of seven hours every night, try to set yourself up for a good night’s sleep. Winding down at the same time each night, avoiding heavy meals just before bed, and spending plenty of time outside are just a few of the simple steps that might be able to help you get more rest.

At your annual physicals, be sure to discuss your risk for heart disease with your doctor and ask about recommended screenings for your individual health needs, including a fasting blood glucose test to screen for diabetes.

2. Limit your sodium and cholesterol intake

3. Learn the warning signs of a heart attack

Your risk for high blood pressure and high cholesterol will continue to increase as you age, so it’s important to keep track of your blood pressure, cholesterol, and blood glucose levels. If you have high blood pressure or cholesterol, follow the treatment plan your doctor has recommended, which may include diet changes, medication, or a combination of both. Even if your blood pressure and cholesterol numbers are within a healthy range, you can only benefit from limiting your sodium and cholesterol intake.

You should also learn the warning signs of a heart attack, as your risk for one also increases with age: 65 is the average age of a first heart attack for a man, and 72 is the average age of a first heart attack for a woman.

Keep in mind that heart attack symptoms may appear differently in women than in men.

Remember, these suggestions are intended as a starting point. Your doctor can advise you on a more individualized plan of action based on your health history. And not only is it never too early to begin prioritizing heart disease prevention, but it’s also never too late. Don’t worry about what you should or could have done earlier in life — instead focus on the actions you can take to be as healthy as possible in the present.

Staying physically active and avoiding foods that are high in sodium and trans fats are simple ways to take charge of your health at any stage of life. Here are more specific suggestions for heart-healthy living in terms of diet and exercise.

As you plan a heart-healthy diet, opt for foods that are low in saturated fats and trans fats, which increase levels of low-density lipoproteins (LDL) cholesterol — also referred to as “bad cholesterol” — in your blood. Low-fat dairy products and chicken are healthier alternatives to full-fat dairy products and red meats, which are high in saturated fats.

High sodium intake can increase your blood pressure, and the American Heart Association suggests aiming for 1,500 mg of sodium/day. Limit processed or prepackaged foods including soups, cold cuts, bread, and frozen meals since they contain sodium-based preservatives. And watch out for compounds that contain sodium as you scan the ingredient list, like sodium benzoate and sodium tripolyphosphate.

Regular exercise can help you maintain a healthy weight and keep your blood pressure, cholesterol, and blood sugar levels in a healthy range. Different activities offer various levels of intensity, and there are a variety of ways to get the American Heart Association’s recommended amount of aerobic activity . You should aim for about 150 minutes a week of moderate-intensity aerobic activity, like brisk walking, or 75 minutes a week of a more intense activity. Many people start off slower and build their way up to a more intense routine.

At Alto, we’re committed to making it as simple as possible to protect your heart health and stay on top of cholesterol-lowering or blood pressure management medications. We offer free same-day delivery and medication management tools like reminders and auto refills in our app. And our team of pharmacists is always here to answer your questions by phone, text, or chat, and will even remind you when your medications are due for a refill.

Reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

How to Prevent Heart Disease at Any Age 

Reproductive endocrinologist Dr. Guy Ringler — a former faculty member at UCLA and an advisory board member at Men Having Babies — was one of the first doctors in the world to help gay men have children through assisted reprodutive technology.

Spotlight on Men Having Babies & Dr. Guy Ringler

There are many ways to start a family and raise a child. And as recent decades have brought forth milestones in marriage equality and the fight for LGBTQ+ rights, the options for LGBTQ+ family building have also expanded.

According to 2019 data from the Williams Institute, almost 29% of people who identify as members of the LGBTQ+ community are raising children, up from 16.2% between 2014 - 2016. That includes a growing number of gay men who’ve had children through surrogacy, a process in which a woman who is not related to the child — a gestational surrogate — carries a baby who is biologically related to one of the fathers and an egg donor.

Breaking down barriers to LGBTQ+ family building

Reproductive endocrinologist Dr. Guy Ringler — a former faculty member at UCLA and an advisory board member at Men Having Babies — was one of the first doctors in the world to help gay men have children through assisted reprodutive technology. Throughout the twenty-five years that he’s been in practice, he’s seen how scientific advances and cultural changes have broken down barriers for gay men interested in parenthood.

“Over two decades ago, when I began my career, people barely understood the concept of surrogacy for gay men,” he says. “It wasn’t as easy to find women who wanted to become surrogates for gay couples. There was still fear about HIV, and there were questions about the impact of surrogacy on a child’s development.”

The landscape looks a lot different today. Thanks to cultural shifts and greater understanding of the science behind surrogacy — and to awareness-raising organizations like Men Having Babies — there are now more options than ever to become a parent regardless of your sexual orientation or gender identity.

“Greater acceptance of the LGBTQ+ community and marriage equality has opened people’s minds and allowed them to see that gay families can thrive, just like any family,” Dr. Ringler says. “Gay men are now able to plan for a future that we once didn’t know was possible.”

Getting to meet prospective fathers at Men Having Babies’ annual conferences is one of Dr. Ringler’s favorite things about working with the organization. He’s observed a greater number of gay men pursuing parenthood at an earlier age.

“I’m so inspired by the next generation of gay men, who are planning their families in their twenties. That simply wasn’t an option when I was their age.”

Men Having Babies and financial assistance for IVF and surrogacy

There are many steps on the road to parenthood for LGBTQ+ individuals and couples: fertility treatments, legal consultation, and financial planning are all required to start a family.

“Having a baby doesn’t just happen for gay men,” Dr. Ringler says. “It takes thoughtful planning and there are many decisions along the way.”

That’s why support from organizations like Men Having Babies is so critical. The organization started as a program at The Center (formerly the NYC LGBT Center) in 2005 and officially became a nonprofit in 2012. Today, Men Having Babies supports thousands of gay men and couples around the world in starting their families through surrogacy, with monthly workshops, annual conferences and financial resources. 

Determining how to pay for IVF and surrogacy is an important part of planning your family. As part of the process, Dr. Ringler suggests mapping out a vision for your family. Knowing how many children you want can help you prepare for the cost: “When you’re making the commitment to start a family as a gay man, think about how you will financially support the decision. It may feel overwhelming, but it’s similar to the process of buying a house. If it’s really important to you, you can find a way to make it work.”

There are many resources to help alleviate the cost, including Men Having Babies’ Gay Parenting Assistance Program (GPAP) . The program offers different forms of financial support, including:

Discounted and free services donated by more than one hundred leading IVF, surrogacy, egg donation, and legal service providers to prospective parents (Stage I support)

Discounted and donated ancillary services, including fertility medication, escrow services, and insurance resource services (Stage I support)

Cash grants for approved prospective parents based on income eligibility (Stage II support)

Learn more about the criteria for applying to Stage I or Stage II support from the GPAP.

You must be a member of Men Having Babies to receive financial assistance. You can become a member by making an annual donation of $150 or more. Learn more about the membership process.

In addition, EMD Serono offers financial assistance for fertility medications and Family Equality has a list of family-building grants that help LGBTQ+ families afford fertility treatment. Be sure to also ask your fertility clinic or pharmacy about available financial assistance programs and payment plans.

The importance of researching your options

As Dr. Ringler emphasized, gay men building a family through IVF and surrogacy have many decisions to make throughout the process. For that reason, it’s important to thoroughly research your options and to work with a medical team that you trust. Here are some additional considerations to be mindful of as you plan your family.

Understanding the process of IVF and surrogacy

In IVF, eggs and sperm are combined in a laboratory. When gay men conceive through IVF, the sperm will come from one of the fathers and the eggs will come from a donor. Then the fertilized eggs, or embryos, are placed into the uterus of a gestational carrier who will carry the baby to term.

Not only is this an exciting time for expectant dads, as Dr. Ringler notes, but surrogates can play a big role in raising awareness of LGBTQ+ families.

“In my experience, surrogates who are asked when their baby is due while out in public may feel comfortable sharing that they’re having a baby for a gay couple. This helps open up more people’s minds to the possibilities for LGBTQ+ parenthood.”

Understanding your goals for your relationship with your surrogate is one of many key decisions, and there is a spectrum of options. Some couples cultivate intimate relationships with the surrogates while others prefer to remain more detached. There’s no one right choice — it’s all about understanding what’s best for you.

“If your surrogate wants a little distance, that does not mean that they are any less committed to the process,” Dr. Ringler says, adding that it’s important to discuss your preferences in an open discussion with your surrogacy agency.

Deciding who will be biologically related to the child

Another important decision for same-sex male couples is deciding which parent will be genetically related to the child. When heterosexual couples have babies through IVF, both parents can contribute their genetic material, so that the baby is biologically related to both, even when using a gestational carrier. 

But with gay men, only one father can contribute his sperm per pregnancy, so it’s important to discuss this decision with your partner if having a child as a couple. Some fathers fertilize multiple eggs so that both can have a biological connection with one of their children. Taking time to identify your family building goals will allow you and your partner to plan for the financial cost of more than one round of IVF, if you choose to pursue that option.

Keep in mind that you can establish a legal paternal relationship with your child even if you are not biologically related to them. It’s critical to research your state’s laws about legal parentage procedures once your baby is born. Movement Advancement Project’s interactive map on parental recognition laws is a good starting point. 

Be sure to speak with an experienced LGBTQ+ family lawyer in your state before starting the IVF and surrogacy process. There are many forms of financial support to help alleviate the cost of these legal services, like Men Having Babies’ Gay Parenting Assistance Program.

There's a wide selection of available egg donors, and one of the factors to consider as you choose yours is whether they will be anonymous or open. With an open donor, you can more easily answer any questions your child may have about their genetic background. However, some families prefer anonymous donors, and sometimes an anonymous donor’s physical or personality traits better fit your goals. Both paths are viable options, and it all comes down to what’s right for your family.

Regardless of which option you choose, Dr. Ringler notes that you should be prepared to share information with your child about how they were conceived. You can even get creative with how you share their journey: some of Dr. Ringler’s patients have created story books for the whole family to read together, which helps children understand their background and feel proud of who they are.

Seeking support for your family building journey

While there are many paths to take, and many decisions to make, as you build your family, all will lead to the same destination of parenthood.

“I personally had a very close relationship with my mother growing up, and as gay men, we can’t guarantee our children that same experience,” Dr. Ringler says. He notes that if you have an open donor, your child’s biological mother may be able to have a presence in their life, which is another important factor to consider when planning your family.

But regardless of your chosen family structure, “I’ve seen again and again throughout my career that all you need to start a happy, healthy family is love and fun.”

One thing that’s certain: family building as a gay man is much easier to navigate with support from organizations like Men Having Babies. If you’re feeling overwhelmed while planning for a family, remember that you don’t have to go through this journey alone. Men Having Babies understands the challenges specific to building a family as a gay man, and their resources can help you fulfill your dreams of becoming a parent.

Learn how to become a member of Men Having Babies.

At Alto, we’re proud to support Men Having Babies, and we’re happy to be a part of your family building journey if fertility prescription medications become part of your plan. Reach out any time to get started via text or phone at 1-800-874-5881, or in-app messaging.

Get an inside look at the patients team at Alto Pharmacy to learn what it's like to work on Alto's customer-facing apps, which projects are on the horizon, and who makes the best barbecue short ribs.

Get to Know the Team That Builds Alto's Customer-Facing Apps

Imagine an app that allows you to buy things and have them delivered to you the same day, for free. Now take that app and put it in a highly regulated space like pharmacy. You face the challenge not only of building an e-commerce platform from scratch, but also of navigating medication pricing, federal and state regulations, and patient safety—and that's just the way the Patients Team likes it.

"It's a really exciting and fun problem to solve," says Mike Riess, the team's Engineering Manager. Software Engineer Angelique Nehmzow agrees: "There's a really strong product and design aspect, like more traditional startups, but then everything gets a little bit more interesting because it's healthcare."

Below, we chat with the team to learn what it's like to work on Alto's customer-facing apps, which projects are on the horizon, and who makes the best barbecue short ribs.

What does the Patients Team do at Alto? 

Ask anyone on the team why they joined, and chances are, they'll tell you they wanted to be on the product team closest to Alto's customers: "We really try to own the customer experience," says Peter Zeng, the latest Software Engineer to join the team. "If a customer is coming to the web app, or they're coming to our mobile app, we want to make sure that they're able to onboard with us as easily and conveniently as possible."

The team is also responsible for the customer experience beyond onboarding, from the moment a customer schedules a medication for delivery to the time that it shows up on their doorstep. "We already offer great services like free, same-day delivery and cost savings. The Patients Team empowers customers to make the most of our offering," Nehmzow explains. "You can see what prescriptions you have, check on the status of your order, and schedule automatic refills. In a more traditional pharmacy, you don't get that kind of visibility. You have to call them up or even wait in line in person. At Alto, it's a different experience."

What was it like in the team's early days?

Today, there are eleven engineers on the team working to build that better end-to-end experience—but it wasn't always that way. When the team first formed in 2019, it consisted of just three members: Riess, Brian McRae, and Andy Lau, all of whom are still on the team.

"The first priority for us was just stabilizing the foundations," Riess says of the team's early days. Every other week, the three team members, along with Alto co-founders Matt Gamache-Asselin and Jamie Karraker, would meet to audit the app's core flows. "For the first three months we probably didn't make it through some flow at least 50% of the time," Riess recalls. "There would be a ton of bugs in the onboarding experience, things that weren't working with the flows or navigation or deep linking."

Among the team's first projects was a redesign of the checkout flow. "There was a lot of work to be done to streamline the checkout flow, which is pretty much the main function of the app," says McRae, who initially joined the team as a software engineer and later transitioned into product management. "We had to make it easier to add a payment, add your addresses, everything you need to do to schedule your prescription for delivery."

"The growth of the team, in terms of both size and stability of the platform, has allowed us to swing at more interesting bets for the company," Riess says. In particular, the Patients Team has turned their attention toward experiences personalized for specific medical conditions.

"Different customers have different needs. A customer who wishes to start a family will have a different experience than a customer who needs to order their routine heart medications that they've been taking for the last eight years,” McRae says. “The challenge for us is how we serve all these customers well through the app."

"I think that's where Alto can be such a differentiator," Riess adds. "A world-class pharmacy experience is about so much more than just dispensing medications. We want to build tools for customers that help them get the most out of their medications—everything from simple videos teaching them how to perform injections safely at home to the ability to synchronize deliveries for multiple prescriptions for managing complex health conditions."

With these new projects on the horizon, engineers have ample opportunity to focus on the areas that excite them most. "We're full-stack and mobile and web," Nehmzow says. "Part of the team focuses more on experimentation, iterating quickly, and using data to make decisions. Part of the team focuses more on platform work, tooling, and improving the developer experience. There are a lot of areas to explore and contribute to."

One spring night, the Patients Team gathered in a back yard in San Francisco’s Mission District for short ribs and an impressive spread of side dishes. "Kudos to Robbi, who's the grill master. I just provide the grill!" Nehmzow says, laughing. While the team barbecue was the first time some members had met in person, Zeng notes that the team has been supportive of one another even while working remotely during the pandemic.

"The first real project that I was assigned to was working with the communications system. Before writing my first piece of code, I spent two weeks exploring what already exists and understanding the different parts of the system," Zeng says. "I've been really impressed with how understanding my teammates have been. They make the space for you to learn all the different pieces of code we own."

That culture of support is by design, reflected in the six principles—complete with matching emojis—at the top of the #patients-team Slack channel: "Empower each other," "be an owner," "find the path," "learn by doing," "embrace complexity," and "foster trust." 

While these principles echo Alto's company-wide values, they are unique to the Patients Team. "For a long time, we were the only external-facing product team at Alto," Riess says. "These principles were intended to be this motivation around how we win. It's a combination of how we treat each other, how we reason about decision making, and how we approach solving a problem that's never existed before."

As the team looks toward the future, those principles have never been more relevant: "We have a goal and an area we want to focus on, but in terms of which projects we're going to do, it's not a top-down thing," Nehmzow says. "It's very much, 'We're going to figure out how to solve this problem together, even when it's difficult.' That's my favorite part about the team."

The Patients Team is hiring! Learn more about open positions here.

In recognition of Women’s History Month, we highlight four women at Alto shaping the future of pharmacy. These leaders share their advice for women in the workplace, their unique super powers, and what they appreciate most about Alto's culture.

Celebrating Women at Alto Pharmacy

Liz Kelly, National Sales Manager Fertility 

I'm responsible for hiring, coaching and supporting the needs of the national fertility sales team. I also work closely with fertility business and operations teams to deliver on our clinic and customer promises.

Before joining Alto, I was finishing up a sabbatical where I spent my time volunteering on the board of a non-profit called ServeHAITI. Prior to that, I was the West Coast Area Business Director at EMD Serono and worked with Matt and Jaime [Alto’s co-founders] to secure a contract to distribute fertility meds when they were still working out of AG Pharmacy!

What do you appreciate the most about Alto's culture? 

Hands down my favorite part of being on the Alto team is that the patient is truly at the center of every decision we make. I value that we make business decisions with our mission in mind.

What do you like doing outside of work?  

Of late, my favorite pastime is heading to the dog beach with my rescue, Bodhi, who has been the best medicine to ease some of the COVID-19 isolation I experienced over the past year. Before the pandemic, I made sure to travel to at least one new international spot a year. I love the experience of getting exposed to all things about another culture: cuisine, culture, belief systems, language.

I like to think that my super power is seeing the greatness in others, sometimes before they see it in themselves.

I aspire to live by the motto "be the change you wish to see in the world." I encourage women to speak up for what they believe is right, even if nobody else agrees. That includes planning for your own career path and making it a priority to develop your skill sets so that you are prepared to climb the ladder that serves your own greatness.

I graduated from pharmacy school in May of 1979 and started working at AG Pharmacy after passing my boards later that year. I bought AG in 1998 when the previous owner wanted to retire - he had been with AG since it first opened in the early 60's.

My family moved to San Francisco from Hong Kong when I was five years old. Our story is one similar to those of many immigrant families who came to America looking for a better life in search of the American dream: own a home, have a car, raise children safely and give them the opportunity of a good education and a chance to have a better life. My parents raised their children here, emphasizing family, hard work and education. They lived their American dream, and I have them to thank for all that I am today.

What’s your favorite thing to do outside of work? 

I love to travel. There are so many unique places to visit in this world. With the different cultures, the food, and the amazing sceneries/landscapes, there are endless things to see and experience! 

The thing I appreciate most about Alto's culture is that everyone works so hard together to bring about the best pharmacy experience for all our customers. You can feel the energy and the motivation of all the Altoids. I cannot emphasize how amazing it is to be a part of this team and to watch Alto grow and evolve into the pharmacy of the future and the pharmacy of our dreams!

What’s your favorite memory thus far at Alto? 

In the very early days, when Alto was still Scriptdash Pharmacy, a customer needed to get her trigger shot [as part of a fertility protocol] within the next few hours. It was close to rush hour, and we had no couriers available to deliver to the South Bay. Our CEO Matt came to the rescue on his motorcycle, and off he went to make the delivery. It was such a wonderful and warm feeling to watch and cheer him on together. That is truly what Alto love is all about!

I manage our amazing IT Support team, helping all Altoids get the technology support they need, when they need it. 

For the better part of the last decade I have been managing IT Support teams. From Facebook and Twitter to Lyft and Uber, I’ve seen it all (or at least most of it!).

Our incredible dedication to our mission. In my short time here, I truly see us putting patients first, and it’s moving to see. 

What do you like doing outside of work? 

I’m a big traveler, but since COVID-19 has put a damper on that, I enjoy flying around Colorado with my partner in our vintage Beechcraft Bonanza. I also love hopping on my motorcycle and just exploring! 

I’m in love with Central and Eastern Europe. Some of my favorite places are Prague, Vienna and Budapest. 

Elnaz Moshfeghian, Senior Engineering Manager

I’m originally from Iran but moved a lot growing up, including Oklahoma, Australia, Qatar, Kuwait, and Chicago. I have been in San Francisco for the last six years. I stumbled across software engineering in college and found a passion for building products and teams. I joined Alto as the third engineer and this is now the largest company I’ve ever worked at. 

I lead a group of 20 engineers across three teams. Two teams are focused on getting prescriptions ready to schedule quickly and accurately, and one is focused on enabling faster, higher quality, and more enjoyable product development across the broader product and technology organization. My work involves a lot of collaboration, creativity, transparency, and flexibility. 

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Spotlight on Men Having Babies & Dr. Guy Ringler

Get to Know the Team That Builds Alto's Customer-Facing Apps

Celebrating Women at Alto Pharmacy

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