LGBTQ+ people face many barriers when trying to expand their families. The COVID-19 crisis has exacerbated existing structural barriers. In this report, we detail several existing structural barriers to reproduction that LGBTQ+ people face, highlight how those barriers are worsened by COVID-19, and suggest solutions to these barriers. We bring into conversation existing literature on family expansion and fertility treatment access for LGBTQ+ people, and situate it in the context of the current global pandemic. We argue that reproductive medicine is an essential service for LGBTQ+ people and that legislators, medical societies, and medical professionals should prioritize removing existing barriers and addressing new COVID-related ones.