It is well established that the drivers of medicalisation have shifted alongside changes in the institution of medicine. The process of medicalisation is no longer incited by macro processes of institutional prestige or control; rather, individual patients/consumers are pushing the process forward. The present study complicates this neat transition and examines the relationship between structure and agency using the case of assisted reproductive technology (ART), specifically the medicalisation of lesbian reproduction in the US. I explore individuals’ influence on and motivations towards medicalisation through 24 in‐depth interviews with women in same‐sex relationships who had ever attempted to become pregnant. In centring on their experiences, I find that while individual consumers may now propel medicalisation forward, oftentimes consumers’ motivations for doing so reside in the prestige and control of medicine. In other words, consumers now seek medicalisation precisely because of the process's previous institutional drivers. In exploring what fuels the engine of medicalisation, the findings reveal its nuance and complexity.