According to interviews accompanying the DVD version, the writers were worried that the story might be offensive. Writer Larry Charles wrote a note that read, "Not that there's anything wrong with that," and Jerry Seinfeld recognized that if that line were added to the script it would not only be funny but it might make it less offensive. Seinfeld seemed to be proved right when the show won a GLAAD Media Award.
When Estelle Harris (Estelle Costanza) wasn't available for one scene in this episode, The The Nanny (1993)'s Fran Drescher stood in for her in the hospital scene. By having Drescher fill in, they could record the laughter from the audience and use that for when Harris was available to film. That scene with Fran Drescher is available to be seen on the Inside Look in the Season 4 DVD set.
Paula Marshall plays journalist Sharon in this episode. Leah Remini auditioned unsuccessfully for the same part.
Kari Coleman plays Allison. Megan Mullally auditioned for the same role but was unsuccessful. She would go on to win another part later in the series.