Increasing Inclusion: Survey Finds Transgender Benefits Trending Upward
Workspan Daily
September 01, 2022
Key Takeaways

  • A rise in transgender-inclusive benefits. A recent survey finds the number of companies offering transgender-inclusive benefits ticking upward.  
  • A host of factors at play. Experts attribute the increase in transgender-inclusive benefits to a number of elements, such as companies’ increased emphasis on aligning their DEI strategies and the employee benefits they offer.   
  • The importance of providing support. Employees going through any gender-affirming care will need support from management, so department managers will need to be trained to understand the process and how to best help the employee navigate the transition with coworkers. 

Employers are recognizing that offering a variety of employee benefits can help their organization appeal to a more diverse workforce.  

So suggests the “2022 U.S. Physical & Emotional Wellbeing Report,” conducted by Gallagher,  an insurance brokerage, risk management and consulting services firm based in Rolling Meadows, Illinois. 

For example, the survey of more than 4,000 U.S. employers found 42% of organizations are now offering medical coverage to domestic partners, with 24% extending this benefit to part-time employees. In addition, the poll saw an increase in the number of responding organizations covering bariatric surgery as well autism spectrum disorder treatment.  

The survey also saw 25% of responding organizations saying they cover gender reassignment surgery, with 22% offering transgender-inclusive benefits other than surgery. 

Tammy Olson, area senior vice president at Gallagher, expects to see the latter two categories to keep ticking upward, albeit gradually.  

“With the increasing emphasis on diversity, equity and inclusion (DEI) initiatives, we will continue to see employers look for ways to ensure their programs — not just medical — are inclusive for all employees,” she said. “But the focus is usually [on] the larger impacted populations first.”  

Transgender benefits is “a very complex topic,” added Olson, noting that all health insurance is required to provide health coverage to transgender individuals, and fully insured health plans are not permitted to deny coverage for gender affirmation service if medically necessary.  

That said, services will vary by insurer, with some insurance companies still considering care related to sex affirmation as “not medically necessary, which makes it hard to access the benefits even if included,” said Olson, adding that typical gender affirmations would fall under non-surgical services.  

In terms of transgender-inclusive benefits that extend beyond gender reassignment or affirmation surgery, different employers cover different treatments and procedures, with non-surgical benefits that typically include hormone therapy, speech therapy, hair removal, mental health, doctor visits and lab work. Surgical procedures other than gender reassignment surgery can include genital reconstruction, breast reconstruction or facial plastic surgery.  

New York-based HR consulting firm Mercer has also studied employers’ use of transgender-inclusive employee benefits. In 2021, Mercer research found growth in the number of organizations worldwide providing transgender-inclusive benefits.  

Diego Ramirez, MD, global health and benefits equity consulting leader at Mercer, saw several factors driving this increase.   

For instance, many organizations are putting more emphasis on the alignment of their DEI strategy and the employee benefits the company offers, as well as focusing on addressing their environmental, social and governance (ESG) strategies more consistently, he said.  

And, from a talent attraction and retention standpoint, remaining competitive requires positive scores on benchmark tools such as the Human Rights Campaign’s Corporate Equality Index, and “[must] reflect for all their employees the [organization’s] commitment to DEI,” said Ramirez. 

Olson said that all employers with self-funded, and fully insured plans need to make sure their plans aren’t discriminating based on member sexual orientation, “not just in theory, as it is a covered benefit, but in practice as well.”  

Olson urged employers to make sure employees have adequate access to providers within their networks who specialize in these areas of medicine, and should ensure that the company’s insurer do not deny claims for gender-affirming care as cosmetic or not medically necessary. Disability and leave policies should also be updated to reflect these services and related treatments, she added.  

Organizations and their benefits leaders do have hurdles to overcome in implementing transgender-inclusive benefits, Olson said, such as ensuring that gender-affirming services are communicating to employees and are correctly administered by the insurer.  

Ultimately, the biggest challenge in the workplace is the lack of understanding of gender affirmation services, said Olson.  

“HR leaders need to use DEI initiatives to help educate all employees. Employees going through any gender-affirming care will need support from management, so department managers will need to be trained to understand the process and how to best help the employee navigate the transition with co-workers.” 

Editor’s Note: Additional Content 
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