A Transgender Transition in the Workplace

While legal campaigns targeting the rights of LGBT people seem to be mushrooming across the country, a growing number of employers are leading the way in supporting the rights of transgender people in the workplace.

From Target Corp.’s recent announcement about allowing transgender employees and customers to use the bathroom that matches their gender identity to companies like Facebook Inc., Kroger Co. and Visa Inc. offering coverage for gender reassignment surgery, more employers are looking for ways to attract and retain lesbian, gay, bisexual and transgender workers. Offering comprehensive insurance coverage of procedures and therapies related to sex reassignment is one way of doing that.

The number of major U.S. companies surveyed by the Human Rights Campaign Foundation offering transgender-inclusive health care coverage has spiked from 49 in 2009 to 511 in 2016, according to the organization’s annual Corporate Equality Index.

But what may seem like a dramatic shift is the result of a long and concerted effort by activists and large employers to make the workplace more welcoming to LGBT workers, according to Beck Bailey, deputy director of employee engagement at the Washington, D.C.-based foundation.

“There is a new public awareness of transgender folks with Laverne Cox and Caitlyn Jenner, but corporate America has been committed to and leading in the area of basic nondiscrimination protections for gender identity for 15 years,” he said.

The HRC index rates companies based on their LGBT anti-discrimination policies and practices, whether they offer health coverage for transgender individuals and domestic partner benefits, and other measures.

Despite a wave of anti-gay backlash sparked in part by last year’s U.S. Supreme Court ruling in favor of marriage equality, LGBT advocates at Chicago’s Rush University Medical Center found widespread support for their push to offer transgender inclusive health benefits. In January, Rush became the first hospital in Illinois to do so, covering mental health counseling, hormone therapy, surgery and all other treatments related to gender transitions. Last year, the city of Chicago began offering similar coverage.

“The winds were definitely in our favor,” said Christopher Nolan, manager of community benefit and population health and chair of Rush’s LGBTQ health committee. “The director of benefits was working with us and our general counsel is a sponsor, so we had legal in our corner as well. You need a champion to do something like this, and we had lots of support.”

Hospital administrators believe the decision will benefit not only employees, but also the hospital and patients as well, according to Drew Elizabeth McCormick, Rush’s associate general counsel.

“We want to be a desirable place for people to work, and by being more diverse and inclusive, we’re better able to relate to and provide services to all sorts of patients,” she said. “The cost is so minimal and the cultural value of offering these benefits is so high that we felt very comfortable making this decision.”

HRC’s Bailey said that offering these benefits has little effect on overall employee health care costs because the number of transgender people in the workforce in so small.

“By all accounts, this is a rare condition, and everyone’s journey is different,” he said. “Not all transgender people use the medical treatments available to them, so the utilization rate is quite low.”

While employers have been supportive, getting insurance companies to offer coverage to transgender people was an uphill battle, according to Bailey. Today, denying coverage to people who identify as transgender is illegal under federal law.

“Historically, when we look at transgender inclusive health care, the insurance industry has had broad blanket control,” he said. “In some cases, the exclusions were so broadly stated that we would find a transgender woman seeking treatment for migraines having coverage denied because it was deemed related to her transexualism.”

The Affordable Care Act, which was passed in 2010, prohibits insurers and providers from discriminating against patients because of their gender identity.

Currently, 14 states and the District of Columbia have issued similar policies aimed at private insurers, according to Anand Kalra, health program manager at the Transgender Law Center in Oakland, California.

“This is an important time for people in HR to pay attention to these things and to make sure that they have fair and equal treatment when it comes to company health care policies,” he said. “People may not be aware that what’s in their insurance contract is unlawful. It’s important for HR to understand what constitutes discrimination.”

Rita Pyrillis is a writer based in the Chicago area. Comment below or email editors@workforce.com. Follow Workforce on Twitter at @workforcenews.