Making the Case for Gender Affirmation Benefits

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One of the hardest conflicts a person can face in life is when the gender they were assigned at birth differs from the gender they identify with.

The burdens posed by gender transitioning including changing birth certificates, medical procedures, and altering ways of speaking, walking and dressing can be truly daunting. A person transitioning may spend as much as $200,000 on therapies, treatments, drugs, surgeries, wardrobe and official paperwork. In addition, there are potential intersectionality issues of race, age, faith or family repercussions such as divorce.

Gender affirmation benefits provide financial support for medical treatments or procedures that help a person in gender transition. In today’s diverse workplace, there are good reasons why employers should support transgender employees with gender affirmation benefits.

First, transgender persons are among the most marginalized by society. They can be forced to leave home at an early age. The transgender unemployment rate is three times higher than the national average. Over one quarter of transgender people who held or applied for a job in the last year reported being fired, not hired, or denied a promotion due to their gender identity. In the transgender population, estimates for those who consider suicide run as high as 75%. Denial of access to gender affirmation benefits is associated with high risk behaviors such as drug or alcohol abuse, and increased rates of HIV infection. Any assistance to help transgender persons has clear societal benefits.

Second, demand for gender affirmation benefits is rising. One reason is societal acceptance due to more transgender public figures. Another reason is the wider availability of insurance coverage. According to a 2018 study in the Journal of the American Medical Association, among the estimated 1.4 million transgender adults in the U.S., more than 4,100 gender affirming procedures were performed between 2000 and 2014. Earlier in the study time frame about half the patients paid for the cost of these procedures on their own, rising to 65 percent from 2006 to 2011. But by 2014, only 39 percent of patients paid out of pocket, while private insurance, Medicare or Medicaid provided coverage for other patients.

Third, and importantly for employers in a tight labor market, there is a wealth of evidence that LGBT+ inclusive companies simply perform better. According to a 2018 report from Open for Business, companies that are LGBT+ inclusive ultimately have superior financial performance, better share price performance, higher return on equity, higher market valuations and stronger cash flows.

Gender affirmation benefits are increasingly in demand. Recently IBM became the first company to offer them as an employee benefit in Mexico. We now offer gender affirmation benefits in multiple countries including the U.S., Canada, the Philippines and India. While a recent adopter of LGBT+ protective laws, India recognized transgender as a third gender in 2014. We are in active discussions to expand the benefits to other countries.

For companies considering gender affirmation benefits, here are some actions to consider:

  • Make inclusion part of the corporate culture from the top down. Too many corporate leaders make too little time for diversity issues. Inclusion is not something you do. It’s the way you are. It is what leaders say, how they say it; how they approach and make employees feel valued for who they truly are. If a senior executive decides to transition, are you ready to provide support? (For guidance, see this whitepaper.) Are the out LGBT+ leaders in your firm visible? Their presence is tangible evidence of inclusivity.
  • Be a responsible benefits provider. In every country where we offer gender affirmation benefits there is a compelling story supporting that decision. Many people work for years to bring gender affirmation benefits to a new country. You need a committed benefits team willing to have provocative conversations with insurance providers. The benefits team needs training to support employees in transition. You also need to ensure there are qualified medical professionals in the markets where gender affirmation benefits are provided.
  • Leverage the expertise of other companies, including competitors. Global enterprises recognize the value of sharing expertise around diversity and inclusion practices. We may compete fiercely for talent, but we understand the need to pool expertise and experience to identify and offer the best practices and support for our workforces. It’s about being a good corporate citizen effecting societal change for the better.

If you have any doubts about which way the wind is blowing, just listen to collaborative communications channels flowing through your company. Where the transgender journey once was hushed behind closed doors, today persons at any stage of their career may openly seek advice in forums like Slack with the following typical inquiry: “I’ve started to transition…do you think I should tell my manager?”

The employer that knows how to answer that question will be the one who earns a truly engaged employee.

For more information: https://www.ibm.com/thought-leadership/LGBT+pride/

Bridget van Kralingen is Senior Vice President, Global Markets, and Senior Executive Sponsor of the LGBT+ community at IBM.

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