Transgender-Inclusive Benefits for Employees and Dependents

Transgender people face many forms of discrimination in the provision of health insurance. Employers, as consumers of group health insurance products, can advocate on behalf of the transgender people insured on their group health insurance plans. Employers should work with their insurance carriers or administrators to remove transgender exclusions and provide comprehensive transgender-inclusive insurance coverage.

The American Medical Association joined the movement to end discrimination in health insurance for transgender people by passing the following resolution at their annual meeting in June 2008:

"RESOLVED, That our American Medical Association support public and private health insurance coverage for treatment of gender identity disorder as recommended by a physician."[1]

Businesses are increasingly addressing this discrimination.

Number and Percentage of Employers with Transgender-Inclusive Health Insurance Benefits

Fortune 100 Fortune 500 Fortune 1000 AmLaw 200
2012 56 (56%) 140 (28%) 165 (17%) 81 (41%)
2004 1 (1%) 1 (0%) 1 (0%) 1 (0%)

What is the Problem?

Health insurance plans generally discriminate against transgender people.

Discriminatory trans gender insurance exclusions in insurance contracts cause coverage to be denied for non-transgender care and care related to sex affirmation or reassignment.

Does Your Health Insurance Discriminate?

Countering Misconceptions About Transgender Medical Care

Treatment is medically necessary, reconstructive and not cosmetic.

Treatments and services related to sex affirmation or reassignment are medically necessary when following the internationally accepted standards of care.

  • World Professional Association for Transgender Health's Standards of Care: The WPATH SOC version 7 from 2011 are the most commonly used standards.
  • Treatment is Not Expensive: Includes available cost and utilization data demonstrating that costs of treatments are inexpensive and utilization of benefits is low.
  • Businesses Can Change their Benefits: Percentage of Fortune 500-ranked businesses with inclusive coverage. Inclusive self-insured and fully-insured plans are available and attainable (see "Finding Inclusive Health Insurance Plans" below).
    • Corporate Equality Index: Businesses with Inclusive Benefits
      418 businesses rated in the CEI 2014 had provided insurance with at least minimum coverage for sex affirmation or reassignment treatments and services.
  • Coverage for Medically Necessary Services is Not Taxable

Fixing the Problem: Making Health Insurance Plans Transgender-Inclusive

Case Studies and Data


Transgender people also face discrimination in the provision of healthcare. Unless an employer operates its own healthcare centers or clinics for employees, it has relatively little control over the provision of healthcare. The Human Rights Campaign Foundation, in collaboration with the Gay and Lesbian Medical Association, provide resources for hospitals on transgender inclusion in patient non-discrimination policies and cultural competency training through the Healthcare Equality Index.

[1]"H-185.950 Removing Barriers to Care for Transgender Patients," American Medical Association, GLBT Advisory Committee, 2008. Available at:


Gender Diversity in the Workplace: A Transgender & Non-binary Toolkit for Employers

Gender Diversity in the Workplace: A Transgender & Non-binary Toolkit for Employers