Home Business In their rush to offer fertility benefits, employers could be unwittingly creating a new inequity for LGTBQIA+ employees

In their rush to offer fertility benefits, employers could be unwittingly creating a new inequity for LGTBQIA+ employees

In their rush to offer fertility benefits, employers could be unwittingly creating a new inequity for LGTBQIA+ employees


Infertility is on the rise. This year, the World Health Organization (WHO) reported that 1 in 6 individuals around the world are impacted. It is no surprise that demand for fertility and family-building benefits shows no signs of slowing down: 54% of the biggest U.S. employers, those with 20,000 workers or more, covered IVF in 2022–up 36% from 2015, according to Mercer.

But in their haste to keep up with these trends, many companies are inadvertently excluding their LGBTQIA+ employees from these crucial benefits: 63% of LGBTQIA+ individuals will rely on different combinations of fertility treatments and resources to build their families.

The fine print on traditional healthcare plans leaves LGBTQIA+ employees behind

Underlying many progressive benefits plans that include coverage of fertility and family-building services is a requirement for individuals to receive a “medical diagnosis of infertility” to access care. However, these policies are often discriminatory, as they usually define infertility as six to 12 months of unprotected, heterosexual sex without successful conception. This policy excludes same-sex couples who are hoping to build their families (along with single parents by choice) from these vital resources.

According to a Progyny survey of 1,000 individuals who identify as part of the LGBTQIA+ community, while 40% of those surveyed have health insurance that covers fertility treatment and family-building services, 68% of respondents with coverage for fertility treatment are unable to access the benefits without pre-certification or a medical diagnosis of infertility.

Exclusive fertility benefits can exacerbate health and economic disparities

Family-building is not a one-size-fits-all journey for anyone, and it is especially unique for the LGBTQIA+ population. Each member of this community will rely on a combination of assisted reproductive technologies and resources to have children. Without insurance, the journey can cost upwards of $200,000.

Building a family or undergoing fertility treatment without coverage is risky–valid concerns over costs can lead individuals to take on debt in order to access services and/or seek less clinically sound advice in order to conceive.

Data from the same Progyny survey shows that of those trying to expand their families, 77% indicated they’re worried about the cost of doing so, and 81% indicated they would take on a second job to lock down employer-sponsored family-building care. To maximize the chances of success with limited benefits, many individuals cut corners, potentially jeopardizing their health. For example, transferring multiple embryos during IVF has often been a workaround to increase the chances of a successful pregnancy, but unfortunately, this path does not actually improve overall rates. Instead, transferring multiple embryos drives up the likelihood of conceiving multiples which can ultimately lead to a higher rate of medical complications, like miscarriages and preterm deliveries.

LGBTQIA+ individuals already face socioeconomic disadvantages compared to heterosexuals: earning 89 cents for every dollar earned by a heterosexual worker–with income disparities increasing for LGBTQIA+ workers who are people of color, women, or transgender. The innate desire to build a family should not jeopardize one’s physical or economic health, but for many, there is no other option.

What employers can do to ensure their healthcare benefits are inclusive

It is imperative that leaders eliminate the inequities in coverage to make a permanent impact on the health of their employees–and their organizations. There are tangible, positive benefits for companies that can be achieved by closing the equity gap on fertility and family-building benefits. After all, limited and inequitable access to care has been known to lead to less productivity in the workplace, and complications in treatment can result in more missed days from work.

Employers need to educate themselves about LGBTQIA+ culture, history, and current issues–staying up to date on the latest legislation impacting this community will help to ensure that your workplace and health benefits are actively inclusive. Employers and HR leaders must have a comprehensive understanding of the ins and outs of the benefits that they are providing to avoid implementing the limits often embedded into traditional insurance plans. As plan sponsors, these decision-makers must take care to address the needs of their employees who have been historically marginalized, discriminated against, or are currently experiencing health care or income inequities.

Employers have the potential to make a critical difference in the lives of their LGBTQIA+ employees by providing inclusive, non-discriminatory fertility and family-building benefits. Equitable and inclusive family-building benefits will send positive ripple effects through a company’s entire culture–and, eventually, healthcare at large.

Janet Choi, M.D., is Progyny’s chief medical officer. Cynthia McEwen is VP of people and head of DEI at Progyny.

The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.

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