In 2012, 270 employers offered health plans that are inclusive of transgender employees — double the number that offered such services last year, according to the Human Rights Campaign. For an increasing number of companies—and any company who wants to earn a perfect score on HRC's Corporate Equality Index — including comprehensive health care for trans employees makes good business sense.
These companies are following the lead of the federal Department of Health and Human Services. HHS recently confirmed that discrimination in health care on the basis of gender identity is explicitly forbidden under the Affordable Care Act.
In response to a letter seeking clarity from several major LGBT advocacy groups, HHS Office of Civil Rights Director Leon Rodriguez in July wrote, "we agree that Section 1557's sex discrimination prohibition extends to claims of discrimination based on gender identity or failure to conform to stereotypical notions of masculinity or femininity… Section 1557 also prohibits sexual harassment and discrimination regardless of the actual or perceived sexual orientation or gender identity of the individuals involved.
While the Affordable Care Act stops short of mandating that employers' insurance plans cover gender reassignment surgery, many companies are providing transgender employees with a framework to get the care they require. According to a National Business Group on Health survey reported by Minnesota Public Radio, 14% of NBG member companies covered gender reassignment surgery for their trans employees in 2010. Five percent of those companies said they planned to add insurance coverage for gender reassignment surgery by 2011.
Not all people who identify as transgender seek gender reassignment surgery. To receive appropriate medical and clinical care, however, most insurance providers require that an employee be diagnosed with Gender Identity Disorder, which reflects a disconnect between the gender a person was assigned at birth and the gender with which they personally identify. According to the NBG poll, 32% of member companies offered coverage for non-surgical treatments like hormone therapy and health counseling in 2010. Three percent said they planned to add such coverage in 2011.