How employers can support trans employees with healthcare

How employers can support trans employees with healthcare

By Jo Faragher on 28 October 2024

Most organisations like to think that the healthcare and other benefits they offer are as inclusive as possible, but as a trans person, this may not always be the case. Only a minority of employers offer trans employees access to specific healthcare support that might help them, such as help with gender reassignment consultations or simply expanding existing benefits to be more trans-inclusive.

Yet employers could really add value here. According to medical experts at the World Cancer Congress in Geneva in September, tens of thousands of trans people in England could be missing out on vital cancer screenings. This might be trans men who are not offered breast or cervical cancer screenings, or trans women whose GP details do not align with their gender, meaning they are not alerted to the check-ups they need.

Trans people often also feel reluctant to access healthcare – according to a survey by the Government Equalities Office in 2017, 16% of LGBT+ respondents had a negative experience accessing public health services because of their gender identity, while 80% of trans respondents who accessed or tried to access gender identity clinics said it was not easy, with long waiting times being the most common barrier.

Broadening support

Jacqueline Gavin BEM, a DEI consultant, spearheaded a number of trans-inclusive benefits available at manufacturing company Britishvolt when she was chief of culture there. “We were creating a brand new organisation and we wanted to make it attractive to the best talent,” she explains. “We had lots of discussions with our insurer about what we could involve, and they were open to hearing about the coverage they could offer.” Alongside support with reassignment surgery, the provider was able to offer options such as male to female vocal feminisation, facial surgery and hair removal, among other things. The company needed to recruit 5,000 new staff at the time, and part of the negotiation was a “recognition that this will not be all 5,000 people wanting to use this, only a select few”. Gavin and her team also engaged with local community organisations such as Pride Northumberland for advice.

“I remembered what it was like for me decades ago – being trans wasn’t even talked about and acknowledged,” she adds. “Being part of an organisation that would say from the outset, ‘we get you’, means there are a lot fewer things to worry about such as funding your own medical care or having someone to talk to.” Employers should also be mindful of their legal obligations when it comes to inclusive benefits and treatment, Gavin warns. In 2017, a transgender engineer won a tribunal claim against Jaguar Land Rover after being on the receiving end of abusive jokes and issues with toilet facilities. The tribunal ruled that the claimant had been given inadequate support by HR and management, who had dismissed their concerns about poor treatment.

Specific needs

Adrien & Pierre Gaubert, co-founders of LGBT+ business community myGwork, say that trans employees often face barriers due to gaps in the public healthcare system and a lack of awareness about their specific needs. Furthermore, not every organisation has as positive an experience with their insurers as Britishvolt did. “Many plans exclude gender-affirming treatments like hormone therapy or surgeries, which are frequently labelled as ‘cosmetic,’ and can make it difficult for trans people to obtain necessary care. Additionally, many healthcare providers lack proper training in transgender healthcare, leading to mistakes, misgendering, or even outright refusal of care,” they explain.

Accessing mental health support can also be a challenge, as many trans employees may be directed to their employer’s standard employee assistance programme or counselling service. “Finding therapists who are knowledgeable about trans issues is difficult, and even when available, the high costs or lack of insurance coverage for such services can present significant obstacles,” they add. “Administrative hurdles add to these issues, as trans employees frequently struggle to update their gender markers on official documents, leading to misgendering or denial of care when their records don’t match their identity.”

Interconnected challenges

Sophie Hennekam, professor in organisational behaviour at management school Audencia, sums it up like this: “Transgender individuals tend to experience more health issues compared to the general population. Yet, they are less likely to receive adequate treatment and access health services.” One of the key barriers is that employers often fail to understand the interconnected challenges faced by trans employees that can impact their mental and physical health. She says: “Employers can play a crucial role in addressing the unequal access to healthcare services faced by transgender individuals. Organisation-wide education and training can help shift societal attitudes towards gender identity, reducing stigma and harmful stereotypes.” Other supportive actions could include creating and/or consulting with employee resource groups on trans issues, and including trans-specific provisions in healthcare.

Catherine Leaver, chief people officer at Colt Technology Services, argues that such policies are the “foundation” of a safe, supportive and inclusive workplace. After a series of focus groups last year, the company found that transgender and non-binary people in the technology sector tended to experience reactive rather than proactive inclusion policies, so the company produced three guides to help colleagues, managers and HR to support trans employees. “The healthcare provider we work with has spent time creating a programme of healthcare support for people experiencing gender dysphoria,” she explains. “Experienced healthcare professionals offer support for employees along their journey. Offering this support is important for many reasons: firstly, it acknowledges and supports a unique and highly individual healthcare need that we know can be connected to deeper mental and physical ill health; and secondly, it demonstrates humanity and respect, sending a very clear message: that there is no one group of people more entitled to health and wellbeing than another.”

Employee experience platform company Culture Amp has adopted a similar approach, with coverage for gender-affirming healthcare complementing other inclusive policies such as use of gender pronouns in meetings and IT tools and a secure process for employees to easily request name changes. It has invested in anti-deadnaming features in its platform, too, meaning customers benefit as well as employees. It recently introduced a new wardrobe reimbursement benefit of £400 to help trans and non-binary employees build a wardrobe that aligns with their gender identity.

“Though the number of employees who may directly benefit from these policies are low at the moment, we know that these policies signal how progressive and inclusive our culture is. We are building an inclusive environment for the future,” says Thushy Muruges, equitable design lead for people experience. “Introducing this benefit was a small step with a significant positive impact. As society continues to be challenging and dangerous to transgender and non-binary people, we believe committing to and taking meaningful, transparent action to support the trans, non-binary, and gender non-conforming community matters now more than ever. It shows that the employer is willing to invest in its employees.”