A one-size-fits-all approach to benefits and healthcare doesn’t work for queer employees

By Colin Quinn

June 25, 2021

The past year has been a time of cultural awakening across the U.S., with diversity, equity, and inclusion becoming a larger part of the national conversation. Employers, healthcare providers, and others are recognizing the need to create more inclusive environments and reassessing their benefits and service offerings to ensure they are aligned to their DE&I initiatives. 

But for many in our LGBTQ+ community, there is still much progress to be made. A one-size-fits- all approach to healthcare and benefits doesn’t work anymore; therefore, offering tailored solutions for unique member populations is key to inclusivity and driving equitable outcomes. Studies have found that our community is at higher risk for certain health conditions such as asthma, diabetes, obesity, cancer, mental health, and sexually transmitted diseases. 

Employers are starting to realize that our community has been left in the dark, and it is having a negative impact on our health and wellbeing. It’s time they take a critical look at themselves and ask, “Are our benefits really inclusive for all employees?”  

Today, healthcare is so much more than a trip to the doctor. It’s a receptionist recognizing and using correct pronouns, OBGYNs not assuming pregnancy is an option, and primary care physicians celebrating a patient’s decision to go on PrEP. These positive and affirming moments start with the choices employers make around typical medical, vision, and dental benefits they offer, and are bolstered by other tailored solutions they include in their benefits ecosystem.

 Here are some steps and questions for employers to consider when reviewing health benefits:

General healthcare

Helping employees find a good healthcare provider shouldn’t be difficult. But the LGBTQ+ community faces higher rates of discrimination and access. Employers, ask yourselves “Does our network of healthcare providers include those that are culturally and clinically competent clinicians?” and “Does our network of healthcare providers include those that are experienced with and supportive of LGBTQ+ health needs?”

While the answer may be yes, employees are still extraordinarily challenged in figuring out which providers meet that criteria. Typical provider directories do not capture the level or type of detail that our community seeks in understanding if their care experience will be safe, affirming, and clinically helpful. Past trauma and overt discrimination in the healthcare setting has made the LGBTQ+ community wary to engage. Employers need to be aware of the barriers employees face in achieving inclusive health benefit coverage and be diligent to identify solutions that provide value for our community. Helping everyone engage, or re-engage with the healthcare system by connecting them to vetted clinically and culturally competent healthcare providers is a great first step.

Additionally, healthcare benefits should be provided to domestic partners and queer couples alike. Making sure employees and the people that they love are supported by healthcare benefits reveals how much employers value them and helps to promote better overall wellbeing.

Paid leave benefits

Paid family leave provides relief when people need to take time away from work to care for a loved one. While the federal Family and Medical Leave Act allows eligible employees to take unpaid, job-protected leave for certain family and medical reasons, some LGBTQ+ families won’t qualify for these benefits if they’re not legally married. It’s up to employers to amend paid family and sick leave policies to include paid family leave for all families.

There may also be some wrinkles that need to be ironed out in terms of bereavement policies when it comes to queer couples. For example, are all employees allotted a specific bereavement leave for the death of a spouse or life partner, regardless of sexual orientation or partnership classification (e.g. not legally married?)

Queer couples and their families should be recognized with full, equal access to all company benefits, including domestic partner, adoption, foster care, caregiving, parental and marriage benefits. 

Transgender-inclusive health

Ensure that health coverage includes complete health benefits for transgender employees, without exclusions or exhaustive lists of procedures that are not considered medically necessary. Employers should ask themselves, “Do we have transgender health benefits and do they cover all aspects of gender-affirming care?” Employers also need to understand if their chosen health plan provides a network of trans-friendly doctors and/or doctors who have adequate training working with transgender patients and availability to provide care. 

Unfortunately, many surgeons that perform gender-affirming care are not part of health plan networks—the result for employees is then either drastically delayed care due to extensive wait times, or the financial burden of out-of-network care plans. Employers and Health Plans need to be diligent about identifying solutions that help them to holistically understand their healthcare network for their transgender members, where the opportunities for inclusivity are found and areas to expand benefit offerings. 

Additionally, it will be important to review disability plan coverage to confirm that it includes temporary disability for gender affirming care-related needs. 

Mental health

The LGBTQ+ community is more likely to experience challenges with their mental health, particularly anxiety and depression. Mental health can impact every aspect of a person’s life, including their work life. Those who struggle with depression have higher rates of workforce absenteeism and presenteeism, which impacts their productivity.

Employers should ask themselves, “Do our employees have access to therapists and other mental health professionals who are experienced treating the unique needs of LGBTQ+ individuals across gender identity and sexual orientation?” If the answer is no, it’s time to revisit the mental health provider network and work with external tools to capture the detail that our community needs. Greater resources need to be allotted to ensure our community can access timely, affirming, and vetted mental healthcare providers who are clinically and culturally competent.

With Pride celebrations throughout June, now is a great opportunity for employers to reevaluate just how inclusive their workplace and benefits are for their LGBTQ+ employees and families.  

Healthcare is no longer a one-size-fits-all approach and employers can be the change agents to provide thoughtful, tailored solutions that are more inclusive so that all employees can take advantage of the benefits offered. Thinking through these considerations, as well as reviewing and/or updating benefits to be more equitable for all, will be the key to successfully providing inclusive health benefits.

Colin Quinn is cofounder and CEO of Included Health, a care portal for the LGBTQ+ community that connects members to inclusive providers who understand their unique health needs. As a member of the LGBTQ+ community, Quinn is passionate about raising care equality for underserved patient populations.