Employee Benefits & Policies Resources

This criteria is designed to familiarize a community with best practices, from The Joint Commission and other sources, to promote equity and inclusion for LGBTQ employees.

Reviewing the practices implemented by other communities and recommended by experts, an organization can identify and address gaps in their policies and practices. A healthcare organization’s LGBTQ employees play a vital role in ensuring LGBTQ resident-centered care by informally educating their co-workers about patient concerns, offering feedback about organizational policies and practices, and conveying to the local community their organization’s commitment to equity and inclusion.

It is critical that LGBTQ employees, like LGBTQ residents, receive equal treatment, particularly vis-à-vis health-related benefits and policies.  Competitive employer-provided benefits’ packages are critical to attracting and retaining talent.

These policies are also informed by the HRC Foundation’s Corporate Equality Index, or CEI. The CEI is the national benchmarking tool on corporate policies and practices pertinent to lesbian, gay, bisexual and transgender employees.

As an organization you can provide health coverage for transgender individuals available in at least one firm-wide available plan without exclusion for medically necessary care that meets the following baseline criteria:

• Insurance contract explicitly affirms coverage
• Plan documentation is readily available to employees and clearly communicates inclusive insurance options to employees and their eligible dependents

Benefits available to other employees must extend to transgender individuals. Where available for employees, the following benefits should all extend to transgender individuals, including for services related to transgender transition (e.g., medically necessary services related to sex reassignment):

• Short term medical leave
• Mental health benefits
• Pharmaceutical coverage (e.g., for hormone replacement therapies)
• Coverage for medical visits or laboratory services
• Coverage for reconstructive surgical procedures related to sex reassignment

We encourage you to review HRC’s Trans Toolkit for Employers for a wide range of resources and best practices for employer transgender inclusion. The Toolkit includes HRC’s best practice advice for implementing transgender-inclusive policies (including sample policies) and practices as well as guidance for implementing transgender-inclusive healthcare benefits.

Read HRC’s White Paper on Transgender-Inclusive Health Care Coverage and the Corporate Equality Index.

The WPATH Standards of Care are the most widely recognized standards of practice in transgender healthcare. The WPATH Standards of Care have been recognized by the American Medical Association, the American Psychological Association and the National Association of Social workers, as well as in numerous psychiatric textbooks.

For example:

See page 22 of the City of New York's Summary Plan Document. This SPD clearly indicates how psychotherapy, hormone therapy, and gender affirmation surgeries are covered under all of the health plans offered by the city. 

Resources:

• Visit the HEI page on FMLA-Equivalent Benefit for LGBTQ Workers to learn more about how these benefits affect LGBTQ employees
• View our 2018 US LGBTQ Paid Leave Survey report which reveals an urgent need for inclusive employer-paid family and medical leave
• See the Movement Advancement Project's Equality Map on Family Leave Laws to learn about the laws in your state

For example:

An inclusive FMLA policy from Woodland Pond.

For example:

Inclusive bereavement leave policy from Woodland Pond.

LGBTQ employees sometimes face additional harassment from co-workers and supervisors based on their sexual orientation and gender identity.  Including protections for LGBTQ employees in the anti-harassment policy strengthens protections for them.

It is often said that when a person transitions gender, everyone around them transitions along with them. In other words, a workplace transition involves change not only for the employee but also for their manager, colleagues and clients.

Business leaders know the importance of proper planning, communication and training in implementing successful organizational change. A successful gender transition is no different. A little planning can go a long way to ensuring a successful outcome for all involved — the transitioning employee, managers, colleagues and clients/customers.

Gender transition guidelines, a written set of guidelines to manage an on-the-job gender transition, outline protocols for gender transitions that clearly delineate responsibilities and expectations of transitioning employees, their supervisors, colleagues and other staff.

Resources:

Review HRC’s Template for Gender Transition Guidelines for best practices for transitioning employees, managers and HR representatives and more.

See our page on workplace gender transition guidelines to learn more about organizational protocols for gender transitions that should include guidance on restroom and facilities access, dress code and internal recordkeeping that fully recognize an employee's full-time gender presentation and maximize privacy for the employee.

Review HRC’s Sample Restroom Policy to better accommodate transgender employees.

See the Guide to Restroom Access for Transgender Workers by the Department of Labor’s Occupational Safety and Health Administration which addresses why restroom access is a health and safety matter.

Resources:

See our page on self-identification of LGBTQ employees to learn more about asking these questions and why anonymity is so important to employees who disclose their LGBTQ status.

See the Corporate Equality Index's document on collecting SOGI data from employees. 

In example:

Employee climate survey from Woodland Pond at New Paltz

Some example questions for this survey might be (but are not limited to):

• Does this organization value differences in age, gender, sexual orientation, gender identity or expression, and race or ethnicity? Measure level of agreement and rating scale.
• Are diverse people (differences in race, gender, age, religion, sexual orientation, gender identity etc.) treated fairly at this organization?
• Do all staff members have an equal opportunity for promotion regardless of race, religion, gender, sexual orientation, age, ethnic background, national origin, or disability?
• Have you personally witnessed or experienced discriminating behavior at work, on the basis of some diversity-related characteristic in the past twelve months?
• Identify the type of discrimination that occurred, including sexual orientation and gender identity as an option.

In example:

Employee climate survey from Woodland Pond at New Paltz

Demonstrate how hiring efforts are proactively LGBTQ inclusive. Simply having an employment non-discrimination statement that includes “sexual orientation” and “gender identity” posted on job descriptions or career website does not count for this criterion, however, it does count for publicly communicating you employment non-discrimination policy.

Resources:
Organizations can target potential LGBTQ employees in a variety of ways:

• Job postings are sent to LGBTQ organizations and/or print/online LGBTQ publications
• For more information on LGBTQ-inclusive hiring and recruitment, visit our webpage detailing LGBTQ recruitment and LGBTQ-specific job sites

Note: We are looking for a senior/executive-level administrator at your organization.

The presence of visible LGBTQ employees in management communicates to the LGBTQ employees of your company that their company is open and accepting and enables LGBTQ employees to be open at work, which in turn improves their engagement and retention.

A diversity and inclusion office can be a driving force in your journey towards inclusivity for all older adults.