The Quiet Revolution of Transgender Healthcare Coverage in America
How the Human Rights Campaign mainstreamed transgender benefits in corporate America and what we can do about it
Ideology does not spawn out of nowhere
Amidst the noise of the lament over how “woke” America is, we forget the fact that policies and organizations do not spawn out of nowhere. Behind every ideological policy or product you encounter are people responsible for its creation and execution. In this newsletter, I will briefly explain which group is responsible for the widespread corporate offering of transgender healthcare benefits and what can be done in response.
The “Human Rights” Campaign
The Human Rights Campaign (HRC) is one of the largest and most influential political stakeholder organizations in the United States. The HRC describes its flagship project, the Corporate Equality Index (CEI), as “the national benchmarking tool on corporate policies, practices and benefits” for LGBTQ+ employees. Before you think this is a self-congratulatory description, bear in mind that in 2023, 1,386 corporations participated in the CEI, including 378 of the Fortune 500 (the 500 largest publicly traded companies in the United States).
To evaluate major corporations on the LGBTQ+ inclusiveness of their governance and assign them a CEI score, the HRC sends an annual survey to the Fortune 1000, the AmLaw 200 (The top 200 revenue-grossing law firms), and private corporations with 500+ employees who request to fill it out. The survey asks about the presence of specific policies and practices a corporation implements and requires validating information to prove they are in effect. Every few years the HRC expands the list of required policies to earn a perfect score, announcing the changes at least 2 years in advance. Then, the HRC releases new resources and actively consults corporations to help them adjust their policies to retain/increase their score. Those who earn a perfect score receive the designation “Leader in LGBTQ+ Workplace Inclusion”. This title is frequently used by companies as a badge during recruitment, celebrated on their news page, and listed as an award on their website.
2023-2024 CEI
The methodology and key findings of the 2023-2024 CEI can be found here.
The 2023-2024 CEI evaluates corporations on four major criteria:
Workforce Protections
Inclusive Benefits
Supporting an Inclusive Culture
Corporate Social Responsibility
Example:
Scoring a 100 on the CEI entails many ideological commitments, including:
Recruiting employees based on sexual identity
Discriminating against vendors who do not promote divisive sex and gender policies
Withholding donations from non-religious charities unless they embrace controversial gender identity policies
Mandating employees attend multiple, controversial trainings on gender identity, sexual orientation, transgender issues, and divisive racial ideology
Providing gender transition guidelines to employees and a specific benefits guide with a comprehensive explanation of transgender services funded by the company
Marketing or advertising based on controversial sexual issues
Pledging philanthropic support of at least one organization or event that promotes sex and gender ideology
Covering transgender-related costs for company employees and their children, including paid short-term leave, puberty blockers, cross-sex hormones, chest surgeries, genital surgeries, medical visits and lab monitoring, travel, and lodging
Publicly advocating for controversial sex and gender ideology through local, state, or federal legislation or initiatives
“Equal health coverage for transgender individuals”
Since 2012, the HRC has asked corporations to offer “Equal health coverage for transgender individuals without exclusion for medically necessary care”. Applied to dental or vision benefits, this sounds insignificant. However, according to its Inclusive Benefits Guide, the HRC considers surgical intervention for the treatment of gender dysphoria (including genital, tracheal, facial, vocal, and stomach surgeries) to be “reconstructive” (necessary) rather than “cosmetic” (unnecessary). This means as long as medically necessary care is offered to non-transgender people, “these same healthcare benefits must also be extended to transgender people covered by the plan”.
According to the 2023 CEI Survey, to get a checkmark in this category covered benefits must include puberty blockers, cross-sex hormones, medical visits, lab monitoring, travel, lodging, and paid short-term leave for gender transitioning. Moreover, since it is standard for employer health insurance to provide coverage for employees’ children, compliance with the CEI in this area means covering transition-related medical costs for employees’ children. This makes “Equal health coverage for transgender individuals” the most ideological component of the CEI.
In 2009, before the HRC announced these changes, zero Fortune 500 companies had “transgender-inclusive” healthcare benefits in at least one firm-wide plan. In 2023, 365 of the Fortune 500 (73%) had “transgender-inclusive” healthcare benefits in at least one firm-wide plan. In total, 1,298 companies (94%) rated on the 2023 –2024 CEI offered these benefits.
HRC’s influence on corporate America
The HRC openly brags about the influence of the CEI on the governance policies of Fortune 500 companies. In 22 years the HRC has convinced 90% of major American corporations to include gender identity as a protected class and 73% to cover transgender healthcare costs for its employees and their children. A full analysis of the ideological policies the HRC is responsible for introducing into corporate America is beyond the scope of this article, but these two statistics alone suffice to prove the influence of the HRC on the governance of American corporations.
HRC’s Influence on the F500
Growth in “Gender Identity” Protections
Growth in “Transgender-Inclusive” Benefits
The WPATH Files
If the prospect of corporate America offering transgender healthcare benefits to children is not enough to scare you, consider the recently released WPATH files. The WPATH files document how the “experts” of “gender-affirming” care are “aware of the debilitating and potentially fatal side effects of cross-sex hormones and other treatments” and know that children cannot consent to transgender healthcare. Hence, corporations have a strong legal, moral, and scientific basis to refuse to comply with the CEI, including a refusal to cover transition-related medical costs for employees and their children.
What now?
Moving forward, here are 6 ways these ideological and antihuman policies can be combated:
Medical professionals, journalists, and researchers need to continue to educate the masses on the dangers of “gender-affirming” care.
Religious leaders need to help people understand the benefits of living life as God designed it and the importance of defending life as God designed it.
Fortunately, there is no shortage of great people working in these spaces at places like Do No Harm, the Alliance for Responsible Citizenship, or the Colson Center. However, oppositional identities are never effective in the long run. For this reason,
Policymakers should develop an ethical and family-oriented corporate benefits package as a compelling alternative
How many corporate benefits packages that offer transgender and abortion-related benefits also offer de-transition benefits or quality maternity leave policies?
Politicians need to exert pressure on corporations in their state that offer these services in opposition to state law
State Attorneys General should launch investigations to ascertain whether corporations providing transgender healthcare benefits in defiance of state law have effectively implemented these benefits.
Shareholders who have enough stock should file proposals demanding companies they invest in to stop funding transgender healthcare benefits
If this is not a viable option or if a company refuses this request, shareholders should request the company to cover the cost of de-transition (like Disney shareholders did in April 2024).
Corporations should stop filling out the CEI and complying with CEI policies, especially the offering of transgender healthcare benefits to employees and their children
How many corporate executives who are charged with overseeing the financial activities or legal affairs of their organization are aware of the CEI or who is filling it out for their company? For companies who have previously submitted a survey, surveys are always sent to the individuals responsible for prior submissions.
On a personal level, we should avoid companies that score high on the CEI. Of course, if we stopped supporting every bad company we would have to stop giving business to nearly everyone. We have to remember that American corporate reform is a generational battle. However, we should make an extra effort to avoid the worst actors, particularly corporations that offer transgender healthcare benefits.
Thankfully, plenty of groups exist to help people find companies that serve the interests of their employees, customers, and shareholders and avoid ideological causes, organizations, or policies.
Check out Public Square “where you can buy everything your family needs from businesses who respect traditional American values” or the 1792 Exchange’s Corporate Bias Ratings which has rated 3000+ companies based on their likelihood to to serve ideological purposes rather than shareholder interests.
*As a researcher for the 1792 Exchange, it is important to state that the views expressed in this piece are mine and not reflective of any other person or organization, including the 1792 Exchange*
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