Fertility benefits are essential for LGBTQ+ individuals and couples, but coverage for these services is still lacking. Here's what you need to know about these benefits and strategies we can take to include this community in fertility benefits.
Fertility benefits are essential for LGBTQ+ individuals and couples, but coverage for these services is still lacking. Companies need to consider the impact of their benefits offerings for everyone – not just heterosexual couples. Here's what you need to know about current fertility benefits for the LGBTQ
What are fertility benefits?
Fertility benefits are
fertility treatments that have been partially or fully paid for by your employer. If your employer offers fertility benefits, those benefits might cover a visit to a fertility specialist, assisted reproductive technologies (ARTs) such as IVF or IUI, or non-invasive measures like drug therapy. Because these fertility-enhancing procedures are considered “ elective” and not “medically necessary,” they are often prohibitively expensive for individuals who need to pay out of pocket.
Historically, fertility benefits were considered a luxury benefit and were not offered by many employers; however, the tides are slowly turning due to increased pressure on the corporate world to become more inclusive and work towards equity.
In 2020, Mercer’s National Survey of Employer-Sponsored Health Plans
put out a report that pointed to rapid growth in employer sponsorship for several fertility-enhancing procedures, especially for employers with 20,000 or more employees.
By 2020, 73% of these large companies covered evaluation by reproductive endocrinologists or infertility specialists, and 42% of them covered IVF cycles.
While these statistics point to signs of progress, access to fertility care is still limited, especially for members of the LGBTQ+ community.
Challenges faced by the LGBTQ+ community regarding fertility
While fertility benefits are partially geared toward heterosexual couples struggling with the costs of treatments used to combat infertility, they also extend to
members of the LGBTQ+ community who are interested in having children.
People who are LGBTQ+ are no strangers to fertility struggles. The system of fertility care was constructed to support heterosexual couples trying to conceive as naturally as possible. There are still many additional barriers to access for people who are not in a heterosexual couple. Lacking financial support can make starting a family even more difficult for LGBTQ+ individuals and couples.
These barriers can become even more insurmountable for people at the intersection of multiple disenfranchised identities.
The cost of fertility procedures is an issue for nearly everyone. However, LGBTQ+ people trying to conceive also have to deal with discriminatory policies set in place by healthcare providers and insurers.
Some fertility benefits operate under a strict definition of infertility, which might mean that same-sex couples do not meet the criteria for being treated for “
infertility.” Additionally, many insurance policies do not account for how trans people receiving gender-affirming care should be treated when it comes to fertility support. Notably, these policies rarely cover fertility preservation options for individuals preparing to transition who may still want to have biological children later on. Why are fertility benefits important for the LGBTQ+ community?
The mere existence of fertility benefits, that are offered on top of traditional health insurance plans, is a step in the right direction toward the inclusion of the LGBTQ+ community.
In the past, the most common family benefits offered by employers were geared toward family health care, not family planning support. This meant that individuals were typically responsible for funding all fertility treatments.
As a result, more often than not, fertility treatments were limited to rich, white, heterosexual couples.
While access to care is still a significant issue, more couples, and individuals are now able to opt into services that can help them to create a family. These fertility benefits are available to a much larger proportion of the population. Offering fertility benefits to the LGBTQ+ community goes beyond allowing individuals to row their families. It can also support employees' mental health and wellbeing. is also a huge boost for mental health and well-being.
Legal developments in fertility laws
The 2015 legalization of same-sex marriage and the 2017 legalization of adoption by same-sex couples finally made it legal for non-heterosexual couples in all 50 states to start families. This cultural shift, and the removal of legislative discrimination, had a huge impact on access to fertility services: at that point, fertility planning became possible for many couples for whom it had never been an option.
Of course, that didn’t mean all fertility benefit programs suddenly jumped into gear and began offering totally-inclusive care. Currently, only a handful of states actually have laws dictating that fully-insured, private insurance plans controlled by the state must cover fertility treatments.
Yet, this requirement does not extend to health insurance offered by employers, which is a far more popular option for workers. (61% of workers with employer-sponsored health insurance use the latter option,
according to a 2020 report by KFF.)
So government involvement has made a difference in the journey towards equal fertility rights for LGBTQ+ community members, but it also is going to take more than a law to ensure that all people have access to the fertility care they need.
Strategies to ensure inclusion of the LGBTQ+ community in fertility benefits
True inclusion of the LGBTQ+ community in fertility benefits will require actions to be taken by employers.
It will require a thorough review of the existing policies and procedures, with an eye toward diversity, equity, and inclusion (DEI).
While many fertility benefits are offered to people wanting to become pregnant, employers often overlook the type of fertility treatment that takes place outside of the body—which is often a necessity for LGBTQ+ individuals or couples looking to conceive.
For example, gestational carriers, surrogates, egg or sperm donation, and even adoption services are essential to couples who don’t have the ability to conceive or carry a baby. These happen to be the forms of fertility care least likely to be covered by employer-funded healthcare.
There also needs to be more sensitivity training for healthcare providers and insurers. There is still
significant bias and discrimination in medical practice.
While there are many great doctors out there, there are still healthcare providers who have not been trained to effectively and affirmatively provide care to members of the LGBTQ+ community.
In order to get there, we need more education about what fertility care looks like for a more diverse audience.
We need to advocate for a future where anyone who wants to start a family has the opportunity to do so and the support they need to get there.