Your fertility benefits may be excluding LGBTQ+ employees from treatments

Callahan Family 2020
Lindsey Callahan holds her son Charlie, along side her wife Chrissy Callahan. The couple used reciprocal IVF to concieve their child with the help of an employer sponsored benefit.
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For LGBTQ+ employees, recent legislation has ensured a safe and equal workplace, and now employers need to make sure their benefits reflect that too.

The recent ruling by the Supreme Court extended a federal law that prohibits discrimination based on sex to include sexual orientation and gender identity, ruling that employers who fire workers because they are LGBTQ+ are violating their civil rights and breaking the law.

This decision, along with the the 2015 ruling that legalized gay marriage across the nation, are important steps in providing equal rights and protections for LGBTQ+ people. But without inclusive employee benefits, LGBTQ+ employees could still face barriers to equal treatment and care, especially when it comes to fertility and family planning.

When Lindsey Callahan and her wife Chrissy Callahan decided to become parents, they knew they would face more challenges on the road to parenthood than opposite sex couples. Family planning benefits support, including fertility treatments, are offered by just 31% of companies, according to the Society for Human Resource Management.

However, thanks to a fertility benefit offered by Lindsey’s employer, Salesforce, she and Chrissy had a smooth transition into motherhood. Salsesforce offers employees access to Progyny, a fertility benefits provider. The Callahans were able to take advantage of education services, and were provided with a care management professional who walked them through the more complicated parts of their journey and helped connect them with the appropriate clinics and doctors. Today they have a 10-month-old son, Charlie.

The experience was much smoother than Callahan ever expected, especially when compared with her previous experience going through an insurance carrier.

“You are assigned a patient care advocate and when I called, Manuela walked us through the entire process, throughout my pregnancy journey,” Callahan says. “[Progyny was] so easy to work with on the back end and the experience was very personal. We had a high level of emotional support throughout.”

That support was especially comforting as Callahan struggled to deal with the guilt she felt over the ease of the process, compared to her other friends who had started their family planning journey first, but were having their own issues.

“There's this combination of feeling guilty that you have this amazing benefit but also feeling so thankful,” Callahan says. “A really close friend and her wife have been trying to have a baby for a few years and they started the process before I did. I think about that a lot. They didn't have a Manuela or a PCA to keep them on track. It was just confusion.”

While Salesforce's fertility benefits are available to all employees, many employers are often unaware at the ways their offerings can exclude certain populations, says Lisa Greenbaum, the chief client officer at Progyny. Infertility is one area where LGBTQ+ couples are often excluded from access, because of the way infertility is defined, she says.

“Employees are looking for fertility benefits that help them build their family, regardless of the path to pregnancy, in a supportive and healthy way,” Greenbaum says. “[A supportive benefit] does not have a preclusion criteria that requires a diagnosis of infertility.”

Typically, heterosexual couples are diagnosed with infertility after one year of trying to get pregnant through regular intercourse, with no resulting preganacy, defined by the Office of Women’s Health, a branch of the Department of Health and Human Services.

“This of course precludes LGBTQ+ members or single parents by choice,” Greenbaum says. “They have to meet that strict diagnosis definition of infertility, and so regardless of what service is offered to help [employees] get pregnant, [LGBTQ+ employees] may not even have that service offered to them.”

However, Progyny doesn’t require an infertility diagnosis; instead the company allows the physician and patient to work together to determine what the most appropriate path to pregnancy is. This can include treatments such as intrauterine insemination, surrogacy, in vitro fertilization, and reciprocal IVF, the option the Callahan’s used. With reciprocal IVF, an egg is taken from one partner and fertilized and then carried to term by the other partner.

“Reciprocal IVF, also referred to as co-maternity, is a fertility treatment option for lesbian, or trans men— couples that allow both partners to be intimately involved in the child creation process,” according to CNY Fertility, a low cost fertility treatment provider. “Since it is not yet possible to create a child by combining two eggs, reciprocal IVF may just be the coolest way to make a baby.”

While reciprocal IVF is growing in popularity among lesbian couples, there are other paths to parenthood for LGBTQ+ parents-to-be. Michael Proppe, a principal with professional services firm PwC’s advisory practice, and his husband James Hall, took advantage of the fertility benefit offered by PwC and used a surrogate to have their now two-year-old daughter Emma. The couple plans to use the benefit again to have their second child. PwC works with WINFertility in order to provide employees with fertility treatments, education, and funding.

Proppe and his husband received $25,000 to offset the costs associated with family planning. Proppe was also able to take six weeks of extra leave, in addition to the eight weeks of paternity leave PwC already gives employees, since he is the primary caregiver for their daughter.

“We have a benefit where there was an additional time for bonding [with my] child, and I really appreciated that I was able to extend beyond the traditional parental leave given my primary caregiver status,” he says."

Like Progyny, WINFertility also offers nurse care managers and educational resources on parenting and fertility, a critical resource for Proppe and his husband, especially as they begin to plan for their second child.

“There're so many moving parts, when you're going through surrogacy in particular,” Proppe says. “We were pretty far along in our process [for Emma] when all these benefits were rolled out. So we didn't tap into the education and support as much, but certainly for our next baby, we'll be leaning on them for more personal coaching and guidance on how to manage the process.”

Proppe and his husband, as well as the Callahans, were able to walk their path to pregnancy and start a family with relatively few bumps in the road. But this isn’t always the case for LGBTQ+ parents-to-be — beyond the required infertility diagnosis, there are state and local laws that can block other avenues to parenthood.

Some states, including Kansas, Oklahoma and Texas, have passed so-called religious freedom laws that allow state-licensed child welfare agencies to discriminate against LGBTQ+ individuals and couples looking to adopt or provide foster care. But despite these barriers, 77% of LGBTQ+ millennials are either already parents or are considering having children, making it almost twice as common as it was for their previous generation, according to the national survey from the Family Equality Council.

If employers want to create an equal work environment that attracts and retains top talent, then they need to embrace benefits that are inclusive of every individual in the organization.

“Diversity, inclusion, and equality are not afterthoughts,” Proppe says. “It needs to be at the forefront of any company that's looking to grow, to transform, and to evolve in today's world. We bring better ideas and we bring better perspectives, when we have people from all backgrounds and walks of life.”

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