Inclusive Healthcare Strengthens the Bottom Line

While none of the recent executive actions have directly impacted our care model at FOLX Health—we only serve adults— the rhetoric and proposed policies have created widespread confusion and fear, particularly around gender-affirming care. We’ve seen how fear, misinformation, and systemic discrimination delay care, worsen health outcomes, and heighten mental health needs. While we remain fully operational and continue to provide care in all 50 states, these policies are putting lives at risk by weaponizing fear and spreading harmful narratives about lifesaving care.

Gender-affirming care includes a broad spectrum of services that support trans and nonbinary people in aligning their bodies and identities—and not all of it is surgical. At FOLX Health, we offer everything from hormone replacement therapy and mental health care, to gender-affirming surgery letters, name and gender marker changes, community support, primary care, therapy, and even access to voice coaching.

While access to surgery is important for many, it’s just one piece of the puzzle. Therapy with affirming providers, medication management, peer support, and access to providers who understand trans-specific health needs is both lifesaving and smart business. It improves mental health, boosts retention, and costs less than many employers expect. While more companies are covering gender-affirming surgery— about two-thirds of large employers now do—many plans still fall short. The most forward-thinking employers ensure comprehensive, affirming care is covered and accessible.

Lack of coverage for gender-affirming care: Many plans don’t explicitly include hormone therapy, puberty blockers, or surgeries like chest reconstruction or facial feminization. If they’re not named, they’re often denied. Also gendered service restrictions: Some plans deny care based on legal sex marker, such as refusing a pap smear for someone listed as male or a prostate exam for someone listed as female. And mental health care exclusions: Trans and nonbinary people often face high barriers to affirming mental health care, especially if providers aren’t trained in gender identity or if coverage excludes therapy that supports transition.

Employers should understand the demand is real: nearly one in four Gen Z adults identifies as LGBTQIA+, and more people are coming out and seeking care than ever before. Offering comprehensive, inclusive benefits isn’t just the right thing to do—it’s a competitive advantage. Plans that support their LGBTQIA+ employees help reduce turnover and build inclusive workplace cultures where people feel seen and supported.

LGBTQIA+ people face higher rates of anxiety, depression, and suicidality—not because of who we are, but because of the discrimination, isolation, and lack of affirming care we encounter. Despite these elevated risks, many LGBTQIA+ people delay or avoid mental health care altogether due to prior negative experiences, a shortage of affirming providers, or lack of coverage.

At FOLX, our members repeatedly share how difficult it was before joining to find mental health providers who understand the LGBTQIA+ experience. When care doesn’t feel safe or affirming, people don’t access it. Employers play a critical role here. Ensuring mental health benefits include access to LGBTQIA+ affirming and expert providers is essential.

Most benefits plans aren’t designed with transgender people in mind, and the language used to describe coverage is often vague, outdated, or overly clinical. For many trans folks who have experienced discrimination or dismissal in healthcare settings, this can lead to a baseline of distrust and confusion. Too often, they’re put in the position of having to educate their provider or justify their care, instead of being met with understanding.

Employers can make a real difference by providing benefits education that is clear, inclusive, and specific—and they can partner with healthcare providers like FOLX who can guide their employees through the process with trust and expertise. Doing so is good business. Forty percent of FOLX members did not access care prior to joining FOLX, resulting in higher inpatient admissions, and 25% of those who sought care did so out of network. Offering services like FOLX can help keep healthcare costs down and drive productivity—40% of FOLX members saw an increase in their quality-of-life score that amounts to two more days per month for work and play.

One reason so few employers offer it is simply a lack of awareness. Many companies don’t realize the wide range of recovery needs tied to gender-affirming care—from surgery to hormone adjustments to mental health. Others rely on outdated plan templates that don’t account for trans and nonbinary employees at all. Offering gender-affirming leave is about dignity, inclusion, and signaling to your employees that their health matters.

For LGBTQIA+ people—especially trans and nonbinary folks—affirming care isn’t just about medical accuracy, it’s about safety, respect, and trust. Before joining FOLX, too many of our members had been misgendered, dismissed, or denied care entirely by providers who don’t understand or affirm their identities. That’s why FOLX was created: to provide care by and for the LGBTQIA+ community, with clinicians who not only have clinical expertise but the lived experience to show up with expertise and understanding.

For companies not yet partnering with FOLX, finding truly affirming providers through traditional networks is difficult but not impossible. It requires asking the right questions: do plans include providers trained in gender-affirming care? What does that training entail? Can employees easily identify LGBTQIA+ friendly clinicians? How is that term defined? Are mental health providers vetted for experience with LGBTQIA+ patients? We always recommend conducting a benefits audit and working with your broker or benefits team to build in LGBTQIA+ specific provider filters and coverage criteria.

Absolutely. The business case for LGBTQIA+ inclusive benefits is both compelling and well documented. When LGBTQIA+ employees lack access to affirming care, it leads to increased absenteeism, higher turnover, and diminished engagement—all of which directly impact an organization’s bottom line.

Thirty-four percent of LGBTQIA+ employees have reported leaving a job because the work environment was unaccepting of their identity. Approximately 30% of LGBTQIA+ workers—and notably, 50% of transgender workers—have avoided applying to companies perceived as unsupportive of the LGBTQIA+ community. Investing in LGBTQIA+ inclusive benefits is not just the right thing to do, it’s a strategic business decision that fosters a more loyal and productive environment.