Supporting LGBTQIA+ employees on their parenthood journeys with inclusive benefits

From antiquated laws around adoption to stigma surrounding different pathways to parenthood, traditional healthcare systems aren't built to support LGBTQIA+ people and their families. Because of the discrimination LGBTQIA+ families face, inclusive family benefits are crucial to combat gaps in care in the traditional healthcare system. From fertility treatments and preservation to adoption and surrogacy support, employers play a critical role in bridging these equity gaps for queer and trans employees and signal that all paths to parenthood are valued and supported.

Designing LGBTQIA+ inclusive benefits that reflect the diverse realities of modern families is not only the right thing to do; it's also good for business, leading to higher employee engagement, loyalty, and retention outcomes. Read on to learn how to better support LGBTQIA+ employees through equitable and inclusive healthcare benefits.

The spectrum of LGBTQIA+ family-building journeys

The family-building paths available to LGBTQIA+ families are as diverse as the LGBTQIA+ community itself. Common options include assisted reproductive technology (ART), adoption, surrogacy, fostering, and fertility preservation. Between solo parenting or co-parenting, more than 2.5 million LGBTQ+ adults are parenting children under the age of 18.

All family-building journeys are deeply personal and complex, and this is especially true for queer and trans people. Same-sex couples face high financial and legal hurdles related to adoption, surrogacy, or assisted reproductive technology. A single round of IVF costs more than $20,000. From a legal standpoint, 17 states in the U.S. don't have any anti-discrimination adoption laws or protections for same-sex spouses, and this doesn't even account for the steep costs of adoption and surrogacy too.

Consistently navigating a medical system that is not inclusive of them, trans and non-binary people may also need gender-affirming care alongside fertility preservation or ART. Intersex individuals can encounter added clinical complications, as well as a lack of provider knowledge, let alone tailored fertility guidance. Queer and poly families often face legal ambiguity around parentage rights or are excluded from traditional benefit structures entirely.

The challenges of LGBTQIA+ family-building often intersect, creating a journey fraught with barriers. From the stress of navigating biased systems to the prolonged nature of many fertility journeys, family building can be an especially emotionally taxing process for queer and trans employees. From a clinical perspective, access to affirming care is often limited, and care matching is sparsely available for LGBTQIA+ folks. Additionally, their fertility and family-building journeys can be disproportionately expensive, on top of inadequate and inconsistent legal protections. For IVF and IUI, many health plans still require a medical diagnosis of infertility, excluding nearly all LGBTQIA+ individuals and their families. 

The impact of inadequate benefits on LGBTQIA+ employees

Unsurprisingly, this discrimination and lack of inclusive family-building benefits impacts LGBTQIA+ employees in all aspects of their lives, including in the workplace. When benefits packages are not intentionally designed to be inclusive, they are often exclusionary, even unintentionally so. This exclusion can take a severe toll on employee mental health, especially as LGBTQIA+ employees navigate complicated healthcare systems that don't recognize or support their identities. Women of color and LGBTQIA+ employees are the least likely to have their mental and physical healthcare needs met, with 66% of LGBTQIA+ people reporting two or more unmet basic needs. 

Between out-of-pocket costs for fertility treatments and legal fees for adoptive parents to secure parental rights, building a family as an LGBTQIA+ individual or couple can be disproportionately expensive, and these expenses are not often covered by traditional benefit plans. 

The result? A real, detrimental impact on talent retention, engagement, and productivity. A recent Maven report found that 69% of employees have taken or considered taking a new job because another job offered better reproductive health benefits. Other studies show that employees who feel unsupported are more disengaged and less productive. Providing inclusive family benefits is not only the right thing to do—it’s a smart investment in people and culture.

Core benefits to support LGBTQIA+ family building

1. Inclusive fertility and reproductive health benefits

Considering more than 60% of LGBTQIA+ people plan to use assisted reproductive technology to grow or build their families, fertility and family-building care is a crucial yet underserved need. To create inclusive family-building benefits, it's important to consider the different ART paths available. The treatments, costs, and needs of your employees will vary based on their chosen path to parenthood, which can include:

• In-vitro fertilization (IVF) or intrauterine insemination (IUI) with donor gametes
• Egg or sperm preservation before or after gender-affirming care
• Hormonal care access (e.g., pregnancy-safe transition management)

For queer and trans employees to receive this inclusive, culturally competent care, they need to have access to providers who have worked with other LGBTQIA+ individuals or better yet, identify as LGBTQIA+ themselves. Since only 3.2% of doctors identify as LGBTQIA+ themselves, it can be extremely difficult for LGBTQ employees to access inclusive clinical partners and networks. In contrast, over 8% of providers on Maven identify as LGBTQIA+, and 40% have strong clinical experience working with the LGBTQIA+ community.

Learn how one couple found inclusive support through Maven:

2. Adoption, fostering, and surrogacy support

Adopting and fostering are more prevalent in the LGBTQIA+ community, especially among same-sex couples, 43% of whom have adopted or step-children. According to the UCLA Williams Institute, same-sex couples are four times more likely to adopt than different-sex couples, yet they face disproportionate discrimination. Some agencies still deny services based on sexual orientation or gender identity, and legal systems across states vary widely in recognizing LGBTQIA+ parental rights.

Navigating domestic vs. international adoption presents a different set of challenges. Domestically, laws differ by state, with some offering more protections than others, with 17 states offering no legal protections at all. Internationally, many countries restrict or ban adoption by LGBTQIA+ individuals, further limiting options—it's only legal for same-sex couples to adopt in 39 countries.

Financial barriers also loom large. Including legal fees, travel, and agency support, adoption can cost anywhere from $20,000-45,000 or more, and surrogacy is even more expensive. With this in mind, employers need to address both legal and financial discrimination to make adoption accessible and provide truly inclusive benefits.

3. Legal guidance and protections

As of 2023, only 23 U.S. states have clear statutes affirming parental rights for non-biological LGBTQIA+ parents, leaving many families vulnerable in cases of separation, death, or interstate moves.

When it comes to gender and name changes on health and HR records, administrative hurdles remain rampant. Updating gender markers is often a critical step for not only affirming identity but also ensuring seamless access to family-related benefits.

LGBTQIA+ employees may need additional legal guidance when navigating family-building contracts, such as sperm or egg donor agreements, surrogacy arrangements, and custody documentation. Offering legal coaching or reimbursement benefits for services like second-parent adoption, estate planning, or court filings helps level the playing field and provide equitable access to all employees.

4. Mental health and emotional wellbeing

Since LGBTQIA+ individuals are twice as likely to have a mental health condition than their heterosexual counterparts, access to LGBTQIA+-affirming therapists is crucial for equitable support. Culturally competent and trauma-informed care is especially important during life transitions like gender affirmation, family-building and parenting, and coping with grief and loss. 

Peer support groups and identity-specific communities can also offer invaluable safe spaces for shared experiences and mutual support, fostering LGBTQIA+ community and alleviating an often pervasive sense of isolation in a predominantly cisgender and heterosexual society. Employers can provide these resources and allow LGBTQIA+ employees to connect with each other in employee resource groups (ERGs) as well.

5. Paid parental and family leave

When it comes to paid parental and family leave, it's important for leave policies to be equitable across all family types, whether the employee's family-building journey includes birth, adoption, or surrogacy. Additionally, leave policies should be inclusive of all genders and family configurations by using gender-neutral language and ensuring non-birthing parents are supported as well. Beyond parental and family leave, inclusive benefits should also include leave policies for miscarriages and other loss, postpartum support, and gender-affirming surgery recovery and caregiving.

6. Career coaching and workplace integration

Another way to improve inclusivity is by offering coaching for returning to work post-parenthood or post-transition, be it medical, social, or both. LGBTQIA+-affirming career coaching can help queer and trans employees navigate identity at work and offer additional support for non-traditional family structures and dual-career families.

Additional areas of support

Transition-aware reproductive care

While family-building can be intense and challenging for anyone, it can be especially difficult for transgender people needing to navigate various fertility treatments, body dysmorphia, and misgendering. Only 13% of trans people have talked about the effects of gender-affirming hormones on fertility with their doctors, and 50% have to educate their doctor about providing gender-affirming care in the first place.

With all these discriminatory barriers, care matching can be a lifesaver during the family-building journey. Digital family health benefits can connect trans employees to midwives, doulas, OB-GYNs, fertility specialists, and more who are either transgender people themselves or are highly experienced in supporting LGBTQIA+ individuals. In addition to offering trauma-informed care that includes proper pronouns and gender-inclusive language, these knowledgeable specialists can also address fertility preservation before or during transitioning, dysphoria during fertility treatments or pregnancy, and support for individuals navigating pregnancy while transitioning.

Education for managers and people teams

Offering equitable benefits is not just about having culturally competent providers; it starts in the workplace. As part of your inclusive healthcare benefits, managers and HR should receive training on inclusive language, policies, and support pathways for LGBTQIA+ employees. Regardless of sexual orientation or gender identity, family-building disclosures should always be handled with care and sensitivity to protect employee privacy and respect their wishes.

Global considerations for multinational workforces

In addition to navigating state variances in the U.S., global companies also need to consider country-specific restrictions or barriers for their LGBTQIA+ employees. At times, this support may entail tailored assistance for employees working in places with restrictive legal environments and ensuring benefits equity across geographies.

The business case for inclusive family benefits

Studies show 77% of employees are more likely to stay with an employer that offers inclusive family benefits, and companies with strong LGBTQIA+ support see 1.5 times higher employee engagement. In addition to employee retention and engagement, LGBTQIA+-inclusive benefits are increasingly important for younger generations in the workforce, with 83% of Gen-Z employees looking at a company's LGBTQIA+ support specifically when applying for jobs.

The cost of fertility, adoption, or legal support is far outweighed by savings from improved retention and reduced turnover—each lost employee can cost up to two times their annual salary to replace. Beyond the numbers, inclusive benefits help employees feel seen and supported, fostering resilience and loyalty.

How Maven helps support all families

To best support LGBTQIA+ employees who are starting and raising families, employers need a digital family health benefit that offers virtual, holistic, and inclusive care. As a complete digital health solution for family-building benefits, Maven is uniquely equipped to support all pathways to and through parenthood, with customizable family-building benefits for every identity and path that include clinical, emotional, financial, and community services.

Over 8% of providers on Maven identify as LGBTQIA+, and 40% have strong clinical experience working with the LGBTQIA+ community. From fertility to adoption, surrogacy, or pregnancy and into parenthood, Maven has the specialty care providers, Care Advocates, and resources to help LGBTQIA+ employees navigate this vulnerable, challenging, and joyous process. To find out how Maven can help support families on your team and close the equity gap, contact us today.