I don’t know if I want to start a family of my own, but I at least want the option. Family planning, for me, is so much bigger than abortion access or prenatal care — although yearning to return to my Southern roots and being Black put these things at risk. Nationally, due to Dobbs v. Jackson Women’s Health Organization, abortion protection is a legal patchwork.
Notably, the mortality rate for Black mothers during pregnancy and postpartum is three times that of White mothers. Historically, doctors don’t take Black people’s pain seriously, leading to health issues left ignored and contributing to disproportionate mortality rates. All of these risks I face seeking medical care are further complicated by the fact that I’m a transmasculine person.
As a trans person trying to re-establish an OB-GYN — even with pretty good health insurance and situated in an earthy-crunchy, multicultural, liberal area — I’m finding it difficult to access quality healthcare where my essential personhood is respected. I’ve started to wonder: What options do trans and gender nonconforming people have? And where can people-first employers step in?
In my past life, as a sex and dating reporter, I wrote service journalism that filled in the K-12 education system’s gaps. What does safer sex look like? How does contraception work? How does conception work? How do you center consent in your sexual interactions? And while not the sole focus of my appointment at HR Dive, I have continued to write about reproductive health — this time, at the intersection of compensation and benefits.
I’ve sought to capture what comprehensive parental leave looks like and where employers can include LGBTQ working parents. Last year, I cataloged the top companies pledging monies to their employees’ medical travel expenses. I broke down the legalities and how employers could apply theory to practice — mainly by using HRAs to support abortion access for their workforce.
Transitioning out of my parents’ health insurance for my birthday last year brought challenges — mainly, parting with my most recent gynecologist. He was among a handful of practitioners working at that health insurance provider’s LGBTQ clinic. I could book him easily through an app, without questions regarding coverage or co-pay. He didn’t miss a beat regarding my pronouns and was one of a few gay men I’ve met that have made me feel included in the community.
With my eye turned personally and professionally to the LGBTQ healthcare space, I’ve observed a number of boutique clinics pop up over the years. FOLX Health — whose selling point is a digital-first clinic equipped to treat STIs, administer estrogen or testosterone therapy, prescribe PrEP and treat erectile dysfunction — comes to mind.
Of course, HR professionals can comb insurance packages for gender-affirming care. But I find it interesting when companies such as Stork Club make it a point to consult employers on ways to fold diversity and inclusion into compensation and benefits. The company focuses on supporting individuals and couples in their family planning process — a cause founder Jeni Mayorskaya wants to help employers extend to all people.
She birthed her company from her own reproductive challenges and realized quickly, she said, that this healthcare lane excluded certain groups of people. “It’s even bigger than we think about either fertility care or maternity care. Historically, this type of care was designed, like almost a century ago, and designed for mostly heterosexual couples,” Mayorskaya said.
“We want to really build the next generation of family building and reproductive care and we want to include every single person,” she added, noting her desire to champion LGBTQ folks, single parents and those who want to start families later in life. This is where connecting talent to IVF treatments, surrogates and adoption services comes in, as well as providers specializing in hormone replacement therapy — in the U.S. and abroad.
Ditto what Mayorskaya calls the three pillars of hormonal reproductive care: menopause support, hormone replacement and gender-affirming care. “The reason we decided to move in this direction is that reproductive hormones affect our physical but also mental well-being,” she said, nodding to the ways people in transition and people going through menopause sometimes suffer in their personal and professional lives due to hormonal challenges.
Clearly, access to insurance is not a panacea to the disparities that trans people face, but it’s a solid stepping stone. And employers actively championing trans equity — by taking the time to consider resources for us, outside of support to medically transition — are a start.