At Google, a Transgender "Gold Standard"

In a move predicted by one advocate to become the gold standard for LGBT health, Google has significantly increased coverage of transgender health care for its U.S. employees, and other companies are expected to follow suit.



The updated benefits, announced internally by company officials on Friday and effective immediately, cover transitioning procedures and treatment in accordance with the World Professional Association for Transgender Health’s (WPATH) Standards of Care, and include gender reassignment surgical procedures determined to be medically necessary by a doctor.



Some of the procedures covered by Google’s health care plan include genital surgery as well as facial feminization for transgender women and pectoral implants for transgender men — surgeries that can be considered medically necessary depending on the “unique clinical situation of a given patient’s condition and life situation,” according to WPATH’s seventh version of care standards, published in September.



“As the WPATH Standards of Care are considered the highest standards of care for transgender individuals, we agreed to cover the full range of procedures under WPATH,” Google spokesman Jordan Newman told The Advocate.



Google also has more than doubled the maximum dollar amount for transgender health care benefits, from $35,000 to $75,000, the minimum amount required for a 100% rating on the Human Rights Campaign’s 2012 Corporate Equality Index, which is expected to be released in the coming weeks. The benefits are covered by the company’s existing insurance providers and apply to domestic employees, Newman said. Google is considering extending similar benefits to international employees, though it does not currently have a timeline for doing so.



While Google’s benefits track the updated criteria of HRC’s latest annual workplace equality survey, the Mountain View, Calif.-based company, which has active LGBT employee groups known as “Gayglers” in offices from Michigan to Singapore, also sees the move as part of a larger progressive strategy crucial to maintaining a competitive edge.



In June, Google joined a small but growing list of companies that offer additional salary for gay employees whose domestic-partner health insurance benefits are taxed as income by the federal government — a result of the discriminatory Defense of Marriage Act. In the practice, known in benefits parlance as “gross-ups,” employers reimburse workers for the added tax incurred, which averages around $1,069 a year, according to a 2007 study by UCLA’s Williams Institute. The tech giant Cisco and boutique hotel chain Kimpton also are among the handful of businesses that have adopted the policy.



Google began reevaluating its transgender health coverage more than a year before adding its gross-ups policy, Newman said, with discussions continuing throughout 2011 between Gaygler representatives, outside consultants, and Google’s executives and benefits team.



“We're always looking for new ways to create a more inclusive culture and support our employees,” said Sarah Stuart, program manager of Google’s global diversity and inclusion team. “The decision to improve our benefits for our LGBT employees started as a grassroots effort driven by the Gayglers, who worked closely with our benefits team.”

Other corporations with progressive records on transgender coverage have worked this year to achieve similar parity and will include additional benefits effective January 1, said Todd Solomon, an attorney in Chicago who specializes in LGBT employee benefits issues (he declined to name specific companies that have already implemented increased coverage or are preparing to do so, citing client confidentiality reasons).



“The companies I’m talking to who believe in fully inclusive benefits probably would have ended up doing this at some point anyway, though the [HRC] survey brought it to the forefront of their attention,” said Solomon, whose firm, McDermott Will & Emery, has also implemented comprehensive trans health benefits aligned with WPATH care standards. “This is certainly an emerging trend, and I expect many more employers to add this benefit in the coming year."



Last month Google joined Starbucks, Microsoft, and other American corporations in an amicus brief opposing DOMA, which they argue undermines workplace equality and hurts the bottom line, in part because of the byzantine accounting practices for gay employees versus straight employees that they are forced to implement.



Meanwhile, the cost of covering transgender-related health care benefits at Google is expected to be minimal for the company, which reported $8.5 billion in profits last year.



“Our assessment of most large companies shows that the cost of providing comprehensive benefits is negligible,” said Masen Davis, executive director of the Transgender Law Center in San Francisco, where transgender health benefits have been offered to city employees since 2001. Seattle and Portland, Ore. have recently followed suit for its municipal employees.



Newman said that Google used information on the number of employees who have previously taken advantage of transitioning procedure benefits under the smaller lifetime cap to project how many workers might use the enhanced benefit offerings. “While it's impossible to know exactly how many people will decide to use these new benefits, we decided that it was well worth the cost,” he said.



Beginning in June, Davis’ organization consulted with Google on expanding such health benefits — an initiative that never included questions of “if” or “why,” he said.



“We’ve never worked with a company so clearly dedicated to doing the best they can with transgender employees,” Davis said. “I would anticipate that what they’ve adopted will become the gold standard in the United States.”



In addition to influencing benefits policy, the Gaygler groups have also promoted a fiercely LGBT-friendly face for Google in recent years, even in less progressive locales around the globe, company representatives said.



Google Singapore, which has a Gaygler chapter, was a first-time sponsor in 2011 of the annual Pink Dot event, attended in June by over 10,000 people in the city’s Hong Lim Park. Sex between men remains illegal in the country, with penalties of up to two years’ imprisonment (Newman said the company carefully considers safety concerns for its employees when deciding whether to officially sponsor pride events around the world).



“In places where opinions about LGBT people aren’t as favorable, where it’s not as normal for gay people to be out, these chapters have really made a difference,” said Matt Yalowitz, a senior policy analyst at Google who helped launch the company’s Ann Arbor, Mich., Gaygler chapter in 2007. “People have told us that if there hadn’t been a Gaylger group in their office, they simply wouldn’t have felt comfortable being at out work.”

