• Home
  • Latest
  • Fortune 500
  • Finance
  • Tech
  • Leadership
  • Lifestyle
  • Rankings
  • Multimedia
CommentaryFertility benefits

In their rush to offer fertility benefits, employers could be unwittingly creating a new inequity for LGTBQIA+ employees

By
Janet Choi
Janet Choi
and
Cynthia McEwen
Cynthia McEwen
Down Arrow Button Icon
By
Janet Choi
Janet Choi
and
Cynthia McEwen
Cynthia McEwen
Down Arrow Button Icon
July 21, 2023, 11:20 AM ET
63% of LGBTQIA+ individuals will rely on different combinations of fertility treatments and resources to build their families.
63% of LGBTQIA+ individuals will rely on different combinations of fertility treatments and resources to build their families.

Infertility is on the rise. This year, the World Health Organization (WHO) reported that 1 in 6 individuals around the world are impacted. It is no surprise that demand for fertility and family-building benefits shows no signs of slowing down: 54% of the biggest U.S. employers, those with 20,000 workers or more, covered IVF in 2022–up 36% from 2015, according to Mercer.

But in their haste to keep up with these trends, many companies are inadvertently excluding their LGBTQIA+ employees from these crucial benefits: 63% of LGBTQIA+ individuals will rely on different combinations of fertility treatments and resources to build their families.

The fine print on traditional healthcare plans leaves LGBTQIA+ employees behind

Underlying many progressive benefits plans that include coverage of fertility and family-building services is a requirement for individuals to receive a “medical diagnosis of infertility” to access care. However, these policies are often discriminatory, as they usually define infertility as six to 12 months of unprotected, heterosexual sex without successful conception. This policy excludes same-sex couples who are hoping to build their families (along with single parents by choice) from these vital resources.

According to a Progyny survey of 1,000 individuals who identify as part of the LGBTQIA+ community, while 40% of those surveyed have health insurance that covers fertility treatment and family-building services, 68% of respondents with coverage for fertility treatment are unable to access the benefits without pre-certification or a medical diagnosis of infertility.

Exclusive fertility benefits can exacerbate health and economic disparities

Family-building is not a one-size-fits-all journey for anyone, and it is especially unique for the LGBTQIA+ population. Each member of this community will rely on a combination of assisted reproductive technologies and resources to have children. Without insurance, the journey can cost upwards of $200,000.

Building a family or undergoing fertility treatment without coverage is risky–valid concerns over costs can lead individuals to take on debt in order to access services and/or seek less clinically sound advice in order to conceive.

Data from the same Progyny survey shows that of those trying to expand their families, 77% indicated they’re worried about the cost of doing so, and 81% indicated they would take on a second job to lock down employer-sponsored family-building care. To maximize the chances of success with limited benefits, many individuals cut corners, potentially jeopardizing their health. For example, transferring multiple embryos during IVF has often been a workaround to increase the chances of a successful pregnancy, but unfortunately, this path does not actually improve overall rates. Instead, transferring multiple embryos drives up the likelihood of conceiving multiples which can ultimately lead to a higher rate of medical complications, like miscarriages and preterm deliveries.

LGBTQIA+ individuals already face socioeconomic disadvantages compared to heterosexuals: earning 89 cents for every dollar earned by a heterosexual worker–with income disparities increasing for LGBTQIA+ workers who are people of color, women, or transgender. The innate desire to build a family should not jeopardize one’s physical or economic health, but for many, there is no other option.

What employers can do to ensure their healthcare benefits are inclusive

It is imperative that leaders eliminate the inequities in coverage to make a permanent impact on the health of their employees–and their organizations. There are tangible, positive benefits for companies that can be achieved by closing the equity gap on fertility and family-building benefits. After all, limited and inequitable access to care has been known to lead to less productivity in the workplace, and complications in treatment can result in more missed days from work.

Employers need to educate themselves about LGBTQIA+ culture, history, and current issues–staying up to date on the latest legislation impacting this community will help to ensure that your workplace and health benefits are actively inclusive. Employers and HR leaders must have a comprehensive understanding of the ins and outs of the benefits that they are providing to avoid implementing the limits often embedded into traditional insurance plans. As plan sponsors, these decision-makers must take care to address the needs of their employees who have been historically marginalized, discriminated against, or are currently experiencing health care or income inequities.

Employers have the potential to make a critical difference in the lives of their LGBTQIA+ employees by providing inclusive, non-discriminatory fertility and family-building benefits. Equitable and inclusive family-building benefits will send positive ripple effects through a company’s entire culture–and, eventually, healthcare at large.

Janet Choi, M.D., is Progyny’s chief medical officer. Cynthia McEwen is VP of people and head of DEI at Progyny.

The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.

More must-read commentary published by Fortune:

  • ‘The global economy is due for a reality check,’ warns the central banks‘ bank
  • A much-feared emerging markets crisis didn’t happen. Is the global economy off the hook?
  • ‘The Feckless 400’: These companies are still doing business in Russia–and funding Putin’s war
  • Great Place To Work CEO: ‘It’s time to acknowledge why diversity makes us uncomfortable’
Join us at the Fortune Workplace Innovation Summit May 19–20, 2026, in Atlanta. The next era of workplace innovation is here—and the old playbook is being rewritten. At this exclusive, high-energy event, the world’s most innovative leaders will convene to explore how AI, humanity, and strategy converge to redefine, again, the future of work. Register now.
About the Authors
By Janet Choi
See full bioRight Arrow Button Icon
By Cynthia McEwen
See full bioRight Arrow Button Icon

Latest in Commentary

Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025

Most Popular

Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Finance
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam
By Fortune Editors
October 20, 2025
Fortune Secondary Logo
Rankings
  • 100 Best Companies
  • Fortune 500
  • Global 500
  • Fortune 500 Europe
  • Most Powerful Women
  • Future 50
  • World’s Most Admired Companies
  • See All Rankings
Sections
  • Finance
  • Fortune Crypto
  • Features
  • Leadership
  • Health
  • Commentary
  • Success
  • Retail
  • Mpw
  • Tech
  • Lifestyle
  • CEO Initiative
  • Asia
  • Politics
  • Conferences
  • Europe
  • Newsletters
  • Personal Finance
  • Environment
  • Magazine
  • Education
Customer Support
  • Frequently Asked Questions
  • Customer Service Portal
  • Privacy Policy
  • Terms Of Use
  • Single Issues For Purchase
  • International Print
Commercial Services
  • Advertising
  • Fortune Brand Studio
  • Fortune Analytics
  • Fortune Conferences
  • Business Development
  • Group Subscriptions
About Us
  • About Us
  • Editorial Calendar
  • Press Center
  • Work At Fortune
  • Diversity And Inclusion
  • Terms And Conditions
  • Site Map
  • About Us
  • Editorial Calendar
  • Press Center
  • Work At Fortune
  • Diversity And Inclusion
  • Terms And Conditions
  • Site Map
  • Facebook icon
  • Twitter icon
  • LinkedIn icon
  • Instagram icon
  • Pinterest icon

Latest in Commentary

retirement
CommentaryRetirement
Our retirement system gets a C-plus; policymakers have an opportunity to make it A grade
By Chris MahoneyMarch 25, 2026
6 hours ago
david-f
CommentaryVenture Capital
Europe has survived 3 energy shocks in 4 years. The only way out is to stop buying power from its enemies
By David FrykmanMarch 25, 2026
7 hours ago
fauci
CommentaryCOVID-19 vaccines
How COVID turned America against science — and what it will take to win it back
By David Blumenthal and James A. MoroneMarch 24, 2026
1 day ago
alex
Commentarydisruption
AI’s disruption is a choice, not a forecast
By Alex StephanyMarch 24, 2026
1 day ago
trump
Commentarynational debt
The Treasury just declared the U.S. insolvent. The media missed it
By Steve H. Hanke and David M. WalkerMarch 23, 2026
2 days ago
kuo
CommentaryUnicorns
Alibaba.com President: The one-person unicorn is coming. AI is making it possible
By Kuo ZhangMarch 23, 2026
2 days ago

Most Popular

Magazine
The youngest-ever female CEO of a Fortune 500 company is fighting Trump's cuts to keep Medicaid strong
By Fortune EditorsMarch 24, 2026
1 day ago
Commentary
The Treasury just declared the U.S. insolvent. The media missed it
By Fortune EditorsMarch 23, 2026
2 days ago
Success
Palantir’s billionaire CEO says only two kinds of people will succeed in the AI era: trade workers — ‘or you’re neurodivergent’
By Fortune EditorsMarch 24, 2026
1 day ago
Energy
Nobel laureate Paul Krugman calls it 'treason': $580 million in suspicious oil futures traded minutes before Trump's Iran reversal
By Fortune EditorsMarch 24, 2026
21 hours ago
Economy
It took 200 years for national debt to hit $1 trillion. Annual interest alone now exceeds that—a 'crushing legacy we must reverse,' says budget chair
By Fortune EditorsMarch 23, 2026
2 days ago
Personal Finance
Current price of oil as of March 24, 2026
By Fortune EditorsMarch 24, 2026
1 day ago

© 2026 Fortune Media IP Limited. All Rights Reserved. Use of this site constitutes acceptance of our Terms of Use and Privacy Policy | CA Notice at Collection and Privacy Notice | Do Not Sell/Share My Personal Information
FORTUNE is a trademark of Fortune Media IP Limited, registered in the U.S. and other countries. FORTUNE may receive compensation for some links to products and services on this website. Offers may be subject to change without notice.