Want a sex change? Work for Coke: How America's biggest corporations are paying for transgender surgeries
They're among the biggest corporations in the world, largely because they do what it takes to stay competitive.
So when some of Wall Street's biggest names were faced with losing valuable employees, or paying thousands to reassign their genders, it was an easy decision.
Now corporate giants such as Coca Cola, Yahoo!, American Express and AT&T are expanding their insurance coverage to meet the needs of transgender employees.
Gina Duncan, who underwent a transgender reassignment surgery four years ago with the help of her employer Wells Fargo
The trend has been growing quietly. But it is set to spike this year when the Human Rights Campaign, America's largest gay rights advocacy group, raises the bar in its annual corporate diversity card.
Large companies covet a 100 per cent rating in the HRC's Corporate Equality Index.
But to achieve that when the next one is published in the fall, companies will have to offer at least one insurance plan that covers at least $75,000 worth of transgender surgery and other treatments recommended by a patient's doctor.
Some companies, New York Life Insurance among them, balked at the programme at first - often for financial reasons.
Stephanie Battaglino, an assistant vice president at New York Life, started her transition five years ago, becoming the first New York Life employee to do so openly.
To finance her surgeries, which were on a list of procedures not covered by insurance, the 52-year-old borrowed from her retirement account.
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'I've often said to friends, "My transition at work went really, really smoothly, and if I had to do it again, the only thing I would change would be if I had my surgery covered,"' she said.
Now she is working with a senior executive at her company to add transgender health benefits to the employee insurance plan.
'To know it was covered and completely reimbursed would have cast everything in a much different light,' she said.
The company initially was uncomfortable agreeing to $75,000 of allowable coverage, she said.
But she said that concern was alleviated when it was explained that only two or three employees would likely need the benefits.
'The big misconception is we are going to go broke and all these transgender people are going to come out of the woodwork asking for gender reassignment surgery,' she said.
'We understand people simply get appendicitis, and it is something our community deals with through insurance... That's what we need to understand about transsexualism.'
Now some businesses see covering the cost of transgender surgery as not only an important human resources statement, but good business sense.
Joanne Herman, the author of 'Transgender Explained For Those Who Are Not,' said such surgeries are not merely cosmetic.
People with untreated Gender Identity Disorder are at high risk of suicide and those who get treatment become better workers.
'If you are transsexual, living as anything other than that is a very bleak experience,' she said.
'Wells Fargo elected to offer this benefit to be competitive as an employer and also to support our comprehensive corporate commitment to diversity,' company spokesman Mary Eshet said.
Employee Gina Duncan was one of the first at the San Francisco-based bank to take advantage of the benefits offered.
The bank included breast augmentation and genital reconstruction as coverable expenses under its employee health plan.
She was even assigned a benefits specialist to walk her through the process.
'They had a template in place, and it was surprisingly supporting and mentally encouraging,' said Duncan, 55, who four years later still works for Wells Fargo.
'So much of what I'd heard involved people who ended up losing their job, losing their family, losing their friends, becoming destitute.'
The trend follows a concerted push by transgender rights advocates to get employers and insurers to see sex reassignment the way the American Medical Association does - as a medically indicated rather than an optional procedure.
'We understand people simply get appendicitis, and it is something our community deals with through insurance,' said Andre Wilson, who counsels companies on transgender issues as a senior consultant with San Francisco-based Jamison Green & Associates.
'That's what we need to understand about transsexualism.
'Not everybody will be diagnosed with Gender Identity Disorder, and in fact, few people will be. But the people who are diagnosed with it really need treatment.'
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