As companies beef up benefits in a tight labor market, Massachusetts Mutual Life Insurance Company is one of a rapidly growing number of companies improving coverage for transgender workers.

About 10 percent of companies pay for sex reassignment surgery, according to research by the Society for Human Resource Management. MassMutual has since 2014; It's adding subsidies for cosmetic procedures, such as electrolysis, mastectomy, and Adam's apple reduction surgery — a rarer benefit that an estimated 3 percent of companies provide.

"Our goal was to make sure that our benefits strategy was inclusive," said Dr. Claudia Coplein, the chief medical and wellness officer at MassMutual. "Our definition of inclusiveness has really evolved as society has evolved."

As the labor market has tightened in recent years, companies have boosted their benefits as a way to attract and retain workers. With millennials aging into parenthood, the priority has been benefits that make it easier to care for young children.

But coverage for transgender workers is becoming more common too. The number of companies that pay for sex reassignment surgery doubled from 2015, according to SHRM. Earlier this year Starbucks, also on a benefits spree, announced expanded coverage for transgender workers and now includes some cosmetic procedures as well.

The medical costs of a physical transition add up quickly: Dana Pizzuti, author of Transitioning in the Workplace, said she paid $100,000 out of pocket. Few employees are likely to use the benefit. An estimated six out of every 1,000 Americans is transgender, and an even smaller percentage is seeking related medical care.

But offering coverage can also serve as a signal to transgender workers and other employees. "It's a question between having a neutral atmosphere and a supportive atmosphere," said Thomas Delano, a Project Leader at Boston Consulting Group. "If nothing is being said they cannot really assume that it's safe for them to actually come out in the workplace."

A recent BCG survey of more than 4,000 lesbian, gay, bisexual and transgender workers worldwide found that 35 percent think coming out at work could hurt their careers. Transgender workers, the survey found, were less likely to be out than other LGBT workers.

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Companies beefing up benefits for transgender workers

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