Managing Employee Gender Transition in the Workplace

Gender transitions are generally guided by internationally accepted medical standards of care for gender identity disorders that are designed to ensure success. The process can, but does not necessarily, involve the following steps — the duration and order of which vary depending on the person and the guidance of their health provider.

  • Psychological and overall health evaluation to rule out other diagnoses.
  • Ongoing mental health counseling to assess the extent of the condition and understand options, consequences and obstacles.
  • Hormone therapy generally attributed to the person’s new gender (e.g.: testosterone for transmen or estrogen and testosterone blockers for transwomen).
  • Continued medical supervision to assess hormone-induced physical changes.
  • The “Real Life Experience” of living and presenting in the person’s new gender identity on a full-time basis for a duration determined by the person’s health provider to ascertain level of comfort in reassigned gender. Most transgender employees will approach management about their transition at this stage of the process.
  • Continued hormone administration and life in the reassigned gender may be accompanied by surgery to adjust primary and secondary sex characteristics, facial structure, etc. 
    Note: A transgender person’s pursuit of surgery tends to become a central focus of a person’s transition. Medical treatment related to a gender transition should be treated with the same confidentiality as other medical treatments.

Overwhelmingly, gender transitions successfully allow people to live a well-adjusted life in the gender consistent with their gender identity. The degree of success, however, is strongly influenced by a person’s ability to maintain a stable job and income during transition, and the support level of the work environment.

Gender Transition Guidelines

Employers that establish and utilize gender transition guidelines proactively will be most prepared to provide a supportive work environment for transitioning employees and their colleagues.

Figure. Example timeline for a transitioning employee (transitions will vary based on the person).

Standards of Care

The most well-known standards of care for transitioning people are maintained by the World Professional Association for Transgender Health (formerly known as the Harry Benjamin International Gender Dysphoria Association), whose standards have been in use since 1979. "Standards of Care, Sixth Edition" outlines commonly accepted treatments and procedures that health professionals may follow when assisting people through gender transition.

Another increasingly common protocol is known as "Informed Consent." Through this protocol, transgender people are made aware of the effects of medical treatment and then asked to consent, much like other medical procedures. Some health providers supervise medical transitions through a combination of both protocols.

Medical treatment for transitioning people follows commonly accepted practice; treatment should be considered medically necessary and covered under health insurance plans.