Equal pay is impossible without equal fertility benefits

Wage inequality is rooted in a complex maze of historical systemic problems including sexual harassment, racial discrimination, and prejudice against those who are LGBTQ+

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Wage inequality is rooted in a complex maze of historical systemic problems including sexual harassment, racial discrimination, and prejudice against those who are LGBTQ+. Though we’ve made progress over the years, both gender and sexual orientation wage gaps persist. Studies have found that on average, men in same-sex couples earn 10% to 32% less than heterosexual men, and women earn less than both straight and gay men.

Many biases exacerbate this inequality—a huge one that’s often overlooked is fertility benefits. Equal pay is impossible without equal access to fertility benefits. Equal pay must factor in the monetary value of what is included and excluded from employer-sponsored healthcare coverage.

The high costs of fertility care disproportionately fall on single women and LGBTQ+ people, who often end up paying tens of thousands of dollars out-of-pocket for services like egg freezing and surrogacy. Some turn to loans—a dangerous choice since medical debt is the number one reason Americans file for bankruptcy. Without employer-sponsored fertility benefits to help level the playing field, many people face harsh long-term financial implications on top of already deficient wages.

This absence of fertility benefits has far-reaching financial repercussions. It cost me more than $150,000 in potential earnings, eliminated most of my retirement savings, and limited my options for major purchases like a house or a car. I felt let down by my employer and victimized by the healthcare system—I just wanted to freeze my eggs, not cryogenically preserve my whole body for millions of years.

Others face even harsher financial barriers to fertility care. For example, gay couples who seek donor eggs or surrogates must pay for legal services, a donor agency, a surrogate or gestational carrier, travel expenses, in vitro fertilization, medication, and pregnancy, which can cost a total of more than $100,000 and take several years. Most gay men in the US who can afford these treatments and services pay for them out-of-pocket while earning 10–32% less than their heterosexual counterparts.

Fertility is a fundamental part of healthcare. So fertility care should be accessible to everyone regardless of age, sex, sexual orientation, gender identity, expression, or marital status. This Pride Month, we can all help close the wage gap by fighting for inclusive fertility benefits. Here’s how:

As an employee, know your negotiating power. Ask your company’s HR leader whether the company offers fertility benefits and, if so, whether there are any restrictions to care. Some plans cannot be unlocked without a formal medical infertility diagnosis—which only describes heterosexual couples who try and fail to get pregnant for 12 months.

Though companies cannot—and should not—break the bank to provide financial coverage for fertility care, every company can provide some coverage. As an employer, take the first step to evaluate where you stand in the industry to help make the case for fertility benefits at work. Carrot can help you learn what similar companies are doing to attract and retain talent, control healthcare costs with a managed fertility care program, and establish inclusive workplace policies.

Equal pay is impossible without equal access to fertility benefits—but both are well within our reach. Let’s work together to accelerate widespread access to fertility benefits and get one step closer to wage equity for all.

Tammy Sun is the co-founder and CEO of Carrot, a company that offers a global fertility benefits solution for US multinational employers. Services include financial coverage and expert care navigation for treatments like egg freezing, IVF, surrogacy, adoption, and more. Learn more at

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