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Let’s talk about health equity for LGBTQ+ employees

Explore the significance of health equity for LGBTQ+ employees in the workplace. This article highlights barriers to healthcare access, offers actionable recommendations for employers, and emphasizes the need for inclusive policies to foster a supportive and equitable work environment for all.

06/10/2025 · 9 minute read

Discover the importance of health equity for LGBTQ+ employees, barriers to care, and actionable steps for employers to create an inclusive workplace.

They may not always be vocalizing it, but many employees are struggling: delaying care, feeling unwell or navigating systems that aren’t built for the complexity of their lives.

What’s needed now isn’t louder messaging, but a renewed focus on health equity that meets real needs more effectively — not only for LGBTQ+ employees, but across the entire workforce.

Despite good intentions and well-resourced programs, the structures that are supposed to help employees thrive at work aren’t benefiting everyone equally. And while the symptoms of this disconnect may vary by region or population, the larger trend is clear: support isn’t always reaching the people who need it most.

New global research from Mercer Marsh Benefits’ 2025 Health on Demand confirms what many employers already suspect: well-being is slipping across the board. Just 74% of employees report feeling physically and mentally well — a steep drop from 82% just two years ago. Nearly eight in ten say they’ve delayed healthcare in the past two years, often due to cost, time or uncertainty about where to turn.

LGBTQ+ employees are sending a warning signal

Health challenges aren’t limited to one group or geography. They affect employees managing chronic conditions or disabilities, navigating menopause or caregiving for loved ones. They show up among workers with stigmatized mental health concerns, those balancing multiple jobs or time zones, and those who are more reluctant to disclose personal details in order to access care.

But one group in particular is sending a sharp signal and offering a powerful place for employers to learn and act.

Mercer Marsh Benefits’ 2025 Health on Demand research looked deeper into the LGBTQ+ experience for workers in Australia, Brazil, Canada, Colombia, Costa Rica, the Dominican Republic, India, Italy, Mexico, the Netherlands, Spain, the UK and the US.1 We found these employees are most likely to feel unwell, delay treatment, experience financial hardship and consider leaving their jobs.

Consider the following data:

  • 87% of LGBTQ+ employees have delayed healthcare in the past two years — 30% due to fear, anxiety or embarrassment.
  • 53% feel stressed in everyday life, and 49% feel stressed most days at work.
  • Only 68% trust their employer to address a safety concern — compared to 73% of their heterosexual peers.

LGBTQ+ employees also report a lower sense of belonging and are more likely to feel they aren’t treated fairly or supported consistently at work compared to their straight peers. And nearly one in two say they are actively looking for a new job.

What’s happening to LGBTQ+ workers is a preview of what happens when benefits strategies don’t flex, adapt or reach the people they’re meant to support. By tuning into these signals, employers can better identify where gaps are forming and start to address them in ways that benefit the whole workforce — elevating the experience of all employees.

Equity in health benefits: a lens for global workforce support

When support doesn’t reach the people who need it, it’s often not a matter of budget or intent — but a matter of structure. That’s where health equity comes in.

Health equity is about understanding and addressing the lived barriers — financial, cultural, emotional or logistical — that keep people from accessing care, building stability or thriving at work. It’s about recognizing that not everyone starts from the same place and designing support that balances that.

Defining health equity

Health equity is the attainment of the highest level of health for all people, where everyone has a fair and just opportunity to attain their optimal health regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language or other factors that affect access to care and health outcomes.

Equity in health benefits allows organizations to:

  • Adapt strategies across different legal, cultural and geographic realities.
  • Offer personalization without requiring employees to self-identify.
  • Take meaningful action, even in places where public advocacy isn’t possible.

In that sense, health equity is deeply human. And it’s often invisible in the best way — meeting people, where they are, without fanfare or force, and making a tangible difference in their daily lives.

5 ways to build better health equity

For global employers, health equity offers a path to act with care and purpose across varied legal and cultural contexts, removing friction so that more people can access the support already intended for them.

Here are five areas where many organizations can make effective progress:

When support is rigid, it can unintentionally exclude the very people it’s meant to help. Employees today don’t fit a single mold, and their benefits shouldn’t either. Creating opportunities for people to access support in ways that match their lives, without requiring personal disclosure, can go a long way toward building trust.

Health on Demand found that 78% of all employees who could personalize their benefits said their employer cared about their well-being, compared to just 29% of those who couldn’t. And LGBTQ+ employees ranked flexible schedules and work locations as well as personalized mental health resources among their top needed supports at work.

Actions to consider:

  • Offer modular benefits with various eligibility criteria.
  • Work with third-party advisors for a more objective perspective on how your policies impact internal communities.
  • Promote inclusive, digital-first care tools.
  • Allow employees to tailor support without declaring personal identity.

By embracing a flexible and personalized approach to support, organizations can not only enhance employee satisfaction and trust but also foster a more inclusive workplace where every individual feels valued and empowered to thrive.

Healthcare access means little if it’s financially out of reach. While affordability is a concern for nearly every employee, it weighs more heavily on those with fewer financial buffers. Only 78% of all employees in our 2025 data said they feel confident they can afford the care their family needs.

LGBTQ+ employees in particular reported higher rates of financial anxiety about housing (58% vs. 48% of heterosexual peers), retirement (57% vs. 53%) and everyday expenses (56% vs. 47%) — such as costly anti-HIV medication — highlighting how financial insecurity and health access are deeply intertwined.

Actions to consider:

  • Offer health coverage navigators or discount programs to improve access and utilization of benefits across communities.
  • Expand access to emergency savings tools.
  • Provide targeted financial wellness education and support.

By prioritizing affordable care, organizations can help alleviate financial stress and create a workplace where all individuals can access the care they need without compromising their financial stability.

Mental and emotional well-being remains one of the most pressing — and uneven — areas of the employee experience. LGBTQ+ workers continue to report elevated stress, isolation and emotional fatigue, and many delay care due to fear or stigma.

For example, LGBTQ+ employees are more likely to report daily work-related stress (49% vs. 42% of heterosexual peers). They struggle more with loneliness (43% vs. 34%) and tend to worry more about mental or emotional decline (55% vs. 46%). When mental health support is embedded into workplace culture and offered confidentially, it becomes one of the most valued and impactful resources employers can offer. 

Actions to consider:

  • Normalize mental health conversations through manager training.
  • Expand confidential access to trauma-informed care.
  • Use digital tools to screen, support, and build resilience proactively.

Fostering an inclusive culture that prioritizes mental health and psychological safety is essential for creating a supportive and resilient workplace environment for all employees.

Health equity means designing for the full arc of a person’s life, not just responding when something goes wrong. For LGBTQ+ employees, aging can come with added challenges: fewer or non-existent inclusive caregiving resources, less family support and a heightened risk of social isolation. LGBTQ+ employees are more likely to be concerned about physical health decline (53% vs. 47% of their heterosexual peers).

They are also more likely to be concerned about long-term physical and financial security and worry about affordable child or elder care (50% vs 45%) as they age — making it essential that benefit programs reflect these realities.

Actions to consider:

  • Offer long-term care and caregiving planning tools.
  • Design benefits that account for non-traditional family structures.
  • Provide navigation support for aging, caregiving and planning transitions.

By proactively addressing the lifelong health needs of all employees, organizations can create a more supportive environment that allows individuals to succeed at every stage of their lives, rather than merely reacting to crises as they arise.

Fostering an inclusive workplace is essential for creating an environment where every individual feels valued and empowered, regardless of their unique needs. Although legal, cultural and regional limitations vary widely, employers can embed equity and safety into their benefit structures.

Health on Demand revealed that LGBTQ+ workers remain less likely to feel secure, supported or that their concerns will be addressed. Closing that gap doesn’t require grand gestures from employers, but rather thoughtful design and an ongoing commitment to inclusivity and supportive environments for all.

Additionally, LGBTQ+ employees are less likely to feel they’re treated fairly (67% vs. 72% of heterosexual peers), and to trust that safety concerns will be addressed (68% vs. 73%) — all of which culminates in a less strong sense of belonging in their organizations (65% vs. 71%).

Actions to consider:

  • Use gender-neutral, inclusive language in benefits materials.
  • Audit benefit utilization to identify unseen gaps.
  • Offer all resources universally, without identity-based gating.

Employers may not be able to solve for every global or social challenge facing their employees. But by making health equity a foundational priority, they can help reduce risk, increase trust, and support them in accessible ways that matter. And that ultimately lifts up the experience of all employees.

Shifting the focus to what’s possible

Not every organization will, or should, celebrate Pride Month in the same way. But any employer can take this moment to reflect on how well their systems are meeting the true needs of their people’s lives and act to improve them.

The experience of LGBTQ+ employees is offering us insight, not only into where support is missing for them, but into how we can do better for all employees.

It is far from a new idea, but health equity might still be the most overlooked tool employers have to strengthen trust, impact, and care. If we approach equity in health thoughtfully through this lens, building benefits that are more flexible, human and grounded in real-world realities, we don’t just lift up the most vulnerable. We build workplaces that work better for everyone.

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Report

Health on Demand 2025

Smarter benefits, stronger workforce

Global research of over 18,000 employees across all levels captures views on their health and well-being priorities, concerns and values.

Explore the report

1 n= 749 individuals, 6% of employees in those markets. Equal country weighting was given to the data reported here. Mercer Marsh Benefits. “Health on Demand 2025,” available at Health on Demand 2025 | Mercer Marsh Benefits | Marsh

Our people

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Jennifer Schmidt

Partner and Innovation Leader | Mercer Marsh Benefits

  • Canada

Vickki Walton

Vikki Walton

Health Equity Leader, US Mercer

  • United States

Harrison Pope

Harrison Pope

Client Manager and Commercial Strategist, Mercer Global Pride Co-Chair, Mercer

  • Canada

Key solutions

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Employee health & benefits
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Ensuring benefits meet the needs of all employees

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Workforce resilience and wellbeing

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