Some of America’s biggest firms offer their employees medical insurance to cover gender reassignment.

Companies including Coca Cola, American Express and Yahoo! would prefer to pay out rather than lose valuable employees.

More firms are expected to offer the benefit this year because the Human Rights Campaign’s annual Corporate Equality Index is to require companies seeking a 100 per cent rating to offer staff medical insurance which includes at least $75,000 worth of transgender surgery and other treatments.

Stephanie Battaglino, an assistant vice president at New York Life, began transition five years ago, making her the first employee at her firm to do so.

She borrowed from her retirement fund to pay for her treatment but is now encouraging New York Life to offer medical insurance which covers gender reassignment.

Ms Battaglino said that the company was concerned about the cost until she explained that only two or three people would take advantage of the scheme.

“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 told Associated Press.

Transgender advocates say that companies should view transgender treatment in the same way as the American Medical Association does – as medically necessary rather than optional.