On 18 December 2025, the Employment Rights Act received Royal Assent. Among its provisions: Gender Equality Action Plans (GEAPs) for UK employers with 250 or more employees. Mandatory publication is currently expected from Spring 2027, with a voluntary phase that opened earlier in 2026. Approximately 10,000 large employers sit within scope, the same population required to publish gender pay gap data.

The statutory duty under the Act applies specifically to menopause (including perimenopause): employers must publish at least one action that supports affected employees. Government guidance encourages, but does not mandate, extension to other hormonal health conditions including endometriosis, PCOS, fibroids, and fertility.

The clinical dimension of the obligation

42% of UK employees undergoing fertility treatment report feeling pressure to remain at work throughout, the highest of any country surveyed. The annual cost of inadequate fertility workplace support alone is £217.3 million (Fertility Matters at Work, 2026). Hormonal health absenteeism costs the UK economy approximately £11 billion per year (NHS Confederation / London Economics, October 2024).

What the developing standard actually requires

Awareness frameworks address the employer's administrative obligations. The developing GEAP direction points toward the clinical layer that sits above awareness: understanding what employees are actually navigating, the intersection of treatment schedules, medication effects, and the psychological burden of cyclical or chronic conditions.

HHEI was founded precisely for this intersection: a CIC whose founding board holds primary care, occupational medicine, mental health, and secondary care. Multi-lens by composition, independent by structure.

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When clinical and occupational dimensions converge

Primary care manages the clinical presentation. The occupational dimension of hormonal health, how conditions affect working capacity and how workplaces affect clinical outcomes, is a distinct but complementary lens. Only 6.5% of GPs use the "may be fit for work with adjustments" option on fit notes, suggesting an opportunity for closer integration between clinical and occupational guidance.

What an integrated clinical approach contributes

An effective response to hormonal health conditions at work involves more than awareness. It connects the clinical understanding of hormonal health with the functional reality of how these conditions affect working life and mental wellbeing, holding those dimensions in the same conversation rather than in separate systems.

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What the data shows

HFEA data consistently shows that South Asian women have approximately 25% lower IVF success rates compared to White patients. Live birth rates per embryo transferred sit at 24% for South Asian women versus 32% for White women, a gap that has persisted across HFEA reporting cycles from 2017 to 2023.

The HFEA National Patient Survey 2024 found overall patient satisfaction at 73% nationally; for Asian patients, satisfaction was 50%, a 23-point deficit. Only 4% of egg donors in the UK are Asian, against a 15% patient utilisation rate.

The compounding factors

PCOS prevalence is disproportionately elevated in South Asian populations, reported at up to 52% in some cohorts. Vitamin D deficiency affects 72% of South Asian fertility patients versus 36% of White patients. Type 2 diabetes risk for South Asian individuals rises at a BMI of approximately 23.9, equivalent to a BMI of 30 in White populations.

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