American Express Shareholders Reject Proposal Calling for Review of Gender-Affirming Care Coverage for Minors

American Express shareholders voted down Proposal 4 at the company's annual shareholders’ meeting, which occurred on or before Tuesday, May 5, 2026. 57 percent of votes against it. The measure had asked the American Express Board of Directors to analyze and report on the legal, regulatory, political, reputational, and other relevant risks of providing transgender treatments for minors on its healthcare plans.

The American Express Board of Directors recommended a no vote on Proposal 4. The board stated that its healthcare plan selection process already incorporates consideration of relevant risks. American Express has neither confirmed nor denied that gender-affirming care is included in its employee-benefits plans.

The Human Rights Campaign gave American Express a perfect score of 100 on its 2026 Corporate Equality Index. American Express Company reported that it adopted radical adolescent transgender treatments recommended by the World Professional Association for Transgender Health (WPATH), according to that index. The American Express Board stated that it no longer participates in the HRC survey.

The HRC’s 2026 index said American Express has not yet submitted a 2026 CEI survey. The latest HRC Corporate Equality Index score for American Express is based on responses from previous years. com reported these details from the shareholder meeting and related statements.

The conservative Alliance Defending Freedom was part of a coalition that filed 74 shareholder resolutions in the 2024-25 season aimed at challenging left-wing corporate cancel culture. Tim Schwarzenberger, director of corporate engagement for Inspire Investing, addressed the vote outcome. "This result is not surprising at all.

When you start seeing vote outcomes approaching 99% against proposals identifying legitimate company risks, it raises serious questions about how concentrated and institutionalized the proxy voting system has become and whether the process still reflects genuine shareholder democracy rather than the type of predetermined outcomes more commonly associated with authoritarian regimes," he said.

Inspire Investing has been actively pushing for proxy reform for years, particularly pass-through proxy voting. Jeremy Tedesco, vice president of the ADF’s Counter Censorship Task Force, also reacted to the results.

"Paying for the sterilization of children by covering so-called ’sex change’ operations of minors is unacceptable. This result is a reflection of a problematic system rather than shareholder sentiment. American Express and every company should stop covering these harmful, legally risky procedures that irreparably harm young women and girls," he said.

The proposal's backers viewed the near-unanimous rejection as evidence of broader issues in how institutional investors influence corporate decisions on social matters. Supporters had hoped the resolution would prompt greater transparency from American Express on its benefits policies.

The company's stance that existing processes already address risks stood in contrast to the coalition's push for a dedicated review.