By complying with the HRC’s controversial demands, American Water increases the risk of dividing employees, alienating customers and harming shareholders. The company covers transgender-related medical costs for its employees and their children. It also uses sex and gender ideology criteria in employee recruitment, vendor selection, marketing, and philanthropic support. American Water uses its reputation, corporate funds, and political influence to support controversial sex and gender ideologies, organizations, and legislation. The company's CEO signed the CEO Action for Diversity & Inclusion pledge and has donated to the National Urban League. American Water is a corporate partner of the National LGBT Chamber of Commerce. For these reasons, American Water receives a High Risk rating.