How to buy long-term disability insurance as a transgender person


Adam Cecil

Adam Cecil

Former Staff Writer

Adam Cecil is a former staff writer for Policygenius, a digital insurance brokerage trying to make sense of insurance for consumers. He is a podcast producer, writer, and video maker based in Brooklyn, NY.

Updated December 16, 2021 | 2 min read

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Long-term disability (LTD) insurance is one of the most important types of insurance for working people looking to insure their income in case of a long period of illness or a physical accident.

Buying long-term disability insurance as a transgender person may seem complicated, so let’s start off with the most important piece of advice: talk to an agent who understands the nuances, like one of the agents at Policygenius. There are really big differences on how different insurance insurers treat transgender applicants, and the best way to navigate it is with a licensed agent by your side.

How insurers underwrite transgender applicants

The biggest difference between insurers is that some will only price out your policy based on the gender assigned to you at birth, and not your actual gender. Insurers that price based on your actual gender tend to do so with some caveats. You’ll likely need to prove some kind of medical transition, whether that means a surgical procedure (vaginoplasty, phalloplasty, mastectomy, etc.) or hormone therapy.

If you haven’t had any surgeries or undergone hormone therapy, an insurer would likely give you a quote based on the gender assigned to you at birth.

Additionally, many insurers limit benefit periods for transgender applicants to five years. This means that if you have a disability that lasts for longer than five years, your LTD policy would stop covering you. While this is an annoying limitation, it’s not the worst modification – the average disability claim lasts three years, and we recommend that many applicants reduce their benefit period in order to reduce the cost of their policy.

The cost of coverage for transgender applicants

Some insurers may add an additional premium charge to reflect the general uncertainty that they feel around transgender applicants and their chances of disability. Your agent can help you avoid these insurers, and help you reassess your application if an insurer attempts to charge a higher premium.

Your rates will also depend on your individual medical history. Many transgender applicants have a history of depression or anxiety, and if this describes your medical history, you should be prepared for your insurer to exclude any mental health disorder from your disability policy. (Mental health exclusions are one of the most common exclusions across all applicants.)

“The most important thing for transgender applicants is to get coverage for the most common disability claims,” says Policygenius disability agent R. Tyler End, CFP. While many people think of a disability as being caused by a workplace accident, most claims are actually a disease or long-term illness. One in four people suffer a disability before they retire, and most of the time, it’s caused by a musculoskeletal disorder, a nervous-system issue, cardiovascular disease, or cancer.