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.

Published November 20, 2017|3 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. Whether you’re a surgeon, lawyer, rabbi, or trucker, long-term disability insurance is a smart choice to protect you, your family, and anyone else that relies on your income.

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 carriers treat transgender applicants, and the best way to navigate it is with a licensed agent by your side.

As you can probably guess, the biggest difference between carriers is that some will only price out your policy based on the gender assigned to you at birth. This is largely because unlike other forms of insurance, there is a larger price difference between disability insurance rates for men and women. (Like other forms of insurance, there isn’t an option for non-binary applicants. You’ll have to apply as male or female to get a policy.)

Carriers 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. Depending on where you are with a medical transition, a carrier may want you to complete certain procedures before they make you an offer. This will depend on your individual medical record, and is hard to speak about generally – the intricacies of this requirement are best navigated with a licensed agent. The underwriting process will also feature a full review of any surgeries or hormone therapies as part of a review of your full medical record. This is standard for all applicants.

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

Additionally, many carriers 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.

On top of all that, some carriers 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 carriers, and help you reassess your application if a carrier 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 carrier 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.

To learn more about disability insurance, visit our Disability Insurance Learn Center, where you can learn more about how disability insurance works.