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Transgender clients and disability insurance

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With Caitlyn Jenner’s big reveal in recent months, there’s been a lot media attention regarding her transformation and life as a transgender woman. Though her story’s been covered by everyone from Diane Sawyer, Vanity Fair, CNN and Fox News, there’s been little coverage about Jenner’s experience with insurance matters, an issue that many transgender men and women struggle with daily. 

In a recent article with CNN, Lourdes Ashley Hunter, national director of the Trans Women of Color Collective, discussed how there’s still a lot that needs to be done for the transgender community. In regard to Jenner, Hunter said the following: “Her celebrity status is great for visibility, but it can and will be used as a distraction from the lived experiences of trans folk who continue to battle discrimination when accessing basic needs such as housing, employment, education and health care.” 

Although the technical description of an insurance agent is “a person employed to sell insurance products,” it’s also an agent’s job to educate his or her clients on the products available and best suited to their client’s need. 

Whether those products are health, life, long-term care or disability insurance, it’s important than an agent is able to adequately explain everything from coverage and premiums to what can be expected from the application and underwriting process — for any client, including a client who is transgender.

For clients whose medical and psychological histories are extra sensitive, it’s equally crucial that agents are aware of the tools and resources available so clients are ensured a safe, positive experience. Because many agents haven’t written disability insurance for a transgender client, I asked two major DI carriers to provide some insight to the underwriting process in order to both educate and familiarize agents with the process of writing DI coverage on a transgender client. 

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Please note that each carrier’s response is slightly different, meaning that it’s up to the agent to find the appropriate carrier for his or her client. 

Carrier A: ”We would consider transgender clients the same as any other client coming in for coverage based on their particular medical history. With any client, if there is surgery planned, but not yet performed, we would in general postpone consideration until following the surgery, release from care and return to work full-time without restrictions. Post-surgery consideration would be based on any residual symptoms or problems as indicated in follow-up. Policies will be issued based on the gender the proposed insured has indicated on the application.” 

Carrier B: ”For underwriting purposes we underwrite based on the applicant’s gender at birth. During the underwriting process we want to make sure that they have stable employment, no associated psychiatric disorders, or drug and alcohol history. If untreated and all looks favorable, we may consider with just a gender re-assignment exclusion. However, if gender reassignment therapy is planned or contemplated, treated with or without hormone replacement therapy, we would postpone just as we would with any pending surgery. The surgery would need to be completed and the applicant would need to have returned to work on a full-time basis without residuals for consideration of coverage. 

“If therapy was partially completed with no plan to complete, treated with or without hormone replacement therapy, we would typically postpone coverage for the first 3 years and after 3 years may consider with a limited benefit period, extra premium and exclusion of gender re-assignment. If therapy procedures have been completed, without complications, treated with or without hormone replacement therapy, we would also postpone for the first 3 years, and after 3 years we may potentially consider with a limited benefit period, extra premium, and exclusion of gender re-assignment. We most likely would not offer FPO with these cases and there is a high potential for a mental disorder exclusion due to the psychological component that goes along with the decision for gender reassignment. Some jurisdictions have regulations and special laws, so each case would need to be reviewed with legal for input to determine the appropriate underwriting outcome.”