Transgender Applicants and SSDI: What You Need to Know (2025 Update)

Rules and RegulationsLGBTQ
Written By Jacky Writes

🌈 You Still Have the Right to Apply

Transgender and nonbinary people still have the same right as anyone else to apply for Social Security Disability Insurance (SSDI). The Social Security Administration (SSA) evaluates every disability claim based on medical evidence and functional limitations, not gender identity or transition status.

However, several federal policy changes in 2025 have affected how gender information appears in federal records and how some nondiscrimination protections are enforced. These changes don’t alter SSDI medical rules — but they can create new documentation challenges.

This guide explains what’s changed, what hasn’t, and how transgender applicants can navigate the current SSDI system with confidence.

⚠️ Key Federal Changes in 2025

  • Executive Order 14168 (Jan 2025) directs federal agencies to recognize only binary sex assigned at birth. Implementation is ongoing and under court review.

  • HHS Civil Rights Rescissions (Feb 2025) withdrew previous guidance interpreting Section 1557 of the Affordable Care Act and Section 504 of the Rehabilitation Act to include gender identity discrimination. Federal enforcement is limited, though some courts continue to uphold protections.

  • SSA Gender-Marker Halt (Jan 31, 2025): SSA stopped processing changes to the “sex” field on Social Security records. While this affects identification consistency, it does not change SSDI eligibility standards.

Bottom line: You can still apply for SSDI without disclosing gender identity unless it is medically relevant, but it may take extra care to keep records consistent.

⚙️ How SSA Decides Disability (and Where Transgender Applicants Fit In)

SSA reviews every disability claim through a standard five-step process that applies equally to all applicants — including transgender and nonbinary individuals. This structure ensures consistency and fairness in how medical and vocational evidence is evaluated.

Disability determinations are made by your state’s Disability Determination Services (DDS) following POMS DI 70050.000 and 20 C.F.R. §§ 404.1520–404.1569a. DDS examiners collect and assess medical evidence, may schedule consultative exams, and document decisions on Form SSA-831 (Disability Determination and Transmittal).

The Five Steps SSA Uses to Decide Disability

  1. Step 1 – Are you working above the SGA level?
    SSA checks if you earn more than the Substantial Gainful Activity (SGA) limit — $1,620 per month in 2025 (higher if you’re blind). If you earn less, the claim proceeds.

  2. Step 2 – Is your condition severe?
    The impairment must significantly limit your ability to perform basic work activities and be expected to last at least 12 months or result in death.

  3. Step 3 – Does your condition meet or equal a Blue Book listing?
    SSA compares your evidence to the Blue Book.

    • Listings 12.04, 12.06, 12.15 cover depression, anxiety, PTSD.

    • Listings 1.00, 6.00, 8.00 may apply to post-surgical complications.
      If your impairment meets or equals a listing, you may be found disabled here.

  4. Step 4 – Can you do any of your past work?
    DDS establishes your Residual Functional Capacity (RFC) — what you can still do physically and mentally — and compares it with your past 15 years of work.

  5. Step 5 – Can you adjust to other work?
    If you can’t perform prior work, SSA considers your age, education, skills, and RFC to decide if other work exists nationally that you could do. If not, you might be found disabled under 20 C.F.R. § 404.1505.

Why This Matters for Transgender Applicants

Even amid the 2025 federal shifts, the five-step disability process has not changed. DDS examiners must:

  • Evaluate claims solely on medical and functional evidence, not gender identity.

  • Develop missing evidence and consider barriers to care such as discrimination or financial limits (20 C.F.R. § 404.1529(c)(3)).

  • Apply uniform standards nationwide.

Knowing how your evidence fits into this process helps you organize records that clearly show how your condition limits daily functioning.

Conditions Commonly Reviewed Among Transgender Applicants

SSA bases decisions on function, not identity, but transgender applicants often report conditions listed in the Blue Book:

  • Mental Health Disorders (Listings 12.04, 12.06, 12.15): depression, anxiety, PTSD linked to trauma or stigma.

  • Post-Surgical Complications (Listings 1.00, 6.00, 8.00, 14.00): persistent infection, nerve pain, restricted movement.

  • Endocrine-Related Complications (Listing 9.00 cross-references): hormone-related cardiovascular or metabolic issues.

  • Chronic Pain or Fatigue: evaluated across multiple body systems when well documented.

Table of types of medical records SSDI examines in an SSDI claim from startdisability.com

Types of records reviewed in an SSDI claim

🩺 If Bias or Barriers Affected Your Care

If discrimination, fear, or cost prevented treatment, you may document this information in your Adult Function Report (Form SSA-3373-BK). The form includes sections where you can explain how your conditions limit your ability to work and a "Remarks" section for additional information.

Under federal regulation 20 C.F.R. § 404.1529(c)(3), SSA considers various factors when evaluating symptoms, including "any other factors concerning your functional limitations and restrictions."

You may choose to include details such as:

  • Specific incidents that prevented you from seeking care

  • Financial constraints affecting treatment access

  • Transportation or geographic barriers

  • Previous negative healthcare experiences

Consider gathering supporting documentation like letters from healthcare providers or records of your efforts to obtain care.

Consult with a qualified disability attorney or representative for guidance on how to best present your case.

⚕️ What You Do Not Need to Provide

Based on SSA regulations and forms:

  • SSA does not require proof of gender-affirming surgery for disability claims

  • SSA does not require disclosure of transgender status unless medically relevant to your claimed conditions

Note: Due to policy changes in 2025, including HHS rescission of prior Section 1557 and Section 504 guidance, the federal enforcement landscape for discrimination protections has changed. Some court orders may provide ongoing protections in specific jurisdictions. Consult with a qualified disability attorney for current legal protections that may apply to your situation.

Complications

Complications from gender-affirming surgery — such as chronic pain, infection, or mobility limitations — may qualify for SSDI if they last at least 12 months and prevent substantial gainful activity. You can group your medical records by the part of the body that’s affected (for example, bones and muscles, or urinary and reproductive systems). Make sure each section includes clear medical notes or test results, and explain in plain language how your symptoms affect your daily activities.

🌟 Key Takeaways for 2025

  • You can still apply for SSDI without disclosing gender identity unless medically relevant.

  • SSA’s five-step process and DDS evaluation criteria remain unchanged.

  • Keep records consistent across names and gender markers; include cross-reference notes.

  • Explain barriers to care directly on SSA forms.

  • Be aware that federal civil-rights enforcement has weakened, but SSA’s core eligibility rules have not.

🔗 Helpful Resources AND REFERENCES

Disclaimer

This article is for informational purposes only and does not constitute medical or legal advice. Consult a qualified healthcare provider for medical concerns or a licensed attorney for legal advice.

AI Ethical Statement

This article includes information sourced from government and reputable non-profit websites and was generated with help from AI. A human editor substantially reviewed and refined all content. People and machines make mistakes — please contact us if you see a correction needed.

Jacky Writes