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In June 2013, the Social Security
Administration (SSA) announced a new policy to for
updating Social Security records to reflect a
person’s gender identity. Under the new policy, a
transgender person can change their gender on their
Social Security records by submitting either
government-issued documentation reflecting a change,
or a certification from a physician confirming that
they have had appropriate clinical treatment for
gender transition. This policy replaces SSA’s old
policy, which required documentation of sex
reassignment surgery.
How is the gender in my SSA record used?
Your Social Security card only lists your name and
Social Security number – not your gender. However,
SSA maintains information in its computer records on
everyone who has a Social Security number, including
name, date of birth, and gender.
Social Security benefits do not
depend on your gender, and determinations related to
marriage and family relationships are not based on
what gender is in your record. Aggregated data about
gender and other demographic factors from SSA
records is used for statistical and research
purposes. In addition, as discussed below, SSA
gender data is still used for identity verification
by some third-party organizations.
Will changing my
gender with SSA affect my Social Security benefits?
No. Social Security benefits do not depend on your
gender. In addition, Social Security gender markers
do not determine a person’s eligibility for
marriage-related benefits.
Will changing my gender with SSA affect my health
benefits?
Changing your gender marker with Social Security
will typically not affect your health insurance at
all if you have private insurance. While some
insurance plans may automatically refuse coverage of
services that appear inconsistent with a gender
marker in the plan’s records, insurance plans
generally do not base their gender data on, or match
it with, Social Security records, but instead use
data from enrollment forms.
An exception is that if a person
is enrolled in Medicare, or is enrolled in both the
Medicaid and Supplemental Security Income (SSI)
programs, their insurance record will be based
Social Security data. In that case, they may
experience automatic refusals for coverage of
services that appear inconsistent with a gender
marker in Social Security records. These automatic
rules were developed as a means to prevent erroneous
or fraudulent billing, with the unintended
consequence of sometimes affecting trans people.
(This can happen with private insurance too, but
that will be based on the gender in plan records,
not Social Security records.) These types of denials
can usually be resolved by having your provider’s
office either add a specific billing code, contact
the plan, or help you request a formal coverage
determination. For more information, see NCTE’s
health care and Medicare rights below.
What about “No-Match Letters?” Will my SSA record
out me on the job or elsewhere?
This is much less likely than it used to be, but
could still happen in some circumstances. SSA
administers several programs used to verify a
person’s identity for purposes of employment,
applying for public benefits, or other purposes.
Through these various programs, SSA compares
personal data submitted by a business or government
agency with its own programs and reports whether the
data matches.
Some of these systems include
gender among the personal data that is submitted and
matched, while other systems don’t include gender.
The largest system used by private employers, the
Social Security Number Verification System (SSNVS),
eliminated gender in 2011. As a result, it is now
very rare for employees to be outed on the job by
their SSA gender marker. However, some systems used
by state government agencies still match gender
against SSA records. If a person’s recorded gender
with the submitting agency does not match SSA
records, SSA may report this back to the submitting
agency.
In cases where gender data is
submitted to SSA and does not match, it is important
to understand that the submitting agency is under no
obligation to respond in any way. Businesses or
government agencies are not subject to any penalties
or legal requirements when they receive a notice of
gender data that does not match. The organization
can simply ignore the gender mismatch so long as the
other personal data matches with SSA records. For
this reason, NCTE continues to advocate removing
gender from these matching systems altogether.
How do I change the gender in my SSA record?
Social Security will accept any of the following
forms of evidence for a gender marker change:
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A U.S. passport showing the
correct gender,
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A birth certificate showing
the correct gender,
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A court order recognizing the
correct gender, or
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A signed letter from a
[provider] confirming that you have had
appropriate clinical treatment for gender
transition
If you use a physician letter, it
must come from a licensed physician with whom you
have a patient relationship and who is familiar with
your transition-related treatment. This may be any
physician who is familiar with your treatment,
including a primary care physician or a specialist.
All certifications must be on the physician’s office
letterhead and include all of the information seen
in the sample letter below, including the
physician’s license or certificate number.
The following is an example of a
letter that meets all the Social Security
requirements. You should ask your physician to use
this letter and not give additional personal health
information that is not included here.
I,
(physician’s full name), (physician’s medical
license or certificate number), (issuing U.S.
State/Foreign Country of medical
license/certificate), am the physician of (name
of patient), with whom I have a doctor/patient
relationship and whom I have treated (or with
whom I have a doctor/patient relationship and
whose medical history I have reviewed and
evaluated).
(Name of
patient) has had appropriate clinical treatment
for gender transition to the new gender (specify
male or female).
I declare
under penalty of perjury under the laws of the
United States that the forgoing is true and
correct.
Signature
Typed Name
Date
What does “Appropriate Clinical Treatment” mean?
The new policy recognizes that people’s medical
needs vary, and that treatment options must be
decided by health care professionals on an
individual basis. You are entitled to an updated
gender marker if you have had the clinical treatment
determined by your health care providers to be
appropriate, in your individual case, to facilitate
gender transition. No specific type of treatment is
required, and details of your treatment should not
be included in the letter from your physician to SSA.
NCTE encourages you and your doctor to only state in
the letter that you have had the clinical treatment
determined by your health care providers to be
appropriate. Details about surgery, hormone
treatment, or other treatments are unnecessary and
not helpful.
How can I change my name in my Social Security
record?
Social Security’s procedures for name changes have
not changed. You can change the name on your Social
Security card and record by applying through the
mail or in person at a local Social Security office.
This can be done separately from, or together with,
applying for a gender change. You will need to
submit an Application for a Social Security Card,
proof of your identity and citizenship or
immigration status, as well as acceptable proof of
the name change. In general, SSA will accept
any of the following as proof of a name change:
-
Name change court order
(original or certified copy);
-
Marriage, civil union, or
domestic partnership certificate (original or
certified copy);
-
Divorce decree (original or
certified copy); or,
-
Certificate of citizenship or
naturalization (original only).
The new card will be sent to you
in the mail, as will any original documents
submitted with your application.
Note:
Marriage, civil union, or domestic partnership
certificates showing a name change can be used
so long as they are recognized by the issuing
state. For name change purposes, it does not
matter whether the federal government or the
applicant’s state of residence recognize the
relationship. However, locally-issued domestic
partnership certificates not recognized by a
state cannot be used for this purpose.
How does Social Security treat marriages involving
transgender people?
Social Security recognizes as valid any marriage
that was recognized under state law as being a
valid, different-sex marriage when it was entered
into. Any marriage that was valid when it was
entered continues to be valid regardless of a
spouse’s transition.
Social Security looks to state
law and government-issued documents (such as birth
certificates and court orders) to determine marital
status – it is not based on the gender marker in
your Social Security record. For this reason,
changing your gender marker with Social Security
will not affect your or your spouse’s right to
Social Security benefits.
What If I have a problem?
Social Security employees are instructed to treat
transgender customers with respect, including using
appropriate pronouns, and to not ask unrelated
personal questions. If you encounter improper
requests for information, unprofessional treatment,
or other difficulties in a local Social Security
office or with other SSA employees, contact NCTE,
your SSA Regional Office, or your U.S. Senator’s
Office. NCTE is monitoring implementation of the new
policy.
In addition, if you believe you
have been subject to discriminatory treatment by an
SSA office or staff, you may file a formal complaint
of discrimination with SSA. SSA accepts complaints
of discrimination in services and programs based on
race, color, national origin (including English
language ability), religion, sex (including gender
identity), sexual orientation, age, disability, or
in retaliation for filing a complaint. The purpose
of this process is not to provide compensation but
to resolve unfair actions and prevent future
incidents. Complaints must be filed within 180 days
of the discriminatory action, or be accompanied by
an explanation for filing later. The complaint form
can be found at:
http://www.ssa.gov/online/ssa-437.pdf
Additional Resources
Health Care Rights
and Transgender People:
http://www.transequality.org/Resources/HealthCareRight_UpdatedAug2012_FINAL.pdf
Medicare Benefits and Transgender People:
http://transequality.org/Resources/MedicareBenefitsAndTransPeople_Aug2011_FINAL.pdf
SSA Gender Change Policy:
https://secure.ssa.gov/poms.nsf/lnx/0110212200
Application for Social Security Card:
http://ssa.gov/ssnumber/ss5.htm
Social Security Office Locator:
https://secure.ssa.gov/ICON/main.jsp
Social Security phone numbers: 1-800-772-1213 or,
for TTY, call 1-800-325-0778
SSA Discrimination Complaint Form:
http://www.ssa.gov/online/ssa-437.pdf
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