This article is a collaboration between The California Work & Family Coalition and Gender Affirming Professionals.
In California, state laws and programs protect you if you need leave from work to recover from your own serious health condition, whether physical or mental. If you need leave from work in order to receive gender affirming surgery or other types of care, you may qualify for both income replacement and job protection under California state laws. This means that while you recover, you could receive income replacement and your job could be protected.
California State Disability Insurance (SDI) is a California worker-funded program for workers who need leave from work due to their own serious health condition. SDI replaces 90% of regular income for low to middle income workers (who make $65,000 a year or less) and 70% of income for higher income workers up to a maximum weekly benefit amount ($1,765 a week in 2026). You can see if you’ve been contributing to SDI by checking your paystub to see if it says something like “CA SDI”. You can apply for SDI benefits at the Employment Development Department (EDD).
California Family Rights Act (CFRA) is a California state law that protects workers from being fired, discriminated against, or retaliated against at work when they need leave due to their own serious health condition. If you qualify, you can take job-protected, unpaid leave for up to 12 weeks a year. You can learn more about if you qualify under the California Family Rights Act here.
What is considered a “serious health condition”?
In California, for both the California Family Rights Act (job protection) and State Disability Insurance (income replacement), a serious health condition is an illness, injury, or condition that requires recovery (including gender affirming surgery and recovery) or continuing treatment that prevents you from doing your regular or customary work.
Do I need to show proof that I need leave for gender affirming care?
State Disability Insurance
You must submit medical certification from your healthcare provider to the Employment Development Department (EDD) to qualify for SDI. The EDD keeps all claimant information strictly confidential and does not share data unless required to by a court.
California Family Rights Act
Your employer is allowed to request medical certification from your medical provider when you request leave under the California Family Rights Act. However, your Health Insurance Portability & Accountability Act (HIPAA) rights still apply, and your medical provider does not have to provide detailed information about your health to your employer. You can see a sample leave request letter here.
Can I apply for SDI and CFRA in advance?
State Disability Insurance (SDI)
You can’t apply for State Disability Insurance until you’re already on leave and are experiencing wage loss. Once you are on leave, you can apply for SDI at the EDD website.
California Family Rights Act (CFRA)
It’s recommended that you notify your employer at least 30 days before you need CFRA leave. For example, if you have a surgery scheduled two months in advance, notify your employer at least 30 days before you need leave.
If your need for leave is unforeseeable (meaning you unexpectedly need leave), CFRA still protects you. For example, if you have a complication from surgery or an unexpected mental health condition that you need treatment for, you can still qualify for CFRA leave; just notify your employer as soon as you are able to.
Can my family members take leave from their jobs to take care of me?
Note: See the section below for more information about who qualifies as a family member (including chosen family)
Yes! California also protects people who need leave to care for a seriously ill family member. This means if you have a serious health condition, your family members can use their paid sick days to care for you and may qualify for income replacement from Paid Family Leave and job protection under the California Family Rights Act.
California Paid Sick Days California law requires employers to allow workers to earn and use up to 5 days or 40 hours (whichever is more) of paid sick leave each year. Workers can use paid sick leave for their own health or to care for a seriously ill family member (in this case, you!). You can see how many hours of paid sick leave you have earned on your paystub. Employers are not allowed to ask for a doctor’s note in order for you to use your paid sick leave. You can see sample request letters here.
Paid Family Leave (PFL) is a California worker-funded program for workers who need leave from work to care for a seriously ill family member, bond with a new child, or for certain reasons related to military exigency. PFL replaces 90% of regular income for low to middle income workers (who make $65,000 a year or less) and 70% of income for higher income workers up to a cap. Paid Family Leave is funded in the same way as SDI. You can see if you’ve been contributing by checking your paystub to see if it says something like “CA SDI”. You can apply for PFL benefits at the Employment Development Department (EDD).
California Family Rights Act (CFRA) is a California state law that protects workers from being fired, discriminated against or retaliated against at work when they need leave to care for a seriously ill family member, bond with a new child, for their own serious health condition or for military exigency. If you qualify, you can take job-protected, unpaid leave for up to 12 weeks a year. You can learn more about if you qualify under the California Family Rights Act here.
Which family members can take leave to care for me? Can my chosen family members take leave to care for me?
Currently, workers can use leave and apply for Paid Family Leave wage replacement to care for a seriously ill parent (including parent-in-law), child, spouse, registered domestic partner, grandparent, grandchild or sibling.
For chosen or extended family, California workers can use paid sick leave and job protected leave under the California Family Rights Act to care for a seriously ill chosen or extended family member. Starting in 2028, workers will also be able to receive Paid Family Leave wage replacement while caring for a seriously ill chosen or extended family member.
How can my chosen or extended family members take leave to care for me now?
Your chosen or extended family member can use their paid sick leave or California Family Rights Act job-protected leave to care for you. Your family member should tell their employer that they need to use their paid sick leave or job protected leave to care for a “designated person” (that’s how California law refers to a chosen or extended family member). Employers are not allowed to ask for proof of relationship with a chosen or extended family member, but can ask an employee to provide medical certification from the treating medical provider in order to certify CFRA leave. Your employer is allowed to limit leave to one “designated person” per year.
More Resources:
Legal Aid at Work: Transgender and Nonbinary Workers Toolkit
Gender Affirming Professionals:
Patient navigation
General Know Your Rights
What organizations can I contact for more information and/or help?
Legal Help Desk: 213-382-7600
National Center for LGBTQ Rights:
Legal helpline: 800-528-6257 or 415-392-6257
Legal Information Help Desk Form [English] - Servicio de Información Legal [Español]
California Rural Legal Assistance, Inc.
Phone line: 800-337-0690
Health Consumer Alliance LGBTQIA+ Advocacy Initiative - Helps Californians get or maintain health coverage and resolves problems with plans and providers, including access to gender-affirming care and protections against discrimination.
Phone line: 888-804-3536
Bet Tzedek Legal Services - Assists the trans community with name and gender marker changes and confidentiality requests, and with overcoming barriers to gender-affirming health care.
Phone line: 323-939-0506
Unique Woman’s Coalition - Assists the trans community with securing legal documentation.
Phone line: 650-336-8471
Modern Military Association of America - Serves current LGBTQ+ service members, veterans, and their families.
Phone line: 202-328-3244
Contact your local LGBTQ+ Community Center for legal resources specific to your county: For example, the Los Angeles LGBT Center has legal resource information here.
