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Can you get life insurance if you’re transgender?


If you’re transgender, you can still get optimal life insurance coverage, though it might require some extra paperwork.

To get life insurance coverage, you have to go through the life insurance underwriting process for the insurer to figure out exactly how risky you’ll be to insure. The underwriting process evaluates your medical history, family background, and lifestyle choices to essentially determine what the chances of you dying are at any given age.

The higher the likelihood of your mortality, the higher the chances are that the life insurance company will end up having to pay out the life insurance death benefit to your beneficiaries, which means you’ll end up paying costlier premiums or being ineligible for life insurance altogether.

Insurance companies tend to be somewhat conservative and slow to respond to social change, and life insurance companies are no exception. But this doesn’t mean that you can’t still get competitive rates and essential coverage if you’re transgender. Though in the past, getting life insurance has traditionally been a bit complicated, as the world moves forward, insurers are following suit.


  • You can still get optimal life insurance coverage at a competitive price if you are transgender

  • If you are undergoing hormonal therapy and/or gender reassignment surgery, insurers may postpone your application until they are completed

  • A diagnosis of gender dysphoria is not considered a mental illness and should not impact your life insurance application


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The life insurance underwriting process

The life insurance underwriting process accounts for your family history, medical background, and lifestyle choices to determine what health classification you belong in, and thus, what you pay for your life insurance premiums. So where does gender come in? Men and women tend to have different rates of mortality, which is based on a combination of age, gender, and BMI. Insurers calculate this using mortality and build tables during the underwriting process.

So while being transgender won’t directly impact your premiums, your gender may have a nominal impact. Additionally, the long-term effects of societal pressures on mental health alongside hormonal therapies and surgical procedures can also play a role.

Life insurance underwriting for transgender applicants

If you’re transgender, you can still get a preferred health classification and affordable life insurance premiums. These days, most of the top life insurance companies will underwrite you based on your actual gender, not the gender you were assigned at birth. But this policy is rarely codified at life insurance companies; if you ask different underwriters, you’ll probably get a lot of different answers as to how, exactly, they reach their final decision.

Though mostlife insurance companies will underwrite you based on the gender you identify as, each life insurance company — and each underwriter — is different. Some life insurance companies will underwrite you based on the gender listed in any of your official documents (such as your driver’s license or passport). Others may only honor your actual gender if you’ve undergone transition surgery or taken hormonal treatments. We recommend shopping around for a life insurance policy to find an insurer that underwrites you based on your preferences.

Unfortunately, if you’re gender non-binary, this isn’t an option on life insurance applications at this time. An insurance broker like Policygenius can work with you to find the right life insurance company that offers coverage based on the gender you were assigned at birth to ensure you get the right policy and the best possible premiums.

Underwriting during the transitioning process

Gender reassignment surgery isn’t disqualifying you from life insurance coverage — nor should it impact the life insurance premiums you get. But if you are currently going through or plan to undergo gender reassignment, there is a chance that the life insurance company may postpone your application until you’ve completed your transition.

This is largely due to the risk associated with surgery, rather than transitioning itself. Remember that life insurance companies are evaluating the risk of you dying at any given age, above all else. If you have a scheduled surgery or are planning any hormonal treatments, insurers will likely want to wait until you’ve transitioned completely to make sure there are no complications — aka health risks due to medicine and surgery.

You may be asked for an attending physician’s statement (or APS). Insurers sometimes ask applicants for this, but typically require it from any applicant that has had surgery or a chronic medical condition, such as diabetes. An APS is essentially a letter from your doctor that verifies your health.

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Prescription checks

Alongside the life insurance medical exam, insurers look at your prescription history to better understand your medical background. If you’ve taken or plan to take any hormonal therapy, this will show up on your prescription history check. Completed hormonal therapy probably won’t impact your application, but if you’re in the midst of transitioning, insurers will want to postpone your application for the same reasons we stated above — they want to make sure you don’t experience any complications from the medicine that could impact your mortality.

There is one caveat when the presence of hormonal therapy on a prescription check may completely disqualify you from getting a policy: if you intentionally didn’t mention it on your initial application when asked about your prescription history. Underwriters understand that sometimes mistakes happen, but if it becomes apparent that you excluded information purposefully, they probably won’t offer you a policy. We recommend compiling all of your medical and prescription records before you begin your application to avoid the extra paperwork.

Mental health and life insurance

Depression is one of the most common medical conditions affecting transgender applications. And while life insurance companies typically won’t give you higher premiums because you’re transgender, your premiums still depend on your medical profile, including your mental health history. If you’ve been diagnosed with depression or anxiety, the underwriter will want to understand the severity of your mental illness and what you’re doing to treat it to determine your health classification.

If you’ve received a professional medical diagnosis of gender dysmorphia, it likely won’t be treated as a mental illness. However, like much else, some life insurance companies will look at this on an individual basis and may refer to their medical staff for a more thorough evaluation.

Coverage options for transgender applicants

Although life insurance companies can be slow to catch up to society, you can still get competitive coverage if you are transgender. And while your application may be postponed or require further evaluation depending on where you are in the transitioning process, this might just require some extra paperwork — not an increase in your life insurance premiums.

If you are asked to postpone your application and need coverage now, you may be able to get temporary life insurance. Speak to a life insurance agent about what options you have.

Every life insurance application — and applicant — is different, and life insurance companies evaluate them that way. They take a myriad of factors into consideration before deciding what premiums you should play, and no application is the same. And while there is a lot of “this is the case, but this may happen,” shopping around with a life insurance broker is the best way to find an insurer that will offer you the best coverage based on your specific needs.

Life Insurance Expert

Nupur Gambhir

Life Insurance Expert

Nupur Gambhir is a life insurance editor at Policygenius in New York City. She has researched and written extensively about life insurance since 2019, with specialties in life insurance companies, policy types, and end-of-life planning. Her writing on insurance and finance has appeared on MSN, The Financial Gym, and end-of-life planning service Cake. Previously, she worked in marketing and business development for travel and tech.

Nupur has a B.A. in Economics from Ohio State University.