If you’re transgender, you can still get life insurance coverage at a competitive price. When you’re applying for life insurance, most insurers will honor your actual gender. And even though gender confirmation surgery and hormone therapy are taken into account during the underwriting process, they won’t negatively impact how much you pay for your policy.
However, there are some exceptions to the rule, which is why it’s important to shop around for a provider that will work with your profile.
Insurers cannot discriminate against you because you are transgender and doing so is illegal.
If you are planning to undergo gender confirmation surgery, insurers will postpone your application until after your surgery.
A gender dysphoria diagnosis is not considered a mental illness and should not impact your life insurance application.
Transgender individuals should shop around to find a life insurance company that honors their actual gender.
Life insurance underwriting for transgender applicants
The life insurance underwriting process determines your health classification and what you pay for your premiums based on your risk of dying. Men and women tend to have different mortality rates, based on a combination of age, sex, and body mass index.
Most of the top life insurance companies will underwrite you based on your actual gender. But at this time, these policies are rarely codified at life insurance companies. Each application is evaluated on an individual basis and if you ask different underwriters, you’ll probably get a lot of different answers as to how, exactly, they reach their final decision.
Some insurers may have guidelines on applying with your actual gender. They may require that your gender is listed in any of your official documents (such as your driver’s license or passport) or only honor your actual gender if you’ve undergone transition surgery or are taking hormone therapy.
A select minority of life insurance companies underwrite you based on the gender you were assigned at birth. We recommend shopping around for a life insurance policy to find an insurer that underwrites you based on your actual gender identity.
Unfortunately, if you’re nonbinary, this isn’t an option on life insurance applications at this time.
Underwriting and gender confirmation surgery
Previous gender confirmation surgery doesn’t disqualify you from getting life insurance coverage, nor should it impact the life insurance premiums you get. But if you plan to undergo gender confirmation surgery, many life insurance companies will postpone your application until after your surgery.
This is largely due to the risk associated with surgery, rather than the specific surgery or surgeries involved. Remember that life insurance companies are evaluating the risk of you dying at any given age, above all else. If you have any scheduled surgery insurers will want to wait until you’ve recovered to make sure there are no complications.
You may be asked for an attending physician’s statement (or APS), which is a letter from your doctor that verifies your health. 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.
If your application is postponed, some insurers may allow you to backdate your policy. This allows you to reserve your rate — with the caveat that you will have to pay back premiums for every month that your application was postponed.
Alongside the life insurance medical exam, insurers look at your prescription history to better understand your medical background. If you are taking hormone therapy, this will show up on your prescription history check. Hormone therapy probably won’t increase your life insurance rates, but again, each application is reviewed on a case-by-case basis.
Mental health and life insurance
Depression is one of the most common medical conditions affecting transgender applicants. Transgender people may also experience higher rates of mental illness than cisgender people. 
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 your treatment history.
If you’ve received a professional medical diagnosis of gender dysphoria, it 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 react to change, you can still get life insurance coverage if you are transgender. Many insurers offer transgender applicants the best possible health classification and will underwrite you based on your actual gender.
And while your application may be postponed or require further evaluation depending on what type of gender-affirming medical care you are pursuing, this might just require some extra paperwork and a longer application process — 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.
Every life insurance application — and applicant — is different, and life insurance companies evaluate them that way. 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 profile.
Frequently asked questions
Does insurance cover a gender dysphoria diagnosis?
Most life insurance companies offer competitive coverage to individuals who have received a gender dysphoria diagnosis.
Do transgender applicants qualify for life insurance?
Yes. Shop around with an insurance broker to find a life insurance agent that will honor your gender identity and offer you competitive coverage.
How do life insurance companies underwrite transgender applicants?
Most life insurance companies underwrite transgender applicants based on their actual gender, although some insurance companies will underwrite applicants based on the gender they were assigned at birth.