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.

Nupur Gambhir


Nupur Gambhir

Nupur Gambhir

Life Insurance Expert

Nupur Gambhir is an insurance editor at Policygenius and licensed Life, Health, and Disability agent in New York.

Updated February 16, 2021|5 min read

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If you’re transgender, you can still get essential life insurance coverage at a competitive price. Though in the past, getting life insurance has traditionally been a bit complicated, as the world moves forward, insurers are following suit.

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. 

Key Takeaways

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

  • 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

The life insurance underwriting process accounts for your family history, medical background, and lifestyle choices to determine what health classification you belong in, and in turn, 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 body mass index. 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 and any planned surgical procedures can also play a role in the application process.

Life insurance underwriting for transgender applicants

If you’re transgender, you can still get the best health classification and affordable life insurance premiums. These days, 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 gender nonbinary, this isn’t an option on life insurance applications at this time.

Underwriting during the transitioning process

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. If your application is postponed, some insurers may allow you to backdate your policy. This allows you to reserve your rate — but with the caveat that you will have to pay back premiums for every month that your application was postponed. 

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 insurers will want to wait until you’ve recovered to make sure there are no complications from the surgery.

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.

Prescription checks

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.

There is one caveat when the presence of hormone 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 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 or any hiccups in the application process. 

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Mental health and life insurance

Depression is one of the most common medical conditions affecting transgender applicants. According to the American Journal of Preventive Medicine, transgender people 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 what you’re doing to treat it to determine your health classification.

If you’ve received a professional medical diagnosis of gender dysmorphia, 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.

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Coverage options for transgender applicants

Although life insurance companies can be slow to react to change, you can still get competitive 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 where you are in the transitioning process, 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. They consider a myriad of factors before deciding what premiums you should pay, and no application is the same. 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. 


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.

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