If you’re transgender, you can still get life insurance coverage at a competitive price. When you’re applying for life insurance, some insurers will honor your actual gender, but many will underwrite you based on the gender you were assigned at birth.
In addition, 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 can’t discriminate against you because you’re transgender and doing so is illegal.
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.
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 will underwrite you based on your actual gender and may even have application guidelines about it. 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.
At this point, however, many life insurance companies will still only 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.
If you’re nonbinary, this isn’t an option on life insurance applications at this time. If you identify as LGBTQ, this will not impact your eligibility for life insurance.
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 insurers are evaluating the risk of you dying at any given age, above all else. If you have any scheduled surgery life insurance companies will want to wait until you’ve recovered to make sure there are no complications.
You may be asked for an attending physician 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 accept your policy with a lower premium, even though you aren’t able to put the policy in force right away.
The caveat with backdating a policy is that you’ll have to pay back premiums for every month that your application was postponed until it becomes active.
Alongside the life insurance medical exam, insurers look at your prescription history to better understand your medical background.
If you’re 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, 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’re transgender. Many insurers offer transgender applicants the best possible health classification and some will underwrite you based on your actual gender.
Your application may be postponed or require further evaluation depending on what type of gender-affirming medical care you’re pursuing. This might just require some extra paperwork and a longer application process.
A postponement doesn’t necessarily indicate an increase in your life insurance premiums. If you’re asked to postpone your application and need coverage immediately, 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.
At Policygenius, our experts are licensed in all 50 states and can walk you through the entire life insurance buying process while offering transparent, unbiased advice