Gender is one of the driving factors when calculating life insurance, but what happens when someone is transgender? There can be much confusion over how to approach the question of gender when it comes to your life insurance policy. You always want to answer your life insurance questionnaire honestly, but for transgender applicants, this everyday question isn’t always so simple to answer. It’s critical to ensure that you have the right coverage for the life you are living today.

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When shopping for life insurance as a transgender applicant, this is what you need to know.

How gender affects life insurance premiums

Many factors impact the cost of your life insurance, and gender plays one of the biggest roles in pricing. We already know there’s a gender gap when it comes to life insurance, simply because more women have insurance policies than men. Women also tend to live longer, with historical data since the late 1800s showing that men simply have a shorter life expectancy.

The conversation changes when it comes to transgender applications because the medical history is much more unique. To further complicate things, not all insurance companies treat transgender insurance in the same manner. However, certain protections ensure that transgender policyholders are not denied coverage or treated differently from the average policyholder.

“Federal and state law prohibits most public and private health plans from discriminating against you because you are transgender,” says the National Center for Transgender Equality. “This means, with few exceptions, that it is illegal discrimination for your health insurance plan to refuse to cover medically necessary transition-related care.”

That makes it illegal for insurance companies to engage in illegal behaviors, such as placing automatic or categorical exclusions on a policy due to transgender- or transition-related reasons. There also cannot be limits placed on your coverage, nor can you be denied coverage just because you are transgender.

Choosing a gender when applying for life insurance

It is still legal in all states for life insurance companies to charge life insurance rates based on gender. Your gender is one of the many factors that impact how much you pay for your life insurance. Other factors include things like where you live, your occupation and your lifestyle choices, such as whether you smoke or drink.

However, many transgender applicants are unsure how to approach the question of gender on life insurance questionnaires. You are likely to want to list your current gender, but some insurance companies require that you list your gender at birth instead. Most companies, however, will request that you list the same gender as the one listed on your legal documents, such as your driver’s license or other government-issued identification.

Your medical history is another factor that insurance companies typically consider. Medical treatments, such as hormone therapy or gender-affirming surgery, can also impact how a life insurance company sets up your policy.

An important factor for many transgender applicants is how accommodating an insurance company will be of their unique medical history. Companies that refer to a person’s gender assignment at birth may not share the same priorities and attitudes that you may have as a transgender person has today, leaving other companies better suited to your needs. Other customers may prioritize price, looking for the company with the best price. Whatever your preference, there are choices for transgender insurance.

Top-rated life insurance companies for transgender employees

There are many insurance companies that may offer coverage, but not all of them may specialize in the type of coverage that you need. The Human Rights Campaign Foundation (HRC) offers its Corporate Equality Index, which recognizes the top-rated companies that offer equal health coverage for their transgender employees.

These are among the best life insurance companies based on the HRC survey.

Because these companies received good scores for employees, they might also be a good place to look to for life insurance.

Health and life insurance premiums

Unfortunately, the average transgender applicant may not be well-served by just any life insurance company. Some companies may be unable to fulfill specific needs, and the consequences could be severe if it impacts your health. Before calculating price, many insurance companies will look to your medical history, including your mental health. This is an area where transgender applicants are especially affected.

The American Journal of Preventive Medicine reports that transgender people are far more prone to mental illness than cisgender people, with depression and suicide among the most common issues. Suicide is especially prevalent among those with gender dysphoria, a kind of diagnosis that refers to the strong desire to act or be treated as a different gender from the one assigned at birth.

Given these patterns, it’s always best to find a life insurance provider that is mindful of mental illness. Most providers won’t penalize policyholders who manage their mental health with medication or other forms of treatment. Talk to your insurance company about your health and what steps you are taking to manage any issues you may be experiencing.

Life insurance that does not require medical information

Life insurance companies often require a medical exam before issuing a policy. However, some transgender applicants may not be comfortable with this requirement. In this case, you still have options. There are some drawbacks, however. The waiting period can take as long as three years before coverage kicks in, you are not likely to receive as much coverage as you would with a traditional policy. The price tag often runs much more expensive, too.

If you do not want a life insurance policy that requires a medical exam, guaranteed issue life insurance could be a great option. This is a type of life insurance that does not require a medical exam, and you will not have to submit your medical records, either. It’s known as a non-medically underwritten policy.

Another option is final expense life insurance, which does typically require a health questionnaire but skips the medical exam requirement. However, coverage may be limited, and you are not likely to receive the same benefits that a traditional policy may carry.

Tips for applying for life insurance

There are some things you can do to help you find the best transgender insurance for your needs.

Explore employer-provided plans

Some employers offer their employees the option for life insurance. These group plans typically allow employees to skip the medical exam requirement and avoid health questionnaires. Just be aware that your coverage will be dependent on your employment, so you could lose coverage if you ever leave the company.

Talk to a broker

A life insurance broker has professional experience working in the industry, so you can receive seasoned, expert advice that is right for your specific needs. Not only can the broker offer recommended companies for transgender applicants, but your agent can help you navigate the minutiae of various policies to ensure that you choose the best one for you and your family. Insurance brokers can also help you find the cheapest life insurance for your budget.

Ask for help

If you can benefit from additional support, there are additional life insurance resources that can help you understand the type of life insurance available and any applicable laws for your state.

Resources for transgender life insurance

Finding the right life insurance as a transgender person can be frustrating and complicated, but you’re not alone. There are several resources available to provide help.

Transgender life insurance resources

Life Insurance Resources for Transgender Applicants

Resource Description
National Center for Transgender Equality’s Health Coverage Guide The guide helps transgender applicants understand the types of coverage available and locate the right provider.
National Center for Transgender Equality’s A Know Your Rights Guide for Transgender People Navigating COVID-19
Also available in Spanish: Una guía para que las personas transgénero navegando la COVID-19 conozcan sus derechos
Updated for coronavirus, this guide features pandemic-specific details and providers.
Out2Enroll This resource helps transgender applicants find access to healthcare.
OutServe and SPART*A These military-oriented organizations help transgender applicants find support while serving.

Transgender insurance legal resources

There are some legal protections in place for transgender people. One of the biggest medical protections is the Health Care Rights Law. It is an inclusion within the Affordable Care Act (ACA) that provides specific language prohibiting sex and anti-transgender discrimination. Also important is the Health Insurance Portability and Accountability Act (HIPAA). This protects patient privacy regarding health and medical history and status, including information relating specifically to transgender patients. Transgender people also receive anti-discrimination protections under the Americans with Disabilities Act.

Should you encounter any issues, such as discrimination, there is The Transgender Law Center. Created specifically for transgender people, the law center provides critical legal support and resources.

Where to file a complaint

If you feel that you have are a victim of transgender discrimination, there are many federal and private organizations to help.

Organization Who it helps
U.S. Department of Health and Human Services, Office for Civil Rights All transgender applicants
National Association of Insurance Commissioners’ State Insurance Department State-level complaints
The Joint Commission Complaints against hospitals
Local long-term care ombudsman Complaints against nursing, board or care homes
U.S. Department of Health and Human Services (HHS) Privacy and HIPAA-related violations
Office of Personnel Management or the Equal Employment Opportunity Commission Federal employee benefits
Veterans Administration’s External Discrimination Complaints Program Transgender veterans
VA Medical Center Patient Advocate Transgender military members and veterans
TRICARE Military healthcare concerns
Equal Employment Opportunity Commission Employer-employee health plans
State Human Rights Agencies State and local complaints

State transgender laws

There are many state laws in place to protect against anti-transgender discrimination where insurance is concerned.

Frequently asked questions

Can I find life insurance while I am transitioning?

It may be possible to find life insurance while you are transitioning, but it is generally better to wait until your surgery is complete. Many life insurance companies may decide to postpone your application until after your surgery is complete, and they may even offer the option to backdate your policy.

Do insurance companies consider transgender medications?

Insurance companies consider several medical factors when assessing your life insurance application. This includes your medical exam, medical history and any prescriptions you may be currently taking or have taken in the past.

Is transgender insurance more expensive?

Insurance is calculated based on a number of specific factors for each individual. Being transgender does not necessarily lead to higher premiums, but if you have health issues, that can impact pricing and mean more expensive rates.