Life Insurance For Transgenders

Qualifying For Life Insurance When You’re Transgender: How To Secure The Right Policy

Underwriting processes at many life insurance companies still require you to apply as either male or female. If you identify as cisgender, this normally isn’t an issue. But what happens if your identity doesn’t align with your physical body? 

Qualifying for life insurance when you're transgender isn't always straightforward. Here’s what you need to know about the transgender life insurance application process.

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Factors That Affect Life Insurance Rates

When reviewing your life insurance application, an insurance agent looks at three principal factors:

  • Lifestyle
  • Medical history
  • Gender

These factors help an insurer determine how likely you are to die during your coverage period. The higher the risk, the higher your premiums, (or the less likely you will be approved for insurance in the first place). It’s obvious how lifestyle and medical status can affect this, but what role does gender play?

When it comes to life insurance, men typically pay more in premiums – sometimes by the thousands. This is because men tend to live shorter lives compared to women, increasing the risk of payout for the life insurance company.

A life insurance agent will also consider other risk factors such as:

  • Occupation
  • Family health history
  • Criminal record (if any)
  • Instances of bankruptcy
  • Drug use

Each of these factors affects how likely someone is to die and when which is why they affect your life insurance eligibility as well as the premiums you pay. Below is a breakdown of some of the other factors that underwriters consider when you’re applying for life insurance:

Health Risks

In every country, women are more likely to outlive men by an average of five years. In the last century alone, men over the age of 45 had a mortality rate that was 2x higher than women. 

The biggest contributor to this discrepancy is health – men have a higher risk of cardiovascular disease and are more likely to smoke. Still, female smokers can expect lower premiums and more favorable life insurance policy terms compared to male smokers of a similar age.

Since these health risks are associated with biological sex, many insurers will ask transgender applicants to list their sex assigned at birth – not the one they identify with.

Health Risks Specific To Transgender Individuals

Underwriting policies for transgender applicants may vary because there’s not enough research done on how living as a transgender person can impact life expectancy.

There’s at least one significant way that being transgender can affect your insurance application. Transgender people are more likely to find themselves in poor health due to a lack of gender-affirming medical services, a higher probability of contracting untreatable diseases like HIV, and a fear of discrimination which prevents them from seeking health care services.

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Physical Build

Abnormal body mass index (BMI) measurement can potentially put you at a higher risk of premature death, thus affecting your life insurance quotes. What is considered an acceptable BMI differs depending on your gender and insurance company. A BMI of 30, for instance, might be regarded as the upper limit for a man, while 28 may be the ceiling for women.

Dangerous Occupations

Even now, some occupations are “divided” according to gender. Although people of all genders can be found in every industry, men are more likely to take on riskier jobs. Occupations with an increased risk of injury or death include diving, firefighting, construction, forestry, and mining, to name a few.

Men in hazardous occupations likely won’t secure a Preferred Best or Preferred classification risk – the cheapest rate categories for life insurance. If they do qualify, they’ll likely receive a standard rate instead, which is significantly more expensive.

The Underwriting Process For Transitioning Applicants

More progressive life insurance companies will offer unisex options or allow you to apply for a policy with your preferred gender identity. However, other life insurers might choose to process your application according to the gender listed on your birth certificate or other documents. 

Life insurance companies aren’t exactly rushing to change long-established company practices since transgender people only make up a small percentage of the American population. Until their underwriting processes catch up, there’s still no option to select "transgender" or "non-binary" on your application. 

Your insurer may ask you to prepare specific documents as part of your application. If you’re in the middle of hormone treatment or have recently had surgery, this may include an attending physician's statement (APS). They may also request your medical history to identify any underlying health conditions or complications, in addition to a standard life insurance medical exam.

The Role Of Mental Health

Many transgender people experience gender dysphoria, which is now recognized by the American Psychiatric Association as a legitimate mental illness. A transgender person is more likely to experience depression or anxiety compared to a cisgender person and will have to disclose mental conditions during the application process.

Body Dysphoria

Gender dysphoria is characterized by a conflict between an individual's gender assigned at birth and current gender identity. Those suffering from gender dysphoria might indulge in risky behavior, neglect their health, become socially withdrawn, or engage in self-harm. Physical injuries and frequent unemployment due to abuse can also affect your ability to get life insurance.

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Suicidal Tendencies & Depression

Though research is limited, studies show that transgender people are more likely to engage in suicidal ideation than the general population. Some transgender individuals seek gender-affirming therapy or long-term care to reduce suicidal tendencies.

Transgender adults may also be diagnosed with major depressive disorder, generalized anxiety disorder, or experience panic and anxiety attacks. If you get diagnosed with a mental health issue, this can potentially increase life insurance premiums.

A transgender person on anti-depressants may still be able to secure favorable life insurance coverage. However, your insurance company will also have to take a few other things into consideration:

  • That you aren't currently taking any antipsychotic medication.
  • That you have not attempted suicide in the past two years.
  • That you have not had a mental disorder that required hospitalization in the past year.

If any of the above circumstances apply to you, you may need to obtain an APS in adherence to underwriting guidelines. Keep in mind that not all mental illnesses are rated the same – some life insurance companies provide more favorable rates for people diagnosed with depression compared to people diagnosed with more severe conditions such as bipolar disorder or schizophrenia. 

Surgery & Medication

Trans people will often undertake gender-affirming surgery (previously known as gender reassignment surgery) to help their physical bodies align with their gender identity better. Procedures might include breast reduction or augmentation, voice therapy, vaginoplasty, phallectomy, and others.

If you've recently undergone a gender-affirming surgical procedure, this can affect your final life insurance quotes. Though a life insurance company can’t legally disclose how surgery affects your premiums, most will express concerns over potential botched procedures or side effects.

Take Surgical History Into Account

Although many cosmetic procedures don't increase mortality, a life insurance company may still count top surgery or sex reassignment surgery as a risk. This is especially true if you have to undergo a second procedure, as is sometimes the case with breast augmentation – over 15% of patients are required to have a second surgery within a year. 

An insurance agent might insist on holding off on insurance underwriting until after 12 months from the date of your last surgical procedure.

Note Your Prescriptions

Most hormone therapy has only mild to non-existent side effects and doesn't impact cancer rates. However, in rare instances, hormones have demonstrated some concerning side effects.

In feminizing hormones, these adverse reactions include:

  • High cholesterol
  • High potassium in the blood, which can hinder heart function
  • Anemia or blood clots
  • Increase in body fat
  • Mood swings

On the other hand, masculinizing hormones can cause:

  • Increase in red blood cells (polycythemia) and cholesterol
  • Higher risk of cardiovascular problems
  • Hypertension
  • Type 2 diabetes
  • Sleep apnea

Taking professionally prescribed medication to support your well-being is sometimes seen by insurers as a sign of responsibility. Thus, your prescription history may allow you to obtain higher coverage. However, this isn't always the case because of the risks associated with specific medication. 

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Should You Apply Before Or After Surgery?

Some life insurance applications will only consider your transgender identity if you've already completed gender-affirming surgery or have taken hormonal treatments. This is because there are certain health risks associated with surgical procedures and hormone therapy treatment. 

Male-to-female operations have a more significant mortality threat than female-to-male procedures. Fortunately, both gender transition/gender reassignment surgery and hormonal treatments have a relatively low risk of causing heart problems or cancer. 

If you have yet to undergo surgery, your health insurance representative may request an APS and postpone underwriting until after the procedure. Although it may delay approval, surgery or hormones shouldn’t affect life insurance rates, unless you're pursuing your application in the middle of your transition.

Impact On Term Life Insurance vs Whole Life Insurance

Between term life insurance and whole life insurance, the former may consider gender more heavily in the decision-making process. Here’s a breakdown of these two types of life insurance.

Term Life Insurance

Term life insurance policies provide coverage for a fixed period called a “life insurance term” – typically between 10, 20, or 30 years. Your beneficiaries only gain access to the death benefit if you die within the life insurance term.

Term life insurance coverage and rates are heavily based on gender. Applying for term life insurance as a male is significantly more expensive because men are more likely to develop certain diseases at the age of 50 or 60. In comparison, women generally contract the same illness at a later age – usually 70 or 80.

For example, term life insurance health plans with a death benefit of $250,000 may cost a 30-year-old man $523 in annual premiums. A woman of the same age with the same term life insurance may only pay $426. 

Permanent Life Insurance

A whole life insurance policy is less likely to make decisions based on gender identity. Instead, permanent life insurance providers focus on collecting the appropriate information about your health issues, history of drug therapies, and the general state of your well-being. Some whole life insurance policies fall under the umbrella of guaranteed issue (e.g. final expense insurance), which means that there’s no medical exam required.

Tips For Securing A Life Insurance Policy For Transgender Applicants

Regardless of the policy, you choose to pursue, it's best to familiarize yourself with different insurance underwriting standards as a transgender applicant. Keep the following tips in mind as you explore different options.

Take Out Group Life Insurance

Group life health insurance is available through your employer or other entity (e.g. organization, association, a labor union). There’s usually no medical exam so it can be a strategic way to avoid medical/health questions. However, providing less medical information for insurers can make it difficult to secure the coverage you need.

There are a couple of other downsides as well. Transgender people tend to have less stable employment, which makes it risky to rely on employer-provided life insurance. Plus, if you leave your place of employment, you'll lose your coverage altogether.

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Research Your Insurance Companies

Before you get life insurance, you'll want to study your choices as thoroughly as possible. 

There is no doubt that the life insurance industry is becoming increasingly forward-thinking. Nowadays, when looking up a firm in the United States, you'll likely find them listed on the Equality Index under the Human Rights Campaign Foundation. 

This resource lets you know how well a business treats its LGBTQ+ clients, employees, and investors. The higher the score, the more likely an insurance company will treat transgender applicants with care and concern.

While transgender life insurance doesn't yet exist, it's entirely possible to find a company that provides equal health coverage to people regardless of sex/gender. If you're having trouble selecting options for term life insurance or permanent life insurance, consider working with a broker.

Not only is a client-broker partnership completely free, but they also know the ups and downs of term life insurance company guidelines. Client-brokers can provide you with enough information to make better decisions. 

Know Your Rights Under State Law

To secure the health coverage you’re entitled to, research your protection rights under the law. Thanks to the National Center for Transgender Equality, discrimination against sex and gender identity is considered a civil rights issue. Insurers cannot deny your application for a permanent or term life insurance policy on the basis of your gender identity, and they are legally mandated to offer affordable rates. 

If you feel you've been discriminated against while applying for life insurance, you can file a complaint with your state department.

In Conclusion

If you want to get life insurance as a transgender person, you should know that gender impacts your terms and rates. You will also have to disclose medical history, particularly any instances of surgery, hormone therapy, or other medication – and these factors can also affect your rates. 

If you’re unsure about whether to pursue your application before or after surgery, consult with your financial advisor. Still, gender is just one factor that a life insurance agent will look at when determining your rates and eligibility. Factors such as age, financial background, and employment also play a huge part in the underwriting process.

Whether you’re trans or cisgender, Wesley Insurance, LLC can provide you with all the information you need to make better financial decisions and get life insurance. Contact us, and we will help you find the transgender life insurance you deserve.

Written By Cameron McDowell
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