How much does gender influence insurance cover?

Financial advisers ‘100% the way forward’ in overcoming misconceptions


Many are the factors that insurance providers need to consider before offering life or health cover, not least when it comes to a person’s gender.

For instance, women typically live longer than men; with the most recent figures from the Office for National Statistics showing that life expectancy in the UK is 79 years for men and 83 for women.

Then come gender-specific medical conditions – such as cervical and breast cancer versus prostate and testicular cancer.

As such, what is covered by an insurance policy will change according to the policyholder.

But what happens when a client is transgender?

Trans clients come with greater complexities in terms of what type of coverage they may be offered. Let’s take for example a transgender woman (the term used to describe someone who transitioned from male to female) – will she still be screened for prostate or testicular cancer? Will those conditions be covered in a health policy?

And for transgender men (those who transitioned from female to male), will their insurance cover cervical or breast cancer? And will their life expectancy – at least on paper – change?

Arguably, policies should be all-encompassing because ‘transitioning’ is unique to each trans person. Some trans men will only be looking to get ‘top’ surgery to remove breast tissue, while others may go further, and it is the same for trans women.

This means they may potentially still have health risks linked to their biological sex.

International Adviser set out to investigate what the policy application process looks like for trans people and how that changes for those transitioning after they took out cover.

Industry practices

First and foremost, do trans people face any additional hurdles compared to those whose gender and biological sex match – commonly referred to as cis-gender people?

IA contacted 10 of the biggest life and health insurance providers in the UK, in terms of market share and popularity with consumers, to understand what they require from trans clients looking to get cover.

Only half replied. But, on a positive note, they all share similar practices.

Aegon, LV=, Royal London, Scottish Widows and Zurich all told IA they do not have any requirements or questions that are specific to trans clients.

Every application is considered on a case-by-case basis. They will be asked questions about any treatment or medical conditions they may have – like any other customer – and additional information may be required, as a follow-up to the applicants’ answers.

Chief underwriter Craig Paterson said: “At Royal London, inclusivity is fundamentally important to us. We believe trans customers should be treated the same as any other customer, so no additional premiums apply, and the scope of cover is not restricted in any way.

“Our underwriting assessment will be made on the basis of the customer’s current gender and any medical conditions they tell us about during the application process, the same way it is for any other customer.

“If gender-affirming surgery is due within the next six months, or if the surgery has taken place but there are ongoing complications, we may not be able to offer cover until a full recovery has been made. This is consistent to how we would treat our assessment of any significant surgical procedure.”

A spokesperson for LV= added: “[Our company] is happy to offer life and income protection insurance to transgender people. Each application is considered on an individual basis using information provided by the applicant with additional information from a GP if required.

“As with all life assurance, critical illness and income protection insurance applications, premiums and terms of insurance will reflect the applicant’s general health and pre-existing medical conditions.”

‘Not many barriers’

There is a common misconception that trans clients face greater, if not insurmountable, hurdles when it comes to securing cover.

But Krystle Skelton, senior specialist insurance adviser at protection broker Cura, told IA this is not necessarily the case, especially nowadays.

Having advised a number of trans clients and successfully obtained protection for them, she said: “In all honesty, for transgender clients looking at protection insurance, there aren’t that many barriers.

“There’s a couple of insurers that don’t ask about transgender status, although there is a question in most insurance applications that asks ‘Have you ever seen a psychiatrist’, which, for somebody who’s transitioning, it’s a standard part of the process for them to see a psychiatrist.

“Most insurers, however, won’t use that against somebody. Generally, unless there’s been some fairly serious mental health implications prior to the transition, then it’s not too bad.”

She echoed Royal London’s Paterson by adding that providers may hold off on offering cover until completion or after recovery if a trans client is booked in to have surgery, imminently. But again, that is true for anybody undergoing any type of significant medical procedure.

If surgery is not on the cards, even though it might happen in future, that “wouldn’t stop them from getting insurance”, Skelton said.

Preferred gender or biological sex?

But one question remains.

When a trans person applies for cover, are they viewed through the prism of their birth sex or their preferred gender?

Skelton explained that, historically, a gender reassignment certificate was necessary for their application to be processed under their new identity.

Companies are now more willing to accept an updated birth certificate as well. As a result, she said there has been an increase in the number of trans people seeking protection.

And when it comes to taking out a policy post-transition, things are also quite easy for them, Skelton told IA.

As long as they can present either of the certificates referenced above, their gender can be switched “with no issue”.


All insurance products have carveout, caveats and exceptions – those taken out by members of the trans community are no different.

The biggest misconception is that there are products that will cover the costs of transitioning – from initial medical appointments, to psychiatric evaluations and eventually surgery.

Which, at least for now, it is not the case.

Many also think that income protection will cover such expenses, but unfortunately it does not.

That is because income protection will cover a replacement of income and most policies, Skelton said, have an exclusion for cosmetic procedures, since transitioning surgeries are still considered elective.

That is why Skelton believes trans people should not be scared to approach a financial adviser: “There are those of us within this industry, we do our job and we don’t judge people.

“We do our job to get people protection, and it doesn’t matter who you are, what you are, or anything else, we’re not going to judge you, we’re going to make sure that you get protection in the best way possible.”

She added that the belief it’s not possible for trans prople to get protection “is not true”.

“There is protection, it’s not actually difficult to access, it’s not difficult to achieve. I have arranged life insurance, income protection, and critical illness for people who have transitioned. I’ve arranged protection insurance for people who are at the start of their journey and looking to transition.”

Those at the beginning of their transition may have to take out cover as their biological sex, but Skelton said, “it can be switched, it’s very quick and simple to do”.

“But I do think speaking to an adviser and getting advice is 100% the way forward. And unfortunately, people may have a bad experience if they speak to their mortgage broker, or they speak to somebody who maybe isn’t as educated in the area as some of the rest of us are.

“The market is very, very accessible, you just need to speak to the right people.”

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