When it comes to gender identity disorder, life insurance companies see a bad bet

May 20, 2014


When “Hiroki,” the parent of a 2-year-old, tried to sign up for a life insurance policy, his application was rejected on grounds he was undergoing medical treatment--in his case for gender identity disorder (GID).

Hiroki, not his real name, was born female. The 29-year-old Shizuoka resident wanted to build up a financial portfolio so that his daughter would not face financial difficulties later in life.

But the company he approached refused the application because he was taking hormone injections to make his physical appearance more masculine.

There are many insurers in Japan, and most balk at issuing policies to people undergoing medical treatment. This is a particular problem for patients with GID because their treatments can add to health risks.

The disorder affects one in several thousand people. A special measures law took effect in Japan in July 2004 to allow people with GID to change the sex that they were assigned at birth on their official family registries.

According to the Justice Ministry, about 3,900 people with GID had done so as of fiscal 2012.

One of them is Hiroki. He applied to Tokyo-based Prudential Life Insurance Co. for a life insurance policy but was rejected after he explained he had been taking hormone injections since January 2013.

Asked for an explanation, a public relations official of Prudential said, “We cannot comment on individual cases.”

Hiroki, even as a girl, realized in elementary school that her masculine tendencies were overpowering. Even so, she tried to act "girlish," even though it was agonizing to do so.

Hiroki felt unable to "out" herself, got married and became pregnant.

After giving birth, and unable to endure the situation any longer, she revealed her gender identity to her husband.

She began receiving hormone injections and her mental stress eased. She began sleeping properly. But her husband left her.

Looking to the future, Hiroki felt the need to get a life insurance policy to provide for a rainy day: “If it becomes impossible for me to earn money, I don’t want to plunge my 2-year-old daughter into financial trouble,” Hiroki said.

Yoko, another alias, is a 53-year-old company employee who lives in Tokyo’s Shinjuku Ward. She was born male and changed her sex to female on the official family registry in 2012. As a male, Yoko had drawn up a life insurance policy more than 20 years previously, but was forced to cancel the contract after divulging his GID.

The special measures law on GID stipulates that changing gender does not adversely affects the rights and obligations of those who do so.

However, the life insurer maintained that changing a person's sexual identity at the conclusion of the contract was unacceptable. Yoko had no choice but to cancel the policy, though a different life insurer allowed her to change her sex from male to female on the contract.

“People with GID must realize that once they begin to receive medical treatment, he or she cannot get life insurance,” said Ran Yamamoto, representative of an association called Japan People with Gender Identity Disorder. “That is a matter of common sense.”

According to the Japan Institute of Life Insurance, policies for life insurance are issued on the proviso that the applicant is in good health.

But each life insurance company is able to draw on a huge data bank that shows the risk from each disease. Because of that, the criteria for assessing the risk of each applicant is changing.

Contacted by The Asahi Shimbun, the 10 leading life insurance companies all said they do not discriminate in terms of GID. The companies were ranked in terms of total assets as of fiscal 2012.

However, some of the companies acknowledged that GID patients could face bigger hurdles in subscribing to life insurance policies as hormone treatments carry the risk of triggering thrombosis or osteoporosis.

Hormone treatment can continue until the patient is in his or her late 40s and late 50s.

“After starting to receive hormone injections, GID patients often undergo sex reassignment surgery, which is covered by insurance benefits,” said an insurance company official. “That also becomes a hurdle for patients when they try to obtain a life insurance policy.”

Many of the companies contacted by The Asahi Shimbun said that when clients changed their gender on their life insurance policies, the contracts were altered accordingly.

However, some of the companies said they would have to assess whether or not the contracts were still valid.

“There is sufficient data to measure the risks of GID patients. We want life insurers to review the criteria for assessing those patients,” Yamamoto said.

Mikiya Nakatsuka, a professor of health sciences at the Graduate School of Okayama University, who serves as the head of the Japanese Society of Gender Identity Disorder, said, “If hormone treatment is conducted appropriately in medical institutions that have specialized staff, there is a low risk of the patients developing thrombosis or other diseases.

“Since the special measures law on GID took effect, fewer patients have developed health problems as a result of advice given by health experts.”

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Hiroki, who changed his sex from female to male, reads a book with his daughter in Shizuoka on Jan. 25. (Ananda Kokumai)

Hiroki, who changed his sex from female to male, reads a book with his daughter in Shizuoka on Jan. 25. (Ananda Kokumai)

  • Hiroki, who changed his sex from female to male, reads a book with his daughter in Shizuoka on Jan. 25. (Ananda Kokumai)

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