What defines a misstatement?
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I doubt it has suffered a court test yet. Logic would dictate it is just plastic surgery and you don't notify your life company when you get a face lift. Excluding all politically correct issues biologically you still can't get a true sex change. They haven't started swapping x and y's yet. Until they do, genetically you would still be the same gender with same actuary tables.
Protocol would be whatever the carrier decides.