Most transgender or nonbinary people in Oregon are misgendered in death, study finds
A group of epidemiologists in Oregon
found that more than half of trans or nonbinary people in the Portland metro area who died between 2011 and 2021 were misgendered on their death certificates.
Their findings were published in the Journal of Public Health Management & Practice.
The epidemiologists identified 51 deaths of transgender people and compared their gender with the sex listed on their death certificates, the study says. More than half of them — 29 out of 47 — were misgendered on their death certificates, they found.
The failure to correctly identify the person’s gender happened most often with transgender women, the study said. Out of the 33 transgender women who died, 20 of them were identified as male on their death certificates.
“What we learned will likely alarm anyone who identifies as transgender or nonbinary — or anyone who cares about the rights of transgender and gender nonconforming people,” Kimberly Repp told KOIN. Repp is the chief epidemiologist for Washington County and a co-author on the study. “When a population is not counted, it is erased.”
There’s no formal system in place to guarantee their trans or nonbinary identity will be honored after they’re gone, Repp said in a news release.
The discrepancies can make it harder for communities to get federal and state resources for social services and public health programs for residents. Transgender people already face increased health risks compared to cisgender populations, the study says.
Three major issues contribute to the common discrepancies, according the study. The case management software medical examiners use to record deaths does not include a field for trans or nonbinary gender identities, there is no requirement for death investigators to collect that information, or how to effectively do so.
And because next of kin has the power to declare the person’s sex on a death certificate, they also have the power to misgender them if they don’t recognize the dead person’s transgender or nonbinary identity, the study states. Authors call this “nonconsensually detransitioning” the dead person.
Epidemiologists suggested rather than relying only on legal next of kin, funeral home directors should have the legal authority to use gender-identifying documentation that they collect before the person dies. That legal process would prevent family members from nonconsensually detransitioning their dead, the study says.
Study authors also recommended federally required death certificates that would have gender options for trans and nonbinary identities, the study states.
That would require a change to the way data is entered into Oregon’s death investigation tracking software, which many other states use as well, the authors wrote. Currently, medical examiners can choose only among three options for identifying someone’s sex or gender: “male,” “female,” or “unsure,” meaning sex couldn’t be determined from the remains.
Medical examiners who are examining transgender patients can only list “transgender” for their sex if they suspect the patient died by suicide, and must do so on a separate form.
Kimberly DiLeo, chief investigator with the Multnomah County Medical Examiner’s Office, told KOIN that she demands change. Portland is the county seat of Multnomah County.
“Our office has strongly advocated for appropriate changes within the database and we have been proactive in training our staff to record gender identity,” she told the outlet. “We’re also working to provide formal training for the tri-county region, but without adequate tools to collect this data and changes at a national level, we are limited in what we can do.”
Last year, California approved adding nonbinary identities on death certificates.
