With no clear guidelines on documenting transgender deaths, advocates & community members must take matters into their own hands

For transgender Ohioans, the recent victory of having an accurate birth certificate could be erased when they die.

Last year, Ohioans were granted the ability to change the gender marker listed on their birth certificate — a monumental victory for the LGBTQ+ community in Ohio, one of the last of two states to grant this right.

But for transgender Ohioans, that victory could be erased when they die. 

In Ohio, and across the country, no clear standards exist for how medical examiners or funeral directors should document the deaths of transgender individuals, a problem that causes confusion, harm, and prevents public health professionals from fully understanding the causes of premature deaths among the trans population whether by homicide, suicide, overdose, or other causes. 

Trans individuals are at a greater risk for experiencing violence, which often results in death, with Black and Latinx trans women at the highest risk.

Broken reporting systems – first responders, law enforcement, medical examiners, and the news media – systemically misgender and deadname trans community members, which helps to hide the true scope of the problem. 

“Not only is this the final indignity, but such misreporting hides the true extent of anti-trans violence,” wrote Eliana Turan, director of development at the LGBT Community Center of Greater Cleveland in a recent piece in Cleveland Scene.  This year is poised to be the worst year on record for trans murders in America, surpassing 2020 — previously the worst year on record. 

In addition to transphobia, unemployment, poverty and homelessness can put trans people at risk for greater violence, issues exacerbated by the Covid-19 pandemic,” according to The Guardian.Compared with cisgender adults, trans adults are at a greater risk of dealing with suicidal thoughts and attempting suicide.”

So far in 2021, at least 34 transgender or gender non-conforming people have been fatally shot or killed by other violent means. “We say ‘at least because too often these stories go unreported — or misreported,” according to the Human Rights Campaign.

Next of kin, those in charge of a person’s welfare after they die, can also misgender and deadame a person as they’re the ones who create the official death certificate. 

When a person dies, a number of people are involved in creating a death certificate. If a person dies due to natural causes and under the care of a physician, the doctor will fill out the cause and manner of death. If the person’s death wasn’t natural, was sudden, or was from a disease, a medical examiner or coroner will make that determination. The funeral director is responsible, with help from the family, for filling in information such as the person’s name,  occupation, and gender.

This is often where misgendering happens. 

Tierramarie Lewis (she/hers)

In the case of Tierramaire Lewis, fingerprints yielded her name and gender to medical examiners, as she had legally changed her name in Franklin County in 2019. But when her family was creating her death certificate with a funeral director, they provided a different name and deadnamed her on her official death certificate. According to information provided by the Cuyahoga County Medical Examiner’s office, they do not overrule families regarding death certificates.

In Summit County, the approach is slightly different. According to information provided by the Summit County Medical Examiner’s office, “If there is a discrepancy between the death certificate and our records, we will add the [death certificate] name to our records as an ‘AKA’ and have the funeral home do the same on the death certificate,” explained Denice DiNapoli, director of administration fo the office. 

Ohio gives no guidance to funeral directors or medical examiners on how to record the deaths of transgender individuals, other than referring them to the U.S. Centers for Disease Control and Prevention’s National Vital Statistics website, which does not include any information specific to transgender individuals. The CDC’s handbooks for medical examiners and funeral directors don’t explicitly state that family members get to decide the name listed, but they do articulate that it is important to get the name right. Guidance for both professions also says that “sex” of the deceased individual should be based on observation or marked as “unknown” if it is unclear. 

Aaron Eckhardt (they/them)

A person has to “jump through hoops” in Ohio to legally change their name, a process which costs money, time going through a court process, and a public declaration, said Aaron Eckhardt, director of the Buckeye Regional Anti-Violence Organization (BRAVO), an advocacy group for LGBTQ+ survivors of hate and bias violence, discrimination, intimate partner violence, stalking and sexual assault.

 “One would think [letting the community and officials know your legal name] would be sufficient. However, that doesn’t seem to extend past one’s death, unfortunately,” said Eckhardt. “Next of kin have the ability to change it back or to really do anything they’d like, which is the sad part.”

Legal name change v. Gender marker change

Going through a legal name change and changing the gender marker on one’s birth certificate are two different processes. 

Typically, legal name changes are accomplished through the court system, following an application and paperwork filing. After the hearing, if the request for a name change is granted, the name change is then protected by the U.S. Constitution’s Full Faith and Credit Clause, which “requires every state, as part of a single nation, to give a certain measure of respect to every other state’s laws and institutions.” 

That means a name change in one state should be respected by governments in other states.

Changing a gender marker on legal documents is more complex. Birth certificates, driver’s licenses, and passports all have a different process to go through in order to obtain a gender marker change.

Olivia Hunt (she/hers)

Because the procedure to update your gender marker on each document is different, it is not uncommon for trans people to have inconsistent gender markers across all of their identity documents, said Olivia Hunt, senior policy council at the National Center for Transgender Equality (NCTE). 

“The inconsistencies among gender markers on official documents can lead to people disregarding them all together and substituting their own judgement for what gender they think the person should be identifying as,” said Hunt. “There are no clear guidelines on how to address this.”

Like Ohio, most states don’t reference any other documents to match the gender marker recorded on the death to the individual’s birth certificate or driver’s license. 

“Usually, there are no guidelines as to how to determine what that marker should be,” Hunt said.


One of the most significant consequences with trans and gender non-conforming deaths not being recorded is overall erasure from society. 

If there is not accurate documentation, public health officials have no way of effectively tracking the statistics of individuals who met a violent end. And if a person’s death isn’t recorded accurately, they, and their identity, are essentially erased. 

“What does that say to friends and chosen family and even family members who were supportive of the individual, and also the trans community as a whole and individuals within it?” said Eckhardt. “That your identity is not important after you die? That’s not a good message. It feeds this overall sense of the discrimination that transgender and gender nonconforming people people face all the time, which is your identity is not a reality. And taking it away after death is a way of stripping somebody of their identity in a very permanent way.”

Improperly recording the death of a trans person is demeaning to the person’s memory, Hunt said. It shows a fundamental lack of respect to the deceased, who they were, how they lived their life and the impact they had in their community.

“It’s often said that a single death diminishes all of us, but trying to change who that person was after they died diminishes our society even more,” Hunt said. “It tries to remove that person from the overall tapestry that is our society, the community that we live in. It’s also insulting and harmful to trans people generally. It communicates to surviving trans people that the acknowledgement of our lives is conditional that our very identities can be done away with by unsupportive family and uncaring bureaucracy after our deaths.” 

These issues of misgendering, deadnaming, and ultimately erasure in death all serve to enforce the mistrust that a lot of trans people have for government agencies and authorities. Improperly recording the deaths of trans people also sends a rather chilling message to closeted trans people, especially trans youth, who are afraid to come out because of how they will be treated by their community. 

“Reporting, whether it’s from the coroner’s office, police department or a newsroom that is misgendering a trans person, says to the closeted person that if you come out, you won’t be treated with respect,” Hunt said. 

Possible Solutions

To prevent future erasure and public misunderstanding about the deaths of trans individuals, education is needed for law enforcement, medical examiners and in the newsrooms that often reinforce incorrect information or stereotypes when reporting on trans deaths, such as including the previous name or gender assigned at birth when publishing stories on the deaths of trans community members. Resources that can be consulted include Gillian Branstetter’s “Transgender people: A guide for reporters,” GLAAD’S guidelines for reporting on trans victims of crimes, or the guidelines from the FBI’s Law Enforcement Bulletin.

Hunt explained that simply having professional associations adopt and promote available best practices for working with the trans community and for reporting on the trans community would “go a long way to making a real change in the lives of trans people in our society.”

Public awareness and speaking the names of trans people who have died is also a useful way to bring attention to these issues, including efforts like the #sayhisname and #sayhername movements. Eckhardt said the more we know about people’s wishes before their death, the better ability we have to follow those wishes.

“I’ve had individuals tell me, ‘Look, I don’t want any of that when I’m gone. My family is going to say what they say. Y’all know the truth. I don’t want that for my life,'” Echhardt explained. “And we leave it alone because that’s their wish. We’ve had people that have asked us to essentially turn all the lights on and make sure people know, and we’ll do that as well.”

Eckhardt further explained that in the absence of policy and structure in the system itself, it’s really up to communities to come together to take care of each other.

“That’s really where good organizing can happen and the movement can push forward within those conversations,” said Echkardt. “Because death is not something we talk about very often, which is also part of the problem.”

Read more about the options for LGBTQ+ individuals to document their wishes related to funeral services, death certificates and more. 

Looking ahead

As of right now, there isn’t any pending or upcoming legislation that would address this issue of trans individuals being misgendered and deadnamed on their death certificates. However, Ohio State Senator and Assistant Minority Leader Nickie Antonio said the Ohio Fairness Act could help. 

Essentially, the Ohio Fairness Act would clarify in Ohio law that discrimination based on a person’s sexual orientation or gender identity or expression is illegal. Specifically, the legislation protects against this discrimination in the areas of housing, employment and public accommodations. 

“If that bill were to pass, it would be a very helpful step forward,” Antonio said.

Though it’s not a tool that is available to everyone, having proper documentation that displays a person’s authentic self, from their name to their gender marker, can be helpful in the process of making sure the person is memorialized appropriately and documented accurately. 

“I think more than anything else there’s still just so much education and understanding of people living their authentic lives as transgender people that we just need to continue to work on,” Antonio said. “I think it’s incumbent on all of us, especially those of us who are part of the LGBTQ community but not transgender, to also lift up and try to continue to help educate folks on what it means to really be respectful of somebody living their authentic life.”

Advocates say that understanding the consequences of erasure in the trans community and the related public health consequences will take legislative and policy changes. But while the legal changes like marriage and probate laws are helpful, the work doesn’t stop there. 

“At the end of the day, no policy change is going to automatically make the community better,” Eckhardt said. “You can’t legislate caring for somebody. Until we start to have more empathy with one another in the communities, and across cultures and identities, things are not going to continue to get better.”  

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