While a number of provinces offer gender-neutral birth certificates, many in Canada’s trans and gender-diverse communities say they are concerned their lived identity is not always reflected in official documents after their death. Callum Tate, a transgender man, is pictured in his Toronto apartment on Saturday, Dec. 22, 2018. (Chris Young/The Canadian Press)

While a number of provinces offer gender-neutral birth certificates, many in Canada’s trans and gender-diverse communities say they are concerned their lived identity is not always reflected in official documents after their death. Callum Tate, a transgender man, is pictured in his Toronto apartment on Saturday, Dec. 22, 2018. (Chris Young/The Canadian Press)

Transgender Canadians say death certificates don’t reflect their lived identity

Medical certificate of death reflects the sex as per the physical characteristics observed at autopsy

While a number of provinces offer gender-neutral birth certificates, many in Canada’s trans and gender-diverse communities say they are concerned their lived identity is not always reflected in official documents after their death.

“It’s the final ‘screw you,’” says Callum Tate, a Toronto transgender man in his mid-30s. ”It erases them without their voice here to say, ‘You made a mistake.’”

Between 2012 and 2017, all Canadian provinces and territories amended their Vital Statistics Act and lifted the requirement of gender confirmation surgery for people to change their gender on various documents. Five provinces and two territories offer a gender-neutral option.

READ MORE: X gender identity now recognized on B.C. IDs

Death certificates, however, are far behind.

“How an individual’s identity is reflected on vital event certificates is an important conversation that is being had in jurisdictions right across the country,” says Maria MacInnis at the Nova Scotia Vital Statistics and Medical Examiner’s Offices.

At the time of death, she says, the medical examiner or last attending physician completes the medical certificate of death, which reflects the sex as per the physical characteristics observed at autopsy. While each province has its own policy, practices across Canada are similar.

As only a small percentage of trans people opt to get gender confirmation surgery, the anatomy of the deceased doesn’t always reflect their gender identity.

READ MORE: B.C. to offer gender-affirming surgeries for transgender people

“In Canada, ascertaining the identity of a deceased person remains a very medicalized and pathologizing process that understands and empathizes the deceased person as a body categorized by sex assignment,” says Kate Hazell, a co-ordinator at The 519 — a Toronto-based agency that advocates for the LGBTQ community.

“There is currently no meaningful mechanism to ascertain the self-identified gender of a deceased person,” she says.

Hazell is aware of trans Canadians who were misgendered in official documents after death, though she declined to share their names for confidentiality reasons. The problem is also present in other countries, including the U.S.

“Not having one’s lived identity recognized at and after death is a form of violence,” says Hazell. “It also does harm to community, friends, partners and family who wish to ensure their loved one is represented in an authentic and respectful way.”

Misgendering after death may be deeply distressing to grieving family and friends, say advocates.

“It can also impact genealogical records, insurance claims and delays in settling the estate,” says Susanne Litke, lawyer and acting chair of the Nova Scotia Rainbow Action project.

For the Canadians who identify as transgender, concerns about death certificates can come tragically early. The 2015 Trans Pulse Report found that 20 per cent of transgender people in Ontario had been physically or sexually assaulted because they were trans, and 67 per cent feared they would die young. The 2017 Canadian Trans Youth Health Survey reports that transgender youth aged 19 to 25 had over 16 times the risk of a suicide attempt in the past year than cisgender youth of the same age.

A will is the only legal document that can help trans individuals express their wishes after death, says Litke.

“People can put in their will their name and gender to be respected and ask their executor to follow those requests,” she says.

Tate, whose father has dementia, says he worries about what will happen if he develops the condition and can’t advocate for himself one day.

“Government identification forms should include this question: ‘In the event of my death, I want to be referred as: Name, Gender,’” he says.

MacInnis says the way forward may include collection of both sex observed at autopsy as well as lived gender.

“Maintaining information on the anatomical sex of a person is important as health conditions related to the cause of the death can present differently” depending on biological sex, she says. “That being said, it is also important to gather statistical information on the 2SLGBTQIA+ community over time to improve health provision, service and outcomes.”

— Marie-Claude Grégoire is a pain and palliative medicine physician and a fellow in global journalism at the Munk School of Global Affairs at the University of Toronto.


Like us on Facebook and follow us on Twitter.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

A nurse performs a test on a patient at a drive-in COVID-19 clinic in Montreal, on Wednesday, October 21, 2020. (THE CANADIAN PRESS/Paul Chiasson)
30 new COVID-19 cases, five more deaths in Interior Health

This brings the total number of cases to 7,271 since testing began

(From left to right) Twin Meadows Animal Rescue co-directors Puneet Grewal and Nycki Wannamaker with Stick & Stone manager Meaghan Collins, and Stick & Stone owner SJ Nelson. Pictured here with Blue, Hombre, Daphne,Skye and Freedom. (Scott Tibballs / The Free Press)
‘Rescue starts from the moment they come through the doors’: TMARS co-founder

Puneet Grewal of Elkford co-founded TMARS in 2020, and with the help of a small army of volunteers and fosters has helped dozens of animals find homes

(Pixabay)
B.C. ranks as fourth most attractive Canadian jurisdiction for resources companies

B.C. was ahead of neighbouring Alberta, which was ranked as the seventh-best Canadian jurisdiction

Castlegar’s Gabrielle Herle (right) will be one of the speakers at the conference. She is seen here with Wendy Gaskill from Chinook Scaffolding accepting their Contractor of the Year Award in 2019 from the Builders Code Champion Awards. Photo: Submitted
Girls in STEAM and Leadership Conference offered free for all girls in the Kootenay Boundary

Virtual conference for girls in grades 8 to 12 will be taking place on March 8

Flowers given to seniors that were 'adopted' through the Buds and Blooms program. (Image contributed by Lilac Terrace, Sparwood)
Brighten a senior’s day with flowers

Receiving flowers can improve well-being by lifting spirits, so the folks at… Continue reading

Dr. Bonnie Henry talk about the next steps in B.C.'s COVID-19 Immunization Plan during a press conference at Legislature in Victoria, B.C., on Friday, January 22, 2021. THE CANADIAN PRESS/Chad Hipolito
456 new COVID-19 cases in B.C., 2 deaths

Since January 2020, 78,278 have tested positive for the novel coronavirus in B.C.

A health-care worker prepares a dose of the Pfizer-BioNTech COVID-19 vaccine at a UHN COVID-19 vaccine clinic in Toronto on Thursday, January 7, 2021. (THE CANADIAN PRESS/Nathan Denette)
Vaccinating essential workers before seniors in B.C. could save lives: experts

A new study says the switch could also save up to $230 million in provincial health-care costs

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

The late Michael Gregory, 57, is accused of sexually exploiting six junior high students between 1999 and 2005. (Pixabay)
Former Alberta teacher accused of sexually assaulting students found dead in B.C.

Mounties say Michael Gregory’s death has been deemed ‘non-suspicious’

According to a new poll, a majority of Canadians want to see illicit drugs decriminalized. (THE ASSOCIATED PRESS)
Majority of Canadians think it’s high time to decriminalize illicit drugs: poll

More than two-times the B.C. residents know someone who died from an overdose compared to rest of Canada

Interior Health officially declared a COVID-19 outbreak at Creekside Landing in Vernon on Jan. 3, which was followed by the first death from the virus 10 days later. (Kaigo photo)
COVID outbreak over at Vernon care home

Creekside Landing cleared of coronavirus, despite additional death in last day

Photograph By @KAYLAXANDERSON
VIDEO: Lynx grabs lunch in Kamloops

A lynx surprises a group of ducks and picks one off for lunch

(Black Press Media file photo)
B.C. residents can reserve provincial camp sites starting March 8

B.C. residents get priority access to camping reservations in province

Most Read