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 health worker holds a vial of AstraZeneca vaccine to be administered to members of the police at a COVID-19 vaccination center in Mainz, Germany, Thursday, Feb. 25, 2021. (Andreas Arnold/dpa via AP)
43 new COVID-19 cases in Interior Health

368 cases in the region remain active

The Williams Lake Trail Riders Arena is slated to have a new roof installed this spring after funding from the province’s Community Economic Recovery Infrastructure Program. (Greg Sabatino photo - Williams Lake Tribune)
Trail Riders Arena, stable stalls, to get new roof at Stampede Grounds

Some of the stalls currently aren’t able to be rented out due to leaks in the roof

A sign is seen this past summer outside Yunesit’in Government office west of Williams Lake reminding visitors and members to stay safe amid the COVID-19 pandemic. (Rebecca Dyok photo)
Yunesit’in First Nation completes second round of vaccinations

A total of 26 people have since recovered from COVID-19 after having tested positive

A 100 Mile RCMP officer stands watch at the intersction of Highway 97 and Horse Lake Road. (Patrick Davies photo - 100 Mile Free Press)
Volunteers, police search Highway 97 for articles related to high-speed chase

Search will stretch from Canco Gas Station in Lac La Hache to 150 Mile House.

An aerial photograph captures snowmobile tracks in the Cameron Ridge area earlier this year, which is closed to snowmobilers. The closures are in place to protect sensitive caribou herds. (Conservation Officer Service photo)
Snowmobilers fined for operating in closed caribou habitat near Likely, B.C.

The investigation revealed they had spent several hours in the closure leaving extensive tracks

Health Minister Adrian Dix looks on as Dr. Bonnie Henry pauses for a moment as she gives her daily media briefing regarding COVID-19 for British Columbia in Victoria, B.C. THE CANADIAN PRESS/Jonathan Hayward
7 additional deaths and 542 new COVID-19 cases in B.C.

Provincial health officials reported 18 new COVID-19 cases linked to variants of concern

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 City of Vancouver estimates there are 3,500 Canada geese in the city right now, and that number is growing. (Bruce Hogarth)
Help tame Vancouver’s Canada goose population by reporting nests: park officials

The city is asking residents to be on the lookout so staff can remove nests or addle eggs

Chief Justice Christopher Hinkson (Office of the Chief Justice)
Judge questions whether B.C.’s top doctor appreciated right to religious freedom

Lawyer for province says Dr. Henry has outlined the reasons for her orders publicly

A sample of guns seized at the Pacific Highway border crossing from the U.S. into B.C. in 2014. Guns smuggled from the U.S. are used in criminal activity, often associated with drug gangs. (Canada Border Service Agency)
B.C. moves to seize vehicles transporting illegal firearms

Bill bans sale of imitation or BB guns to young people

BC Housing minister David Eby is concerned that Penticton council’s decision to close a local homeless shelter will result in a “tent city” similar to this one in Everett, Wa. (Olivia Vanni / Black Press file)
‘Disappointed and baffled’ B.C. housing minister warns of tent city in Penticton

Penticton council’s decision to close a local homeless shelter could create tent city, says David Eby

A recently published study out of UBC has found a link between life satisfaction levels and overall health. (Pixabay)
Satisfied with life? It’s likely you’re healthier for it: UBC study

UBC psychologists have found those more satisfied with their life have a 26% reduced risk of dying

A vial of some of the first 500,000 of the two million AstraZeneca COVID-19 vaccine doses that Canada has secured through a deal with the Serum Institute of India in partnership with Verity Pharma at a facility in Milton, Ont., on Wednesday, March 3, 2021. THE CANADIAN PRESS/Carlos Osorio - POOL
Federal panel recommends 4-month gap between COVID vaccine doses due to limited supply

The recommendation applies to all COVID-19 vaccines currently approved in Canada

A vial of Oxford-AstraZeneca COVID-19 vaccine is pictured at a family doctor office, Thursday, Feb. 25, 2021 in Paris. THE CANADIAN PRESS/AP -Christophe Ena
Trudeau ‘optimistic’ that timeline for rollout of COVID vaccines can be accelerated

Canada set to receive more than 6M COVID-19 vaccine dose than initially expected, by end of March

Most Read