COUNCIL OF THE DISTRICT OF COLUMBIA
OFFICE OF COUNCILMEMBER BROOKE PINTO
THE JOHN A. WILSON BUILDING
1350 PENNSYLVANIA AVENUE, N.W., SUITE 106
WASHINGTON, D.C. 20004
September 18, 2023
Nyasha Smith, Secretary
Council of the District of Columbia
1350 Pennsylvania Avenue, N.W.
Washington, DC 20004
Dear Secretary Smith,
Today, I, along with Councilmembers Christina Henderson, Robert White, Charles Allen,
Vincent Gray, Matt Frumin, Janeese Lewis George, and Anita Bonds am introducing the
“Transgender and Gender-Diverse Mortality and Fatality Review Committee Establishment Act
of 2023.” Please find enclosed a signed copy of the legislation.
With the death of Jasmine “Star” Mack on January 7, 2023, the District marked a grim milestone:
the first transgender person in the country to be violently killed in 2023 lived and died in D.C. 1
Despite transgender and gender-diverse people only making up approximately 1.6 million of the
population2 in the United States, mortality, fatality, and morbidity trends for this group compared
to cisgender people are disproportionately high.3 Although data are limited, some studies suggest
that transgender people are “twice as likely to die as cisgender people” due to “heart disease, lung
cancer, HIV-related illness and suicide,” with trans women being “two times as likely to die”
compared to cis men and “three times as likely” compared to cis women.4 Trans women in
particular are disproportionately vulnerable to the aforementioned risks, as well as to violence and
murder, with one in four trans women likely to be victimized by a hate-related crime.5 Meanwhile,
trans women of color are even more overrepresented as victims of violence and murder.6
1
Casey Parks and Jenna Portnoy, Transgender woman killed in in D.C. ‘just wanted a chance at life’, Washington
Post (Jan. 15, 2023), available here.
2
Williams Institute, Transgender People, available here. “Trans” covers any and all individuals whose gender identity
or expression differs from the sex/gender assigned at birth, irrespective of medical, hormonal, or surgical intervention.
“Mortality” here denotes death by natural or accidental causes; “fatality” denotes death by homicide or suicide. See
also LGBT Mortality Project, Resources, available here.
3
Cf. Sarah S. Jackson, et al. Analysis of Mortality Among Transgender and Gender Diverse Adults in England,
JAMA Netw Open (Jan. 3, 2023); 6(1):e2253687. doi: 10.1001/jamanetworkopen.2022.53687. PMID: 36716027;
PMCID: PMC9887492, available here.
4
Robert Hart, Transgender People Twice As Likely To Die As Cisgender People, Study Finds, Forbes (Sep. 2, 2021),
available here.
5
Cf. Williams Institute, Gender Identity Disparities in Criminal Victimization, National Crime Victimization Survey,
2017-2018, available here. Hannah Schoenbaum, Report says at least 32 transgender people were killed in the U.S.
in 2022, PBS News Hour (Nov. 16, 2022), available here.
6
Harvard Civil Rights-Civil Liberties Law Review, America’s War on Black Trans Women (Sep. 23, 2020), available
here; Faith Karimi, Deadly attacks on Black trans women are going up, advocacy group says, CNN (Jun. 13, 2021),
Transgender fatalities from violence have continued to rise in recent years, making the need for
policy intervention especially urgent.7
All of this suggests that trans and gender-diverse people may face particular vulnerabilities that
cisgender people do not. There is thus an urgent need for more information about trans and
gender-diverse people’s lives and deaths, so that the District can properly support health
outcomes for this constituency.
To facilitate this important work, this legislation would establish a Transgender and Gender-
Diverse Mortality and Fatality Review Committee. This Committee would complement the
District’s existing mortality and fatality review committees administered by the Office of the Chief
Medical Examiner (“OCME”). The Transgender and Gender-Diverse Mortality and Fatality
Review Committee would consist of representatives from OCME and other relevant District
agencies; representatives from District hospitals, transgender and gender-diverse advocacy
organizations, housing organizations, healthcare providers, researchers from a college or
university within the District conducting research in this area, and social workers specializing in
transgender and gender-diverse issues. The Committee would be tasked with identifying and
characterizing the scope and nature of transgender mortalities and fatalities; recording trends;
conducting retrospective socioeconomic analyses; and working to develop policy
recommendations.
The establishment of this Committee will continue the District’s leading role in LGBTQIA+
advocacy and legislation. The Committee will be the first entity of its kind in the United States. It
will contribute important data and analysis and provide important resources for the National Center
for Fatality Review and Prevention and for transgender and gender-diverse people across the
country and inform future strategies and interventions to drive down the disparate outcomes we
are currently seeing with our transgender and gender-diverse residents.
Should you have any questions about this legislation, please contact Michael Porcello, Committee
Director for the Committee on the Judiciary and Public Safety, at mporcello@dccouncil.gov.
Thank you,
Brooke Pinto
available here; Trudy Ring, Here Are the 57 Trans Americans Killed in 2021, Advocate (May 5, 2022), available here;
Laken Brooks, 2021 Has Been A Deadly Year for Transgender People (Nov. 14, 2021), available here.
7
Human Rights Campaign, Fatal Violence Against the Transgender and Gender Non-Conforming Community in
2021, available here; Orion Rummler and Kate Sosin, 2021 is now the deadliest year on record for transgender
people, PBS News Hour (Nov. 18, 2021), available here.
 1 ___________________________ ______________________________
2 Councilmember Robert C. White, Jr. Councilmember Brooke Pinto
3
4
5 ___________________________ ______________________________
6 Councilmember Anita Bonds Councilmember Christina Henderson
7
8
9 ______________________________ ______________________________
10 Councilmember Vincent C. Gray Councilmember Charles Allen
11
12
13 ______________________________ ______________________________
14 Councilmember Janeese Lewis George Councilmember Matthew Frumin
15
16
17
18 A BILL
19 __________
20
21
22 IN THE COUNCIL OF THE DISTRICT OF COLUMBIA
23
24
25 __________________
26
27
28 To establish a Transgender and Gender-Diverse Mortality and Fatality Review Committee within
29 the Office of the Chief Medical Examiner to determine the causes associated with
30 transgender and gender diverse mortalities and fatalities of District residents and those
31 that occur in the District, to identify and characterize the scope and nature of transgender
32 and gender-diverse mortalities and fatalities, to describe and record any trends, data, or
33 patterns that are observed surrounding transgender and gender-diverse mortalities and
34 fatalities, to create a strategic framework for improving transgender and gender-diverse
35 health outcomes for racial and ethnic minorities in the District, to recommend training to
36 improve the identification, investigation, and prevention of transgender and gender-
37 diverse mortalities and fatalities, and to make publicly available an annual report of its
38 findings, recommendations, and steps taken to evaluate implementation of past
39 recommendations.
40
41 BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this
42 act may be cited as the “Transgender and Gender-Diverse Mortality and Fatality Review
43 Committee Establishment Amendment Act of 2023”.
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44 Sec. 2. Definitions.
45 For purposes of this act, the term:
46 (1) “Cisgender” shall have the same meaning as provided in D.C. Official Code §
47 1-607.61(1).
48 (2) "Committee" means the Transgender and Gender-Diverse Mortality and
49 Fatality Review Committee.
50 (3) “Documentation memorializing transgender or gender-diverse status” means
51 documentation that memorialize a decedent’s gender transition, and may include:
52 (A) A written statement by the decedent self-identifying as transgender,
53 gender-diverse, or not cisgender;
54 (B) Documentation of a change to the decedent's gender marker on a
55 certificate of birth, driver's license or state identification card, social security record, or passport;
56 (C) A court order approving a name or gender change; or
57 (D) A statement, signed under the penalty of law, by a licensed healthcare
58 provider or licensed mental healthcare provider who treated or evaluated the decedent, stating
59 that the decedent underwent surgical, hormonal, or other treatment appropriate for the decedent
60 for the purpose of gender-affirming care, based on contemporary medical standards.
61 (4) "Gender-affirming care" shall have the same meaning as provided in section
62 102(12A) of the Human Rights Act of 1977, effective December 13, 1977 (D.C. Law 2-38; D.C.
63 Official Code § 2-1401.02(12A)).
64 (5) “Gender-diverse” means a person whose gender identity or expression is at
65 odds with what is perceived as being the gender norm in a particular context at a particular point
66 in time, including those who do not place themselves in a gender or sex binary. This includes
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67 non-binary individuals as defined in D.C. Official Code § 1-607.61(3) and individuals who
68 identify as not cisgender.
69 (6) “Gender identity or expression" shall have the same meaning as provided
70 in section 102(12A-i) of the Human Rights Act of 1977, effective December 13, 1977 (D.C. Law
71 2-38; D.C. Official Code § 2-1401.02(12A)).
72 (7) "Personally identifiable information" shall have the same meaning as provided
73 in D.C. Official Code § 7-231.01(42) and shall also include documentation memorializing
74 transgender and gender-diverse status as defined in this chapter.
75 (5) “Transgender” shall have the same meaning as provided in D.C. Official Code §
76 1-607.61(4).
77 (6) “Transgender and gender-diverse fatality” means the death of a transgender,
78 gender-diverse, or not cisgender person by a homicide or suicide.
79 (7) “Transgender and gender-diverse mortality” means the death of a transgender,
80 gender-diverse, or not cisgender person by accident or nature.
81 Sec. 3. Establishment and duties.
82 (a) There is established a Transgender and Gender-Diverse Mortality and Fatality Review
83 Committee (“Committee”) within the Office of the Chief Medical Examiner (“OCME”). The
84 OCME shall provide facilities, staffing, and other administrative support for the Committee.
85 (b) The Committee shall evaluate transgender and gender-diverse mortalities and
86 fatalities, including associated factors:
87 (1) That occur in the District; and
88 (2) Of District residents, regardless of the place of death.
89 (c) The Committee’s duties shall include:
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 90 (1) Identifying and characterizing the scope and nature of transgender and gender-
91 diverse mortalities and fatalities in the District and of District residents;
92 (2) Coordinating with other District mortality and fatality review entities to
93 minimize duplicate mortality and fatality case review;
94 (3) Describing and recording any trends, data, or patterns that are observed
95 surrounding transgender and gender-diverse mortalities and fatalities;
96 (4) Examining past events and circumstances surrounding transgender and
97 gender-diverse mortalities by reviewing records and other pertinent documents of public
98 agencies and private entities responsible for investigating transgender and gender-diverse
99 mortalities or treating transgender and gender-diverse persons;
100 (5) Performing retrospective review of socioeconomic determinant risk and
101 protective factors surrounding transgender and gender-diverse fatalities in the District;
102 (6) Developing and revising, as necessary, operating rules and procedures for
103 review of transgender and gender-diverse mortalities and fatalities, including identification of
104 cases to be reviewed, coordination among the agencies and professionals involved, and
105 improvement of the identification, data collection, and record keeping of the causes of
106 transgender and gender-diverse mortalities and fatalities;
107 (7) Recommending systemic improvements to promote improved and integrated
108 public and private systems serving transgender and gender-diverse people in the District,
109 including improved interagency coordination;
110 (8) Recommending systemic improvements to prevent and respond to transgender
111 and gender-diverse mortalities and fatalities;
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112 (9) Recommending policies for improved access to employment, healthcare,
113 mental healthcare, housing, and educational programs for transgender and gender-diverse
114 residents;
115 (10) Creating a strategic framework for improving transgender and gender-diverse
116 health outcomes for racial and ethnic minorities in the District, including reducing disparities in
117 transgender morality and fatality rates for racial and ethnic minorities;
118 (11) Recommending training for providers who treat transgender and gender-
119 diverse health patients to improve the identification, investigation, and prevention of transgender
120 and gender-diverse mortalities and, in the case of fatalities, recommending training to improve
121 the prevention of transgender and gender-diverse fatalities and to identify risk factors and
122 develop protective factors in the individual, family, and community response to violence.
123 (d)(1) By July 1 of each year, the Committee shall make publicly available and submit to
124 the Council and Mayor an annual report of its findings, recommendations, and steps taken to
125 evaluate the implementation of past recommendations, which includes the following
126 information:
127 (A) A description of the causes and contributing factors to the transgender
128 and gender-diverse mortalities and fatalities the Committee reviewed during the preceding
129 calendar year;
130 (B) A description of the state of transgender and gender-diverse health and
131 transgender and gender-diverse mortalities and fatalities in the District, including statistics and
132 causes of transgender and gender-diverse mortalities and fatalities; and
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133 (C) Recommendations for systemic changes and legislation relating to the
134 delivery of transgender and gender-diverse health care in the District and the prevention of
135 transgender mortalities and fatalities.
136 (2) The annual report submitted pursuant to paragraph (1) of this subsection shall
137 not contain any personally identifiable information but may include aggregated data.
138 (3) If a recommendation in the annual report is directed at a particular subordinate
139 agency, the head of the subordinate agency shall respond in writing to the Committee within 30
140 days after the issuance of the annual report, describing the agency’s plans to address the
141 recommendation.
142 (4) The Chief Medical Examiner shall annually, no later than 60 days after the
143 annual report described in paragraph (1) of this subsection is made publicly available, convene a
144 symposium at which the Chief Medical Examiner shall present the report to the public, District
145 agencies implicated by the report's findings, the Deputy Mayors for Public Safety and Justice and
146 Health and Human Services, any relevant health or policy stakeholders, and the Committee's
147 representatives and members.
148 Sec. 4. Composition of the Committee; procedural requirements.
149 (a) The Mayor shall appoint one representative from each of the following District
150 agencies to serve on the Committee:
151 (1) The Office of the Chief Medical Examiner;
152 (2) The Department of Health;
153 (3) The Department of Behavioral Health;
154 (4) The Department of Health Care Finance;
155 (5) The Department of Human Services; and
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156 (6) The Mayor’s Office of Lesbian, Gay, Bisexual, Transgender and Questioning
157 Affairs; and
158 (b) The Mayor shall additionally appoint the following members in accordance with
159 section 2(f) of the Confirmation Act of 1978, effective March 3, 1979 (D.C. Law 2-142; D.C.
160 Official Code §l-523.01(f):
161 (1) One representative from a hospital located in the District;
162 (2) One representative from a community organization specializing in
163 transgender and gender-diverse issues;
164 (3) One representative from a transgender and gender-diverse housing
165 organization;
166 (4) One representative from a transgender and gender-diverse healthcare
167 provider;
168 (5) One representative from a college or university within the District
169 conducting research in transgender and gender-diverse mortality trends or fatality prevention;
170 (6) One social worker specializing in transgender and gender-diverse issues or
171 clients; and
172 (d)(1) Members appointed pursuant to subsections (a) and (b) of this section shall serve at
173 the pleasure of the Mayor, or of the entity designating their availability for appointment.
174 (2) Members appointed pursuant to subsection (c) of this section shall serve a 3-
175 year term and may be removed by the Mayor for cause. Vacancies in membership shall be filled
176 in the same manner in which the original appointment was made.
177 (e) The Committee shall select a Chairperson according to procedures set forth by the
178 Committee.
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179 (f) The Committee shall establish quorum and other procedural requirements as it
180 considers necessary.
181 (g) No member appointed pursuant to subsection (c) of this section shall serve