Christopher Alexander | 4 June 2024

Around the world, LGBTQI+ persons face unrelenting persecution, sometimes with fatal consequences. Following Eleos Justice’s 2021 report on the State-sanctioned killing of sexual minorities, this note examines State complicity in, and responsibility for, unlawful deaths of transgender, gender diverse, and intersex persons.

Killings motivated by gender identity or expression

Between 1 October 2022 and 30 September 2023, 321 transgender and gender diverse people were reported murdered globally—a figure that likely represents only the tip of the iceberg due to underreporting. Almost three-quarters of these killings occurred in Latin America and the Caribbean.^[1] Occurring against backdrops of systemic transphobia, many of these killings were likely motivated by the gender identity or expression of the victim, with such homicides deemed symptomatic of wider patterns of violence, harassment, intimidation, and discrimination against trans and gender diverse persons. The data also reveal intersecting prejudices: 94% of victims were trans women or trans feminine, the majority of whom were also people of colour and/or sex workers.

Violence against transgender women in [Latin America] is of such significant magnitude that activists have coined the term “transfemicide”… The term acknowledges the intersectional violence and discrimination that trans women face under patriarchal social structures built around rigid gender norms and roles.

Some such killings have been perpetrated directly by State authorities. In 2021, the Inter-American Court of Human Rights found Honduras to have violated the right to life of transgender woman Vicky Hernández, allegedly murdered by police. Citing factors such as the pervasive culture of violence against trans women in Honduras, the routine involvement of State authorities in such violence, and the impunity with which such violence is committed, the Court deemed this to be a case of State-perpetrated transfemicide. This landmark ruling sets an important precedent for a region in which such violence is rampant: of the 4,690 murders of transgender and gender diverse persons recorded worldwide since 2008, more than half were committed between Brazil (1,841) and Mexico (701) alone, while Honduras had the highest global rate of such homicides per capita.

^{Killings of transgender and gender diverse persons between 2008 and 2023.}

^{Reproduced from Transgender Europe (TGEU).}

In some cases, killings committed by civilians may be categorised as ‘State-sanctioned’ due to tacit State condonation. In the United States, the so-called ‘trans panic’ defence—a legal strategy whereby killers claim to have reacted to a sexual advance with lethal violence due to their victim’s gender identity—was raised in at least 32 cases between 2000 and 2019. Elsewhere, States have enacted laws that distinguish ‘honour killings’ from murder, reducing criminal liability for the former on account of the ‘honourable’ motives of the perpetrator. In 2019, a man involved in the murder of his transgender daughter’ in Iran was released without charge because the victim’s family could not claim compensation from itself. Likewise, in 2010, two men who killed their transgender sister received reduced sentences because their father forgave them.

Even where States do not partake in or excuse killings, their legal responsibility may be engaged. International human rights law (IHRL) requires States to take steps to prevent, investigate, and redress all unlawful homicides, including the adoption of special measures of protection where pre-existing patterns of violence exist.

Killings of intersex infants

Across Africa, infants born with intersex characteristics are often abandoned or killed due to deep-rooted cultural taboos which construe intersexuality as a "bad omen" or "witchcraft". Killings have been reported in Kenya, South Africa, Uganda, and Zimbabwe—and given the covert nature of such violence, further instances may well have occurred. A study carried out in South Africa between 2008 and 2010 found that 97.8% of birth attendants and midwives interviewed admitted to having disposed of infants with intersex characteristics. Beyond Africa, intersex infanticides have been recorded in China and Nepal, as have abortions of intersex babies on account of 'chromosomal abnormality'. Human rights fora have called on States to combat violence against intersex persons, recommending that they address discriminatory attitudes and stigma, adopt laws prohibiting harmful practices, and ensure accountability for violence.

Deaths of transgender persons in custody

Under IHRL, States owe a heightened duty of care to protect (the lives of) persons taken into custody. With respect to transgender and gender diverse prisoners, this requires accommodating their unique needs and vulnerabilities. When accommodated according to their birth gender, transgender prisoners are exposed to ‘extreme physical, sexual and emotional abuse’. In 2022, transgender woman DeeDee Hall died while she was handcuffed, hooded, and strapped down to a stretcher by police in the United States. Her death was ruled an accident, though the autopsy found that her heart failure had been complicated by how she had been restrained. In 2023, the family of transgender woman Marjorie Harwood called for an inquest into her death, arguing that it was the ‘indirect result’ of physical, sexual, and verbal abuses she faced in a men’s prison in Australia.

Transgender prisoners have also died in custody due to ‘discrimination in and denial of access to essential services’. In 2019, Layleen Polanco, a transgender woman incarcerated in a men’s prison in the United States, died after suffering an epileptic seizure in solitary confinement, where she had been placed to separate her from male inmates. Prison staff knew of Layleen’s epilepsy and were required to check on her every 15 minutes; however, on the day of her death, they left her unattended for up to 57 minutes at a time. No charges were brought.

Deaths linked to inaccessible gender-affirming health services 

For many transgender persons, gender-affirming health care is lifesaving: a 2015 study found that 44% of those who had undergone treatment reported a reduction in suicidal ideation.^[2] But such care is all-too-often inaccessible. Access may be stymied by prohibitive costs—such as in Australia, where a recent study linked desiring but not having gender-affirming surgery to a 71% higher chance of a lifetime suicide attempt. Elsewhere, accessing care is fraught with legal obstacles or altogether outlawed. In the United States, outright bans have pushed trans persons to suicide, which IHRL obligates States to take measures to prevent. In 2021, transgender man Ezz Eldin bled to death following gender affirmation surgery in Egypt, where a ‘dysfunctional, discriminatory system’ drove him to an underground clinic. In China, difficulties accessing appropriate care have compelled some people to attempt to perform life-threatening surgeries on themselves.

As this brief overview demonstrates, States continue to perpetrate, condone, and fail to prevent the killings of transgender, gender diverse, and intersex persons globally. While promising steps to combat such violence are certainly being taken, there is evidently much work yet to be done.

Christopher Alexander is a researcher at Eleos Justice.

^{[1] TGEU, who published the data, acknowledged that ‘[t]he high number of murder reports from Latin America and the Caribbean can be considerably attributed to the existence of established monitoring systems in these regions’.}

^{[2] Despite extensive clinical evidence that gender-affirming health services improve wellbeing and psychosocial outcomes, such treatments can, in some cases, increase suicide risks.}