BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | AB 1577| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- THIRD READING Bill No: AB 1577 Author: Atkins (D), et al. Amended: 8/19/14 in Senate Vote: 21 SENATE HEALTH COMMITTEE : 7-1, 6/11/14 AYES: Hernandez, Beall, De León, DeSaulnier, Evans, Monning, Wolk NOES: Nielsen NO VOTE RECORDED: Morrell SENATE JUDICIARY COMMITTEE : 6-1, 6/24/14 AYES: Jackson, Corbett, Lara, Leno, Monning, Vidak NOES: Anderson SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8 ASSEMBLY FLOOR : 62-5, 5/15/14 - See last page for vote SUBJECT : Certificates of death: gender identity SOURCE : Equality California Transgender Law Center DIGEST : This bill requires a person completing a death certificate to record the decedent's sex to reflect the decedent's gender identity, as specified. Senate Floor Amendments of 8/19/14 make a clarifying change and specify what prevails when documents regarding a decedent's CONTINUED AB 1577 Page 2 gender are in conflict. ANALYSIS : Existing law: 1.Requires each death to be registered with the local registrar of births and deaths in the district in which the death was officially pronounced or the body was found within eight calendar days after the death and before the disposition of the remains. 2.Requires a funeral director to prepare the certificate and register it with the local registrar and to obtain the required information, other than medical and health data, from the person or source best qualified supply this information. 3.Requires the medical and health section data and the time of death to be completed by the physician and surgeon last in attendance, or in the case of a patient in a skilled nursing or intermediate care facility, by a licensed physician assistant legally authorized to certify and attest to the facts, or in certain cases, to be completed by the county coroner. 4.Specifies that a certificate of death shall contain certain information concerning the decedent necessary to establish the fact of the death, including but not limited to the decedents full name, sex, color or race, marital status, name of spouse, date of birth and age at death, birthplace, usual residence, and occupation. This bill: 1.Requires a person completing a death certificate to record the decedent's sex to reflect the decedent's gender identity. Requires the decedent's gender identity to be reported by the informant, unless the person completing the certificate is presented with a document that memorializes the decedent's gender transition, including, but not limited to, a birth certificate, a driver's license, a social security record, a court order approving a name or gender change, a passport, an advanced health care directive, or proof of clinical treatment for gender transition, in which case the person completing the CONTINUED AB 1577 Page 3 certificate is required to record the decedent's sex as that which corresponds to the decedent's gender identity as indicated in that document. 2.Clarifies that if the documents provided are in conflict regarding the decedent's gender and are issued on the same date, the document evidencing the transition shall prevail. Further clarifies that if the documents provided are in conflict regarding the decedent's gender and issued on different dates, the most recent document shall prevail. 3.Requires, if none of these documents are presented and the person with the right, or a majority of persons who have equal rights, to control the disposition of the remains, as specified, is in disagreement with the gender identity reported by the informant, the gender identity of the decedent recorded on the death certificate to be as reported by that person or majority of persons. 4.Permits, if a document specified in #1 above is not presented and a majority of persons who have equal rights to control the disposition of the remains, as specified, do not agree with the gender identity of the decedent as reported by the informant, any one of those persons to file a petition, in the superior court in the county in which the decedent resided at the time of his or her death, or in which the remains are located, naming as a party to the action those persons who otherwise have equal rights to control the disposition and seeking an order of the court determining, as appropriate, who among those parties is to determine the gender identity of the decedent. 5.Prohibits a person completing the death certificate in compliance with #1 above from being liable for any damages or costs arising from claims related to the sex of the decedent as entered on the death certificate. 6.Requires a person completing the death certificate to comply with the data and certification requirements by using the information available to him/her prior to the deadlines for completion specified in existing law. 7.Establishes the above provisions as the Respect After Death Act. CONTINUED AB 1577 Page 4 Background The University of California, Berkeley Gender Equity Resource Center defines transgender in the following manner: Transgender (sometimes shortened to trans or TG) people are those whose psychological self (gender identity) differs from the social expectations for the physical sex they were born with. To understand this, one must understand the difference between biological sex, which is one's body (genitals, chromosomes, etc.), and social gender, which refers to levels of masculinity and femininity. Often, society conflates sex and gender, viewing them as the same thing. But gender and sex are not the same thing. Transgender people are those whose psychological self (gender identity) differs from the social expectations for the physical sex they were born with. For example, a female with a masculine gender identity or who identifies as a man. A University of California, Los Angeles Williams Institute study from 2008 estimates that 0.3% of adults are transgender. Reporting and use of data . The Department of Public Health (DPH) uses the data collected through death certificates for public health research and planning. According to DPH, this bill would not change the way the State Registrar records the death certificate or reports public health data, as the certificate cannot be altered after registration by the local registrar (i.e., information that is listed on the death record is required to be reported). According to DPH, this bill will also not affect the way causes of death are reported in data. The coding of causes of death for California vital records is provided by the National Centers for Health Statistics (NCHS). In coding causes of death, NCHS adheres to the World Health Organization Nomenclature Regulations specified in the most recent revision of the International Statistical Classification of Diseases and Related Health Problems. In general, pursuant to the ICD 10 Mortality Manual 2a 2014, Section N. Sex and Age Limitations, if the underlying cause of death appears to be inconsistent with the gender, the accuracy of the underlying cause of death is re-examined and the gender is verified. In addition, verification of the inconsistency can be accomplished through examination of name, occupation, and other items on the certificate. If the gender is determined to be incorrect, the data record is corrected. If the gender entry is correct but not consistent with the underlying cause of death, the death is CONTINUED AB 1577 Page 5 coded to "Other ill-defined and unspecified causes of mortality." Sometimes on a case-by-case basis, inconsistencies in the underlying cause of death and gender are coded as "unspecified" underlying causes of death, e.g., "unspecified cancer," or they may be coded to the secondary cause of death if it is consistent with the gender, e.g., a primary cause of death for a male with ovarian cancer that has metastasized to the kidneys may be coded as kidney cancer. Comments According to the author's office, the Respect After Death Act will ensure that transgender individuals who have memorialized their gender identity on their legal documents can be recognized properly at death. Additionally, AB 1577 will provide protection from civil suits for funeral directors and coroners who follow the letter of the law. Once we are deceased, we are often at the mercy of others to treat us with dignity. The very least we can do is ensure individuals are given basic human dignity by honoring their authentic selves when they pass so that more pain is not inflicted upon grieving loved ones or the community. Prior Legislation AB 1121 (Atkins, Chapter 651, Statutes of 2013) creates, as of July 1, 2014, an optional administrative procedure for a transgender person born in California to amend gender and name on his/her birth certificate without first obtaining a court order. FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes Local: Yes SUPPORT : (Verified 8/20/14) Equality California (co-source) Transgender Law Center (co-source) AFSCME, AFL-CIO California Communities United Institute City and County of San Francisco Civil Justice Association of California OPPOSITION : (Verified 8/20/14) CONTINUED AB 1577 Page 6 Capitol Resource Family Impact ARGUMENTS IN SUPPORT : The Transgender Law Center and Equality California, the co-sponsors of this bill write that current California law governing the completion of death certificates fails to provide sufficient direction to the authorities, such as funeral directors and coroners who are responsible for determining a person's gender designation after death. In some cases, this lack of clarity has resulted in the issuance of a death certificate that inaccurately reflects a transgender person's gender. When a transgender person is ascribed the incorrect gender, whether on official documents or in the media, it is disrespectful to the memory of the deceased person and can be deeply painful and stigmatizing to grieving friends, family, and fellow community members. The Civil Justice Association of California supports this bill because it grants civil immunity to coroners and funeral home directors when they record the sex of a transgendered person and will allow those professionals to do their jobs without fear of a meritless lawsuit. ARGUMENTS IN OPPOSITION : Capitol Resource Family Impact opposes this bill because it would give an acquaintance the legal authority to change the legal gender of a person after death, and they believe if a person chose to not take the legal steps to change his/her gender during his/her lifetime, no individual should have the right to make that change for that person after their death. ASSEMBLY FLOOR : 62-5, 5/15/14 AYES: Achadjian, Alejo, Ammiano, Bloom, Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian Calderon, Campos, Chau, Chávez, Chesbro, Cooley, Dababneh, Daly, Dickinson, Eggman, Fong, Frazier, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell, Gray, Hagman, Hall, Roger Hernández, Holden, Jones-Sawyer, Levine, Linder, Lowenthal, Maienschein, Medina, Mullin, Muratsuchi, Nazarian, Nestande, Pan, Perea, John A. Pérez, V. Manuel Pérez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas, Rodriguez, Salas, Skinner, Stone, Ting, Wagner, Weber, Wieckowski, Williams, Yamada, Atkins NOES: Bigelow, Donnelly, Beth Gaines, Grove, Wilk NO VOTE RECORDED: Allen, Conway, Dahle, Fox, Harkey, Jones, Logue, Mansoor, Melendez, Olsen, Patterson, Waldron, Vacancy CONTINUED AB 1577 Page 7 JL:e 8/20/14 Senate Floor Analyses SUPPORT/OPPOSITION: SEE ABOVE **** END **** CONTINUED