Suicidal Hanging in an Individual with Gender-affirming Modifications: A Forensic Autopsy Case Report
DOI:
https://doi.org/10.48165/jfmt.2026.43.03.25Keywords:
Forensic autopsy, Hanging, Suicide, Gender-affirming modifications, Medico-legal investigationAbstract
Background: Suicidal hanging is a common method of self-inflicted death encountered in forensic practice. However, atypical anatomical findings and sociocultural contexts may complicate interpretation. Increasingly, cosmetic body modifications are observed among individuals with diverse gender identities and possible involvement in commercial sex work.
Case: A young adult individual assigned male at birth was found deceased in a hanging position at their residence. Police investigation and witness statements indicated residence within a transgender community and possible involvement in commercial sex work. External examination revealed an oblique ligature mark consistent with hanging. Bilateral breast enlargement was observed, and autopsy confirmed the presence of subcutaneous silicone-based breast implants. A healed genital surgical scar was noted. Examination of the anal region showed non-specific findings that may be seen in cases of repeated receptive anal intercourse but are not pathognomonic. Internal examination of the neck structures confirmed ante-mortem hanging. Toxicological analysis was negative.
Results: The cause of death was determined as asphyxia due to ante-mortem hanging. Additional findings were incidental and not contributory to death.
Conclusion: This case highlights the importance of comprehensive documentation, cautious interpretation of non-specific findings, and objective medico-legal reporting in forensic practice.
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