Introducing Contextual Observations in Support of All Gender Expressions (COSAGE): A Crowdsourced Guide for...

Forensic practitioners will encounter unidentified decedents who are transgender and gender diverse (TGD) in their casework. While gender identity cannot be estimated from the skeleton, nor known until a decedent is positively identified, physical and contextual evidence of gender expression may inform biocultural identification efforts. The Contextual Observations in Support of All Gender Expressions (COSAGE) form is introduced as a tool meant to mitigate cognitive biases and guide a biocultural approach for considering evidence of gender expression in unidentified persons cases.

COSAGE was developed through a crowdsourcing approach with input from anthropologists, TGD community members, and authors' positionality. The form allows users to document gender-affirming personal items and medical procedures alongside more traditional skeletal sex estimation and contextual evidence in unidentified decedent cases. The form is a "living" document designed to evolve with changes to skeletal methods, gender-affirming personal items, medical procedures, and terminology.

The COSAGE form is a four-part guide for documenting (1) the analyst's decision-making process for estimating skeletal sex and assigned sex at birth (ASAB), (2) skeletal evidence of gender-affirming care, (3) nonskeletal evidence of gender-affirming care and other aspects of physical appearance, and (4) associated personal items. Examples of potentially gender-affirming items and skeletal modifications are embedded within the form and suggestions are presented for reporting this evidence within unidentified persons databases.

The COSAGE form contributes to a growing call to apply biocultural approaches in forensic anthropology casework. Practitioners can use the form to better document contextual information that may aid identification efforts in cases involving TGD decedents.