Nex Benedict's autopsy report released
The much-anticipated full autopsy report for Nex Benedict, a 16-year-old transgender and Indigenous student from Owasso High School in Oklahoma who died in February, was released Wednesday, offering a more comprehensive understanding of the events leading to his tragic death.
Benedict used he, him, they, and them pronouns. Benedict’s death had previously been classified as a suicide by the Oklahoma Office of the Chief Medical Examiner, citing combined toxicity from fluoxetine and diphenhydramine as the cause.
Benedict had endured bullying and an assault at school, which had raised significant questions about the environment in which he lived and the protection offered to LGBTQ+ youth.
The full autopsy report delves into greater detail than the initial one-page summary previously released, providing insight into the physical injuries Benedict sustained and the levels of medication present in their system at the time of death.
Despite the traumatic experiences Benedict faced, including the physical assault the day before his death, the report highlighted that there were no lethal injuries, including an absence of injuries to the brain. This detail is significant, revealing the fact that the physical trauma observed on Benedict’s body, which included nonlethal injuries like bruises, cuts, and scrapes, did not extend to brain damage. These findings shift the focus towards a combination of medications found in Benedict’s system at the time of death. Specifically, toxicology results pinpointed the cause of death to the combined effects of fluoxetine, an antidepressant, and diphenhydramine, an antihistamine that is also commonly used as a sleep aid. According to the report, the levels of these drugs were significantly higher than therapeutic ranges.
The Advocate consulted Dr. Joshua King, the medical director of the Maryland Poison Center, to better understand the toxicology results. King said that while the fluoxetine values weren’t necessarily alarming, the diphenhydramine amount was.
“The fluoxetine levels aren’t dramatically elevated, but the diphenhydramine ones are,” King said. “That would be in a range compatible with other reports of patients dying from diphenhydramine overdose.” He noted that a person suffering from a fatal overdose would usually suffer seizures, cardiac arrhythmias, or both. According to the report, first responders reported finding written communication attributed to Benedict that contributed to the medical examiner’s impression of self-harm.
Bruises, scratches, and cuts to Benedict’s face, while not contributing directly to his death, according to the report, paint a vivid picture of the struggles he endured. The documentation of medical interventions attempted before Benedict’s death, including resuscitation efforts evident from the injuries related to CPR, highlights the efforts made to save his life.
Benedict’s death has led to a series of advocacy efforts, including calls for a federal investigation into the Owasso Public Schools’ handling of bullying and harassment. The U.S. Department of Education launched a civil rights investigation into the school district. Benedict’s family, community members, and advocates, including the president and CEO of GLAAD, Sarah Kate Ellis, and Kelley Robinson, the president of the Human Rights Campaign, criticized the initial response from local and state authorities, demanding accountability and a more thorough investigation. The controversy also highlighted the broader issue of systemic failures to safeguard vulnerable students and the importance of addressing mental health and bullying in educational settings. Ryan Walters, the state’s superintendent of public instruction, has been criticized for contributing to a hostile environment for LGBTQ+ people in Oklahoma schools. Walters appointed Chaya Raichik, the right-wing extremist who runs the Libs of TikTok anti-LGBTQ+ hate account, to a media and library oversight board in January, sparking widespread outrage.
In response to the autopsy's release, Robinson said in a statement, “The full report does little to fill in the gaps in information about that day or the more than a year of bullying and harassment that led up to it. It does not answer the questions of so many in Oklahoma and across the country. We continue to support the calls from Nex’s family for an independent investigation."
She added, “The release of today’s report does not change the fact that LGTBQ+ students in Oklahoma are not safe at school . And it does not change our continued calls for justice and accountability. We reiterate our call for a full and complete investigation into the district, state superintendent Ryan Walters, the Oklahoma State Department of Education, and into their response after Nex was attacked.”
Ellis also responded to the full report’s release. “This report cannot be seen as a conclusion of the investigation into the death of a teenager who should still be here today,” she said. “Oklahoma’s supposed leaders must still provide answers to the public about the state-sponsored bullying by legislation, the inadequate response to violence in a school bathroom, and all the failures to keep Nex safe that continue to endanger LGBTQ and 2STGNC+ people in Oklahoma.”
Nicole McAfee of Freedom Oklahoma remarked on the collective failures at various levels, emphasizing, “As our community continues to grieve and remember Nex, it’s clearer than ever that everyone from Oklahoma’s State Superintendent of Public Instruction Ryan Walters to Owasso High School staff members to the Owasso Police Department, Tulsa District Attorney, and unaccredited-since-2009 state medical examiner’s office failed to deliver justice for Nex Benedict and Nex’s loved ones.” The Trans Advocacy Coalition of Oklahoma and the Oklahoma Pride Alliance called for urgent reform and protection for LGBTQ+ and Indigenous youth, while Christopher Sederburg from the Rainbow Youth Project USA highlighted the impact of Nex’s death on young people seeking help, urging, “It’s incumbent upon all of us to secure safety and well-being for young people, especially those who are most at risk of being bullied and singled out.”
In addition to the legal and social implications, Benedict’s case has prompted discussions on the medical aspects of their death, particularly the use of common medications such as fluoxetine (Prozac) and diphenhydramine (Benadryl). Toxicology experts noted when talking to The Advocate that these medications are commonly prescribed and generally safe when used as directed, and it's exceedingly rare for them to be implicated in deaths.
On February 7, three girls attacked Benedict in a bathroom after he splashed water on them for making fun of him and another transgender friend. The girls beat Benedict, causing the teen to suffer a blackout, according to Benedict’s report to a school resource officer. Benedict was taken to the hospital by his grandmother and sent home. The following day, Benedict was found in distress and rushed back to the hospital, where the teenager was pronounced dead.
A local prosecutor has declined to pursue criminal charges in the case.
If you or someone you know needs mental health resources and support, please call, text, or chat with the 988 Suicide & Crisis Lifeline or visit 988lifeline.org for 24/7 access to free and confidential services. Trans Lifeline, designed for transgender or gender-nonconforming people, can be reached at (877) 565-8860. The lifeline also provides resources to help with other crises, such as domestic violence situations. The Trevor Project Lifeline, for LGBTQ+ youth (ages 24 and younger), can be reached at (866) 488-7386. Users can also access chat services at TheTrevorProject.org/Help or text START to 678678.
Editor’s note: This story was updated to include reactions from advocacy groups to the release of the full autopsy report.
