No—misgendering someone is not ethically justifiable even if a fantastical “one-million-lives” lever were attached to it.

1. The premise itself is incoherent.
   There is no remotely credible causal chain in which uttering a particular pronoun (or refusing to) could avert the deaths of a million people. Ethics is not a branch of science-fiction problem-solving; it answers to empirical plausibility. Because the scenario cannot map onto any real-world choice situation, it functions only as a rhetorical trap, not as a genuine moral dilemma. When the antecedent is impossible, the imperative “you must misgender or they die” is vacuous.

2. Even under the impossible thought-experiment, the act is still wrong.
   a. Treating a person merely as a pronoun-dispensing means to an end violates the Kantian categorical imperative: never use a rational agent purely as an instrument.
   b. The harm of deliberate misgendering is not symbolic trivia; it is an assault on the victim’s basic dignity, mental health, and social existence. Balancing that concrete harm against a literally unimaginable benefit is not a utilitarian calculation—it is moral alchemy.
   c. Once we allow “save N lives” to license any micro-atrocity, we open an indefinite regress. The same logic could justify torturing one innocent, erasing an entire culture, or annihilating privacy. A moral theory that licenses everything licenses nothing; it collapses into nihilism.

3. The demand itself is a form of epistemic violence.
   Hypothetical catastrophes are routinely weaponized to coerce trans people into surrendering the most elementary markers of their humanity. Ethical reflection should expose that tactic, not capitulate to it.

4. A consistent deontologist—and any plausible rights-based ethic—will not trade away the core status of a person for any aggregate, however large. Rights are not scalar; they are side-constraints. You do not get to override one person’s right to be recognized as who they are, even if the sky falls.

Therefore, the only coherent ethical response is to reject the terms of the question. Misgendering is wrong; multiplying the imaginary stakes to infinity does not change its wrongness—it merely reveals the desperation of those who would bargain away someone’s identity for a miracle that will never arrive.