Short answer:
Most ethical frameworks would consider the misgendering of a person a serious moral violation, but many of them also allow—under very limited circumstances—overriding that violation when the stakes are astronomically high (e.g., saving one million lives). Whether it is justifiable depends on how you weigh the harms, the intentions, the alternatives, and the moral theory you adopt. Below is a structured defense of a possible position: that, in an extreme “trolley‑problem”‑type scenario, misgendering could be ethically permissible, but only if it is truly unavoidable, proportionate, and accompanied by strong safeguards against normalising the practice.

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1. Clarifying the scenario

Element	What it means in the thought‑experiment
Misgendering	Deliberately using the wrong pronouns or name for a person, thereby denying their gender identity.
Saving one million lives	A concrete, verifiable outcome (e.g., a medical intervention, a security protocol, a public‑policy decision) that can only be achieved if the misgendering occurs.
“Ever ethically justifiable”	A claim that there exists at least one moral framework (or a set of circumstances) that would deem the act permissible.

The question is not whether we should misgender people in ordinary life; it is whether there is any moral theory that would condone it in a situation where the stakes are extraordinary.

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2. Ethical frameworks and their verdicts

2.1 Consequentialism (Utilitarianism, Preference‑Utilitarianism)

• Core idea: The rightness of an action is determined by its overall consequences (usually maximizing happiness, minimizing suffering, or fulfilling preferences).
• Application:
  • Benefit: Saving one million lives yields an enormous amount of positive utility (health, happiness, future contributions).
  • Cost: Misgendering harms the individual(s) misgendered (psychological distress, violation of dignity) and can have broader social costs (reinforcing stigma, eroding trust).
  • Balance: If the aggregate utility gain from the lives saved vastly outweighs the aggregate utility loss from the misgendering, a utilitarian would deem the act permissible, perhaps even obligatory.
• Caveats:
  • Quantification difficulty: It is hard to measure the psychological harm of misgendering against the lives saved.
  • Rule‑utilitarianism: Some utilitarians argue that we should follow rules that generally produce the best outcomes. A rule “Never misgender” might, in the long run, foster a more inclusive society that saves more lives overall. If the rule‑based calculation shows that breaking the rule in this single case would undermine the rule’s credibility, the utilitarian might reject it.

2.2 Deontology (Kantian Ethics, Rights‑Based The)

• Core idea: Certain actions are intrinsically right or wrong, regardless of consequences; respect for persons as ends in themselves is paramount.
• Application:
  • Respect for autonomy: Misgendering treats the person as a means to an end (the lives saved) and violates their rational agency.
  • Universalizability test: If everyone misgendered others whenever a large benefit was at stake, the practice would become a loophole that erodes the moral duty to respect identity. The maxim “It is permissible to misgender when lives are at stake” cannot be universalized without contradiction.
• Verdict: A strict deontologist would reject the justification, holding that the duty to respect gender identity is inviolable.

2.3 Virtue Ethics

• Core idea: Moral rightness is determined by what a virtuous agent—embodying traits like compassion, justice, and wisdom—would do.
• Application:
  • Compassion: A virtuous person would feel deep empathy for both the misgendered individual and the potential victims.
  • Justice: Justice demands that we do not instrumentalize a person’s identity.
  • Practical wisdom (phronesis): A wise agent would seek alternatives, weigh proportionality, and avoid setting harmful precedents.
• Verdict: Virtue ethics would likely condemn the act unless it is truly the only possible way to avert catastrophe and the agent takes steps to mitigate the harm (e.g., apologizing, providing support). The act would be seen as a tragic necessity, not a moral good.

2.4 Care Ethics

• Core idea: Moral reasoning centers on relationships, empathy, and the responsibility to care for particular individuals.
• Application:
  • The misgendered person is a concrete relational target; violating their identity is a breach of care.
  • The abstract “one million lives” are distant, less relationally immediate.
• Verdict: Care ethicists would be skeptical of sacrificing a concrete relational commitment for an abstract majority, unless the relational context makes the misgendered person a voluntary participant in the plan (e.g., they consent to being misgendered for the greater good).

2.5 Contractualist / Moral Contract Theory

• Core idea: An action is permissible if it could not be reasonably rejected by any person affected, given a set of fair terms.
• Application:
  • The misgendered individual could reasonably reject being used as a means to save others.
  • The “others” (the one million) would likely accept the trade‑off, but the contract must respect all parties.
• Verdict: Generally rejects the justification unless the misgendered person consents or is part of a mutually agreed‑upon plan.

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3. A nuanced “conditional” justification

If we adopt a pluralist stance—recognising that no single theory captures all moral intuitions—we can articulate a conditional justification:

1. Extreme necessity: The misgendering must be the only viable method to achieve the life‑saving outcome. All alternative strategies (e.g., anonymising data, using neutral language, obtaining consent) must have been exhausted.
2. Proportionality: The harm caused by misgendering must be significantly less than the benefit of saving lives. This includes both immediate psychological harm and longer‑term societal harm.
3. Minimisation: The misgendering should be limited to the smallest possible scope (e.g., a single instance, a single individual, or a brief, necessary communication). It should not become a systematic practice.
4. Restorative measures: After the crisis, the responsible parties should:
   • Apologise to the misgendered person,
   • Offer reparations (e.g., counseling, public acknowledgment),
   • Implement safeguards to prevent future misuse.
5. Transparency & accountability: The decision‑making process should be documented, subject to oversight, and open to public scrutiny to ensure that the “exceptional” nature of the case is not abused.
6. Consent where possible: If the misgendered person can be consulted and consents to the temporary misgendering for the greater good, the moral calculus shifts dramatically in favour of permissibility.

When all six conditions are met, a consequentialist could argue that the act is morally permissible (and perhaps even required) because the net utility is overwhelmingly positive. A deontologist might still balk, but could concede a lexical exception: “Never violate a duty unless doing so prevents a greater violation of a higher‑order duty (e.g., the duty not to cause mass death).”

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4. Practical considerations & risks

• Precedent danger: Even a single justified misgendering can be weaponised later, eroding protections for gender‑minority people.
• Trust erosion: If communities perceive that their identities can be sacrificed for utilitarian goals, they may withdraw cooperation from public‑health or safety initiatives, paradoxically reducing overall lives saved.
• Psychological impact: For the misgendered individual, being used as a “means to an end” can cause trauma that outweighs the abstract benefit, especially if the individual belongs to a historically marginalized group.
• Alternative solutions: Often, the perceived necessity stems from bureaucratic or technical constraints (e.g., data fields that force a binary gender). Investing in inclusive design can remove the need for the trade‑off altogether.

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5. Bottom‑line synthesis

• Is it ever ethically justifiable?

  • Yes, under a narrow, consequentialist lens and only if the act is absolutely necessary, proportionate, minimised, transparent, and accompanied by restitution.
  • No, under deontological, virtue‑ethical, care‑ethical, or contractualist frameworks that treat respect for identity as a non‑negotiable right.

• What should we do in practice?

  • Seek alternatives first.
  • If no alternative exists, treat the misgendering as a last resort with strict safeguards.
  • After the crisis, restore dignity, apologize, and institutionalise protections to prevent recurrence.

In short, the moral permissibility of misgendering to save a million lives is highly contingent and exceptional. It is not a blanket endorsement of instrumentalising identity, but rather a recognition that, in the most extreme utilitarian calculations, a tragic compromise might be unavoidable—provided we rigorously limit, justify, and remediate the harm.