Transgender Oklahoma student Nex Benedict, who died last month the day after a fight at school, left handwritten notes “suggestive of self-harm” that were found by his family and provided to police, according to a full autopsy report released Wednesday.

The Oklahoma medical examiner’s office ruled Benedict’s death a suicide in a preliminary summary report released on March 13. The report listed a probable cause of death as “combined toxicity” from two drugs, one of which is available over the counter and the other by prescription. However, it didn’t provide any additional details regarding why the medical examiner believed the overdose was suicide. 

The full autopsy report notes that Benedict was involved in a physical altercation and had injuries to his head, neck, torso and limbs. These injuries, it found, were not lethal. 

The medical examiner also noted that Benedict’s medical history included bipolar disorder, depression, anxiety, self-harm, and chronic tobacco and marijuana abuse. 

Benedict, who was transgender and used he and they pronouns, according to friends and family, died Feb. 8, a day after a fight at Owasso High School. Benedict had reportedly told his mother that he was bullied at school due to his gender identity. Body camera footage released by police last month shows Benedict lying in a hospital bed following the fight. In the video, he tells a police officer that three students “jumped” him after he threw water on one of them because they were bullying him and his friend for the way that they dressed.

Benedict’s death has drawn international attention and ignited additional backlash from LGBTQ advocates, some of whom believe that the bullying Benedict faced is connected to the dozens of state bills targeting the community in recent years in Oklahoma and other states. In the weeks following Benedict’s death, his friends and classmates led a walkout at school to protest what they described as an unsafe environment for LGBTQ students. 

Tulsa County District Attorney Stephen Kunzweiler announced last Thursday that there would be no charges filed against the other students involved in the fight. Kunzweiler also noted that the contents of the notes found by Benedict’s family, which he said “do not make any reference to the earlier fight or difficulties at school,” would not be released.

Nicole McAfree, executive director of the LGBTQ advocacy group Freedom Oklahoma, responded to the full autopsy with a message to Oklahoma lawmakers as the end of the state’s legislative session nears. McAfree called on them to “send a message of adamant opposition” to anti-LGBTQ legislation and policies and “support measures that enable more empathy, kindness, and compassion, not less.” McAfree added, “Nex should be alive, and the very least we can do in Nex’s memory is demonstrate our commitment to building a better world that makes it impossible for this heartbreaking tragedy to happen again.”

If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline or chat live at 988lifeline.org. You can also visit SpeakingOfSuicide.com/resources for additional support.