Should sex or gender markers be included on government-issued IDs?
In what may be a world first, a child born in British Columbia, Canada, has been issued a health card without a sex or gender designation.
Most health cards in British Columbia are marked with an “M” for male or “F” for female.
But Searyl Doty’s health card is marked with a “U,” which likely stands for “unspecified” or “unknown.”
This may be the first sex-neutral and gender-neutral health card to be issued to an infant, reports the Gender Free I.D. Coalition (GFID), a group that advocates for the removal of sex and gender designations from government-issued identity documents.
In a recent press release, the organization included the following quote from Searyl’s parent, Kori Doty:
“I do not gender my child. It is up to Searyl to decide how they identify, when they are old enough to develop their own gender identity. I am not going to foreclose their choices based on an arbitrary assignment of gender at birth based on an inspection of their genitals.”
Doty is a nonbinary genderqueer trans person who doesn’t identify as male or female.
They are also involved in an ongoing legal battle to obtain a birth certificate for Searyl that is free of gender markers.
According to Dr. Dan Karasic, a health sciences clinical professor at the University of California, San Francisco, this case is part of a larger movement to change how governments manage identity documentation.
“I think it’s related to a broader movement to allow nonbinary legal gender identities and also make it easier for people to change their legal gender,” Karasic told Healthline. “What both of those have in common is the push to allow identification that fits with a person’s identity.”
Putting well-being at risk
Searyl was born at a friend’s home, outside the conventional medical system, and wasn’t subject to a “genital inspection.”
This is a process that medical professionals typically use to assign an infant’s gender to closely related aspects of identity.
Sex describes the physical traits associated with the categories “male” and “female,” including external genitalia, internal reproductive organs, hormones, and chromosomes.
Gender refers to the social distinctions associated with those categories, including the different roles, behaviors, and mannerisms expected of men and women.
Transgender people experience a mismatch between the sex and gender assigned to them at birth and their internal sense of self.
Some transgender people undergo medical interventions to bring their physical traits into closer alignment with their self-image and self-determined identity.
Others socially transition from one sex and gender category to another, without undergoing hormone therapy or surgery.
When the sex and gender markers on their legal documents don’t match their self-determined identity, it can lead to problems.
“You’re essentially outing that person as transgender every time they have to show their I.D. and really taking away the control from them,” Karasic explained.
This can contribute to feelings of anxiety and stress.
It can also expose transgender people to intrusive questions and discrimination from others, putting their well-being at risk.
“My documents feel wrong to me because they don’t reflect my correct gender identity,” Dee Shull, a genderfluid person and communications specialist and coordinator for the Intersex and Genderqueer Recognition Project (IGRP), told Healthline by email.
“I try to avoid situations where I would need to present my documents, and I find myself bracing for an explanation when I know that someone is going to look at them and question me,” Shull added. “It’s also why I don’t want to travel by airplane, either domestically or out of the country. I know that my identity will be in question because it doesn’t match what’s on my documentation.”
Advocates push for change
The World Professional Association for Transgender Health (WPATH) has called on governments to implement a simple administrative procedure to allow people to change their legal identity documents to match their self-determined identity.
In the United States, federal law doesn’t require people to undergo sexual reassignment surgery to legally change their sex or gender.
But many states still require a health professional to certify that a person has undergone medical or psychological treatments for transition.
Only a few states allow for nonbinary sex and gender designations.
“About six years ago in California, they removed the surgical requirements to change legal gender. After that, another law passed that further lowered barriers. And most recently, there’s a bill in the California legislature that would allow a nonbinary gender marker on driver’s licenses,” noted Karasic, who serves as a board member of WPATH.
“Another thing would be to allow people to change their legal gender by self-affidavit, so they wouldn’t have to get a doctor to say they’ve received treatment. They could just legally swear what gender they’re living in.”
Some countries, such as Argentina, already follow that model.
As for omitting sex and gender designations altogether, federal legislation currently requires gender markers to be included on state-issued driver’s licenses and identifications cards.
With that in mind, organizations like IGRP are focusing their advocacy efforts on the push to add a nonbinary gender option.
“The first step there is to get accurate identification for people with nonbinary gender identity,” Shull said. “IGRP has said in any case where we’re asking for a nonbinary option to be added, we would be fine if the designation was removed entirely. Unfortunately, the REAL ID Act requires a sex/gender marker, even though it doesn’t require specifically 'M' or 'F'.”
While some people argue that conventional sex and gender markers on government-issued identity documents help prevent identity fraud and improve law enforcement, Shull questions that logic.
“IGRP’s argument is that this makes no sense because when you require a nonbinary person to be labeled binary, it creates inaccurate identification,” they said.
For now, Shull suggests that people who are interested in changing the sex and gender markers on their legal documents should contact the IGRP, Lambda Legal, or another advocacy organization for help.