In a groundbreaking recommendation aimed at supporting the rights of transgender, non-binary, and intersex individuals, the American Medical Association (AMA) has proposed that sex should not be included in the public sections of birth certificates in the United States. According to a report released in June by the AMA’s LGBTQ+ advisory committee, “designating sex as a binary variable on birth certificates reinforces the idea that it is unchangeable” and “does not acknowledge the medical spectrum of gender identity.”
Importantly, while the sex assigned at birth would still be documented, it would remain confidential and accessible solely for “medical, public health, and statistical purposes.” This change marks significant progress for the LGBTQ+ community, which has long faced stigma and discrimination, especially for those whose gender identities do not align with their sex assigned at birth. Individuals often encounter challenges in various aspects of life, including job applications, healthcare access, and child adoption, when their birth certificate does not reflect their true identity.
Dr. Emily Thompson, an AMA delegate from California, emphasized the need to recognize gender as a spectrum. “Forcing individuals to navigate complex administrative processes to align their identity with a sex assigned at birth based solely on genitalia is not only unnecessary but can also harm their health,” she stated.
Historically, birth certificates have facilitated discrimination. The AMA pointed out that these documents have been used to uphold racial hierarchies and enforce laws against interracial marriage. While the race of parents is no longer included on public birth certificates, sex designation remains, despite its potential for discrimination.
However, there remains considerable work ahead. Currently, 14 states offer a third gender option on birth certificates, and 49 states (including Washington, D.C.) allow for changes to the sex designation, though the process can be cumbersome and may require proof of sex reassignment surgery. Tennessee is the only state that does not permit changes to the gender marker on birth certificates, according to the Movement Advancement Project (MAP).
This recommendation is a positive initial step toward reducing the discrimination and challenges faced by trans and non-binary individuals seeking recognition.
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In summary, the AMA’s recommendation to remove sex from the public-facing portion of birth certificates represents a significant shift toward recognizing the gender spectrum and reducing discrimination against trans, non-binary, and intersex individuals.