American Medical Association recommends removing sex markers from public portions of birth certificates

The National Center for Transgender Equality (NCTE) and the Human Rights Campaign gather on Pennsylvania Avenue in front of the White House in Washington, Monday, Oct. 22, 2018, for a #WontBeErased rally. Anatomy at birth may prompt a check in the "male" or "female" box on the birth certificate, but to doctors and scientists, sex and gender aren't always the same thing.
  • Individuals whose gender identity does not match their birth certificate can experience discrimination, harassment, and violence.

  • Birth certificates were previously used to enforce segregation and prevent interracial marriage.

  • Many modern birth certificates only have male and female options for sex designations.

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The American Medical Association advocated in a June report for the removal of sex designations from the public portion of birth certificates, recommending that it be visible for medical and statistical use only.

While birth certificates are not public documents due to the fact that they contain personal information, individuals have to provide them for a variety of reasons, including obtaining licenses and passports, registering for school, and getting married.

Individuals whose gender identity does not match the sex designation on their birth certificate can experience discrimination, harassment, and violence whenever their birth certificate is requested.

When Gavin Grimm came out as transgender, his school board adopted a discriminatory policy prohibiting boys and girls "with gender identity issues" from using the same common restrooms as students and forced him to use separate restrooms until he graduated, according to the ACLU. Even after Grimm legally changed his sex to male under Virginia law and received a new birth certificate, the school board provided him a transcript identifying him as female, the ACLU said.

The process for amending sex designations on birth certificates varies from state to state, according to the report, with some requiring court orders or proof of surgery from a medical provider. Tennessee and Ohio do not allow amendments of the sex marker on birth certificates.

Grimm's case is far from a novelty. Birth certificates have been used as a tool for discrimination since their implementation in 1900. The Washington Post reported that Walter Plecker, the state registrar of vital statistics in Virginia from 1912 to 1946, worked with the white-supremacist Anglo-Saxon Clubs of America to persuade the state legislature to pass the 1924 Racial Integrity Act, which forbade interracial marriage, created the "one-drop rule," and made it a felony to falsely register a person's race on a government document.

"Historically, birth certificates have also been used to discriminate, promote racial hierarchies, and prohibit
miscegenation. For that reason, the race of an individual's parents is no longer listed on the public portion of birth certificates," the report said. "However, sex designation is still included on the public portion of the birth certificate, despite the potential for discrimination."

Additionally, many current birth certificates only have male or female listed as options for sex markers, forcing many intersex, transgender, and gender non-conforming individuals to select a marker that does not reflect their gender expression.

If sex designation is removed from the public portion of birth certificates, it would have little to no impact on data collected for medical, public health, and statistical purposes, according to the report.

After a WebMD tweet publicized the recommendation, several right-wing outlets and pundits responded with criticism. The Federalist, a conservative online magazine, has published multiple pieces about the recommendation, including one titled "Don't Let The SJWs At The American Medical Association Neuter Your Birth Certificate."

Despite backlash, the association has historically crafted policy recognizing that every individual has the right to determine their gender identity and sex designation on government documents, according to a June press release.

"Assigning sex using a binary variable and placing it on the public portion of the birth certificate perpetuates a view that it is immutable and fails to recognize the medical spectrum of gender identity," the report reads. "Imposing such a categorization system risks stifling self-expression and self-identification and contributes to marginalization and minoritization."

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