Quebec greenlights X gender markers for driver's licences, health cards in policy U-turn

The Quebec government has pulled a 180 on its policy for X gender markers.

In a surprise decision, the province has approved the use of gender markers that reflect the identity of trans and non-binary people on provincial driver's licences and health insurance cards.

The François Legault government had vowed not to make any decisions regarding the X marker until its new gender identity committee submitted its final report in winter 2025.

In a written statement, Quebec Family Minister Suzanne Roy said the decision came after committee experts made the recommendation.

"In light of the consensus reached … the Quebec government agrees that the X marker can now be added to health insurance cards and driver's licences," Roy wrote in a statement.

"The X marker can now be used by people who request it, under the same rules that already apply to other civil status [documents]."

Since 2022, trans and non-binary people in Quebec have been able to legally obtain the letter X rather than M or F on documents such as birth or marriage certificates, but not health-care cards or driver's licences.

In an interview with Radio-Canada, Diane Lavallée, head of the government's gender identity committee, confirmed that a consensus was quickly reached on the question of the X marker after various meetings with concerned organizations.

Lavallée said she informed the government in February that the committee's position would remain the same, whether or not the government waited for the final report in 2025.

"To not move forward would call into question respect for the rights of non-binary people and would not be in accordance with the law that had been passed in June 2022," she said.

"If our work, our comments, allowed for quicker decision-making, we're delighted for the people concerned."

In 2021, Quebec Superior Court forced the province to reword several sections of the Civil Code of Quebec to allow non-binary people to be recognized as such on their birth and death certificates.

System changes needed

Despite the green light from the government, Lavallée said there are still some internal issues to be resolved at the province's health insurance board, the Régie de l'assurance maladie du Québec (RAMQ), regarding the X marker, as she says a patient's biological sex remains an important piece of data.

Until now, Quebec was the only Canadian province not to allow the X marker on driver's licences. As for the health insurance card, Quebec and Alberta were the only two provinces not to authorize the marker. Ontario has simply not included gender on health cards since 2016.

According to Radio-Canada, by early fall 2023, 360 people had sent RAMQ a request to have the X gender marker on their health card. It's unclear how many people the change will affect, as many haven't bothered to send in a request knowing X gender markers weren't available.

The health insurance board said it learned of the decision by the province's families minister Monday morning and planned to immediately begin work to make the change.

"RAMQ welcomes this decision, which will help meet the needs expressed by some of its customers," a spokesperson wrote in an email. "We will work as of today to establish a precise timetable in collaboration with our various partners to implement this decision."

Both the RAMQ and the auto insurance board, or the SAAQ, said clients who have requested a non-binary marker on their cards would be contacted shortly to discuss the next steps in the process.

Trans community celebrates

Arwyn Jordan Regimbal managed to get an X gender marker on their ID before the rules changed. They're happy others won't have to go through the same lengthy legal process for the change to be made.

"I'm happy that we're finally entering the 21st century and disappointed it took so long," they said.

Regimbal had been told by the government that changing their gender marker to an X was "impossible" and that the technology wasn't adequate.

"I think it's quite telling that they reversed course seemingly overnight," Regimbal said. "I believe they realized it was only a matter of time and the delays weren't going to work forever."

Regimbal said the change reaffirms the dignity of trans and non-binary people and allow them "to flourish and thrive like everyone else" without having to explain their identity over and over again.

Celeste Trianon, an activist who runs a legal clinic for trans people in Montreal, said the decision is overdue but welcomed by the community. She said she was surprised to hear the news as she was already preparing a lawsuit against the government for not respecting the 2021 law change.

For many people, an X gender marker is the best way to have their identity reflected on their official documents, she said.

"It certainly is not perfect by any means, but it enables trans and non-binary people to be recognized for who they are. It allows them to be their authentic selves on their ID, and that is why it's not something that concerns everyone. It only concerns a small fraction of the population," she said.

"For that small fraction, it remains essential."

People routinely have to show their ID to access services, and when documents don't match a person's gender presentation, it can open the door to discrimination, said Trianon. She said she's happy people will have one less hurdle to face.