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Washington's nonbinary natives will now have their own gender option on birth certificates. 

Starting on January 27, the state Department of Health will allow individuals to change the sex designation on their birth certificates to a nonbinary gender identity, gender X. The state will also remove the requirement for adults to need a medical care provider to sign off on it. 

Christie Spice, director of the Center for Health Statistics, said her staff began discussing the rule change over the summer as a way to improve their data-collecting process, cater toward demand, and reduce the potential for discrimination when official documents don't match the way individuals present themselves.

In the past few years, demand for changing sex designations on birth certificates has rapidly grown, Spice told Seattle Met. Spice said in 2015, the health department received 100 requests from individuals seeking to change the designation from male to female or vice versa. By 2017, the number about tripled.

"Our social norms are changing," Spice told Seattle Met in December. "We're simply just looking at providing people with options to have a birth certificate that matches who they are and how they show up in the world."

On December 5, the health department held a packed public hearing in Tumwater, where many nonbinary supporters and allies showed up to support the rule change. Health officials also received about 1,000 comments online. 

Ericka Otterman, whose spouse is intersex and goes by "they" and "their" pronouns, told the room they are constantly misgendered and have a difficult time getting accurate medical care at hospitals. 

"This change would allow us to get them the basic medical care that they need, the basic level of dignity that they deserve," Otterman said. "This will be very huge for us. It would greatly impact their health and happiness, and sanity of our home."

A few female opponents from Hands Across the Aisle Coalition—an anti-trans group that describes itself as bipartisan and believes gender identity "harms women"—said the designation should be limited to sex, not gender, and that there are only two sexes. (About one in every 100 babies are born with intersex qualities, according to the Intersex Society of North America.)

Opponents also said it would make statistics unreliable and make it more difficult to treat patients. But advocates say data collection is another good reason to provide the nonbinary option—little information is available on nonbinary or intersex individuals because official documents have never tracked it. In June, Oregon became the first state to offer a third gender option on driver's licenses. 

LGBTQ advocacy groups were pushing for fewer barriers to make the change in the rule. They wanted it to require minors to either show parental or a medical care provider's approval, not both, and to remove the requirement that adults need their request notarized. 

For nonbinary or transgender individuals, updating all their official IDs can become lengthy, expensive, and often feel like a game of "whack-a-mole," said Sophia Lee, board chair at the Gender Justice League and a transgender woman.

"Nonbinary people are just people who are... trying to be genuine, live their own genuine lives," Lee told Seattle Met. "We should all try to help remove these artificial barriers that are put in place that prevents them from doing so."

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