NEJM proposes change in birth certificates to accommodate transgender concerns


The Australian census will begin asking questions this year about gender diversity. It plans to ask people what is their "sex recorded at birth" as well as their declared gender. Changing the information recorded on birth certificates is even more radical – but that was proposed recently in a commentary article in the New England Journal of Medicine (December 17).

American birth certificates should be revised to make ticking a box for male or female optional. Legally identifying information should be reported “above the line” because that is publicly available. To avoid stigma and allow self-identification, fields like race, parental marital status and sex or gender should be below the line.

The birth certificate is a document which evolves with time, argue the authors, who come from Brown University Medical School and Vanderbilt Law School: “it is time for another up- date: sex designations should move below the line of demarcation.”

They argue that “Designating sex as male or female on birth certificates suggests that sex is simple and binary when, biologically, it is not … Assigning sex at birth also doesn’t capture the diversity of people’s experiences. About 6 in 1000 people identify as transgender … Sex designations on birth certificates offer no clinical utility; they serve only legal -- not medical -- goals.”

Assigning sex at birth is unfair and even dangerous, they contend. “Assigning sex at birth perpetuates a view that sex as defined by a binary variable is natural, essential, and immutable … Imposing such a categorization system risks stifling self- expression and self-identification.

The comments of the NEJM’s readers were initially glowing, but rapidly became hostile. “The suggestion that sex is not binary because intersex disorders exist is ludicrous. … spare us the trip down this anti-science, ideological rabbit hole,” was a typical response.

Evolutionary biology Colin Wright, who is also the editor of Quillette, analysed the article in more detail. He pointed out that as recently as August last year, The Lancet published a survey article which concluded that: “The combination of all genetic and hormonal causes of sex differences [yield] two different biological systems in men and women that translate into differences in disease predisposition, manifestation, and response to treatment.”

Michael Cook is editor of BioEdge




MORE ON THESE TOPICS |


This article is published by Michael Cook and BioEdge under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

 
 Search BioEdge

 Subscribe to BioEdge newsletter
rss Subscribe to BioEdge RSS feed

 
comments powered by Disqus