Let's Stop Putting Gender on Birth Certificates

Arthur L. Caplan, PhD


July 19, 2021

This transcript has been edited for clarity.

I'm Art Caplan, head of the Division of Medical Ethics at New York University's Grossman School of Medicine.

Do people have a right to know what your sex was when you were born? How would they know that? Oftentimes they learn it from your birth certificate.

Birth certificates play a big role in our society. We don't think about it that much, but you need it if you want to get a passport, public education, or a number of health benefits. There are many ways in which you need to have a birth certificate to get access to benefits, to be able to be a citizen, or to be able to travel. It is a very important document.

Recently, the American Medical Association (AMA) decided that sex should be removed as a legal designation on the public part of birth certificates, meaning you get a public document as an individual to take home and then certain information is sent to government agencies that track things like gender, sex, race, and ethnicity. This information is private. It's not something that people can publicly access. It's only there for record-keeping. That would still exist.

When a baby is born, you'd be expected to say male, female, or neutral — in some states, that is permitted (I think it's done with an X) — and send that off to government agencies that would start keeping track of that for government purposes.

The birth certificate that you take home doesn't need to have sex on it, according to the AMA. This decision was not taken lightly. There was a large amount of debate. Many doctors said, "Over the years, I've been trained to put the sex on the birth certificate. We do that by basically examining genitalia. It's something that historically has been a part of a birth certificate. I don't see any reason to change it."

Other people argue that we are now becoming more sophisticated about sexual identity and gender orientation, and we realize that sex is not simply a binary concept. It's not just male and female. There may be people who are transgender, bisexual, or who have characteristics of male and female. If you put one sex on there, it can be used — and has been used — to discriminate against people, stigmatize people, even sometimes to punish people.

We all know that there have been lots of disputes about who can use what bathroom and whether they have to do it according to the sex determination that they were given at birth, or what they feel is appropriate for them to do as adults in terms of their orientation.

I support the removal of this classification. I think it's old and out of date. We're more sophisticated, if you will, about sexuality being more of a continuum than it is a hard and fast binary distinction. I don't think it gets used for very much publicly except sometimes to discriminate.

You can certainly keep your birth certificate showing where and when you were born and all the rest of it for legal purposes that you're going to need. Sex rarely comes up as something that has to be there.

Older birth certificates used to list the race of the parents, and we took that out as being unnecessary for public birth certificate documentation. I think gender and sexual classification should go the same way.

I think the AMA is right. I think we should remove sex from public birth certificates and let people identify later as to what sex or what their gender orientation is going to be. I don't think it serves much of a public purpose. It's time to go.

I'm Art Caplan at the Division of Medical Ethics at New York University School of Medicine. Thanks for watching.

Arthur L. Caplan, PhD, is director of the Division of Medical Ethics at New York University Langone Medical Center and School of Medicine. He is the author or editor of 35 books and 750 peer-reviewed articles as well as a frequent commentator in the media on bioethical issues.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: