A new article in the prestigious New England Journal of Medicine argues that birth certificates should no longer include biological sex in order to reduce the “harmful effects” on transgender and intersex individuals.
The Dec. 12 article, authored by three doctors, says birth certificates should be overhauled so that biological sex is no longer listed in the “legally identifying fields.” Such fields currently include items such as name, date of birth and location of birth.
The authors want biological sex moved to the bottom of the birth certificate – that is, below the line of demarcation – where it would be used for statistical purposes but not for identifying purposes.
The article was titled, “Failed Assignments – Rethinking Sex Designations on Birth Certificates.”
“We believe that it is now time to update the practice of designating sex on birth certificates, given the particularly harmful effects of such designations on intersex and transgender people,” the article says. “... Designating sex as male or female on birth certificates suggests that sex is simple and binary when, biologically, it is not. Sex is a function of multiple biologic processes with many resultant combinations.”
About six in 1,000 individuals “identify as transgender, meaning that their gender identity doesn’t match the sex they were assigned at birth,” the authors say. Other individuals “are nonbinary, meaning they don’t exclusively identify as a man or a woman.”
“Sex designations on birth certificates offer no clinical utility; they serve only legal – not medical – goals,” the authors argue. “Certainly, knowing a patient’s sex is useful in many contexts, when it is appropriately interpreted. Sex modifies the clinical suspicion of a heart attack in the absence of classic symptoms and is a proxy for many undefined social, environmental, and biologic factors in research, for example.
“But, in each of these applications, sex is merely a standin for other variables and is not generally ascertained from a birth certificate,” the authors write. “Keeping statistical data on newborn sex may further public health interests. Moving information on sex below the line of demarcation wouldn’t compromise the birth certificate’s public health function. But keeping sex designations above the line causes harm.”
Sex assignments at birth, the authors say, is used to “exclude transgender people from serving in appropriate military units, serving sentences in appropriate prisons, enrolling in health insurance, and, in states with strict identification laws, voting.”
The authors acknowledge such a change could stir controversy. For sports teams, they propose defining male and female by hormone levels and not by biological sex.
“The International Association of Athletics Federations has defined ‘female’ as a person with a testosterone level of 5 nmol per liter or lower, rather than relying on birth certificates,” the authors write. “Although this definition is controversial, it has the benefit of making the goals and assumptions of the policy transparent, thereby allowing for more effective public debate.”
The article was authored by Brown University’s Vadim M. Shteyler and Eli Y. Adashi, and Vanderbilt University’s Jessica A. Clarke.
Albert Mohler, president of Southern Baptist Theological Seminary, called the idea a “capitulation to the rejection of creation.”
“Christians understand [sex is] not designated,” Mohler said on his pocast, The Briefing. “It is merely recognized and it's also recorded – that's why we have birth certificates.”
Mohler criticized the article for promoting a contradiction: Birth certificates are necessary for public health but not for personal health, the authors argued.
“We are in a world increasingly drowning in nonsense,” Mohler said.
Photo courtesy: ©Getty Images/Kathryn8
Michael Foust has covered the intersection of faith and news for 20 years. His stories have appeared in Baptist Press, Christianity Today, The Christian Post, the Leaf-Chronicle, the Toronto Star and the Knoxville News-Sentinel.