On Wednesday, Colorado became the first state to issue a birth certificate that is not assigned "male" or "female."
Anunnaki Ray Marquez, who identifies as an intersex gender-nonconforming gay man and uses they/them and he/him pronouns, recently received an amended birth certificate that declares him "intersex" rather than "male" or "female." The monumental change came after a court ruling and a decision by Colorado's records office, which changed its rules after Marquez provided medical documents that illustrate hormonal and chromosomal variations cause his body to display both male and female characteristics, Themreports.
"I am what they consider hormonally intersex. My hormones are not that of a typical female," Marquez, an intersex advocate who works with Jax Youth Equality, told Them. "My biological sex used to be diagnosed as 'intersexuality with hormonal variations Q56.0, hermaphroditism not elsewhere classified.'"
Assigned female at birth by his parents, Marquez endured unique challenges when he varied from that gender identity and displayed both male and female secondary sex characteristics.
"I was born in 1967 and put into therapy at three years old," he explained. "They called me 'perceptually handicapped' because I thought I was a boy. They didn't even have the word 'transgender,' much less the word 'intersex.'"
Though his parents did not surgically alter his genitals, he feels that being assigned female at birth did not properly represent him genetically.
"Here's the thing that confuses people: My biological sex is intersex. We live in a world that thinks that should be in alignment with my gender identity," said Marquez. He underscores that biological sex and gender are separate. "But my gender identity doesn't match: it's non-conforming, androgynous male. My sexual orientation confuses people even more. If I have an intersex body, they get confused when I say I'm gay."
Though this is the first time a state has issued an "intersex" birth certificate, Sara Kelly Keenan was the first American who was issued an intersex version of the document. It was amended by New York City, which has a vital records department that is not controlled by the state. Several intersex birth certificates have been issued after Keenan's in the city, according to the Intersex and Genderqueer Recognition Project.
However, several states permit gender-neutral markers on driver's licenses and state ID cards.
"These changes to birth certificates and driver's licenses on the state level -- in Oregon, California, Washington, New York, D.C., and now Colorado -- are also likely to have implications in how the Federal Government handles passports," IGRP Executive Director Toby Adams told Them. This is especially timely, as transgender women have complained that under the Trump administration their passports have been retroactively revoked.
However, intersex individuals still face significant challenges.
Marquez explained how growing up, he was shocked to discover that he was anatomically different from other girls.
"I was like 'oh my god, where is her clitoris?' Because I expected it to be so big, almost like a penis," he remembers. "And that's when I realized I was the different one. They never taught that variation in sex ed class."
Biologically able to become pregnant but not able to give birth, Marquez has had four miscarriages. "My pelvis is too narrow, my vagina isn't able to dilate. I had to have two C-sections."
However, Marquez is grateful to have not been surgically altered without his consent. "I thank God that I still have my genital integrity," he said.
Although California recently passed a resolution condemning medically changing the bodies of intersex babies, altering the genitals of intersex infants is legal in all 50 states.