Germany now allows a "blank" option for birth certificates, so that children of ambiguous sex can be designated as such. It is the second country to adopt a third sex option for birth certificates; the first was Australia, which made a similar change about 6 weeks ago. An estimated 1% of babies are born with ambiguous genitalia, with an estimated 0.1% - 0.2% of babies having genitalia ambiguous enough that the sex cannot be determined at birth. Typically, in the past, the newborn would undergo "corrective" surgery to adjust the genitalia to be representative of either male or female.

The articles that I've seen on this topic were written by people who don't know the difference between intersex and hermaphroditic, and who don't know that having ambiguous genitalia does not equate to hermaphroditism. So, let's have a primer on how these terms are used in reference to humans:

  • Hermaphroditism (NSFW image included): possessing both male and female reproductive organs, including the presence of "ovotestes," gonads that have features of both ova and testes.
  • Ambiguous/indeterminate genitalia (NSFW image included): having genitalia that is non-standard enough that doctors cannot identify the predominant sex. This can be due to hermaphroditism or to the absence of some or (theoretically) all reproductive organs.
  • Intersex (NSFW image included): Any mismatch or ambiguity in chromosomes, gonads, or genitalia. There are many possible variations: presentation of indeterminate genitalia; presentation of female external genitalia with male genetics; having a condition that causes natural breast growth in males starting at puberty; clitoromegaly; having a micropenis; etc. Some of these conditions are apparent at birth, others become apparent at puberty, and a few are apparent only through medical testing.

In the past, parents were strongly encouraged to opt for "corrective" surgery, which is a cosmetic procedure, for reasons that I hope don't require an explanation. Prior to this, children were given "corrective" surgery, often without parental knowledge. It was commonly hidden from the child so that the affected children grew up unaware of the "corrective" surgery, although with changing attitudes, this may not hold true anymore.

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You may have noticed by now that I keep putting corrective in scare quotes. Increased awareness of transgender and intersex issues have caused medical and psychiatric professionals to reevaluate the appropriateness of the surgery. Imagine that a child was born a hermaphrodite, had surgery to remove the male genitalia, went through puberty unaware that she had been born intersex, and grew up to identify as male. In this case, the "corrective" surgery destroyed the appropriate genitalia, a situation which is increasingly viewed as a civil rights violation.

There has also been an increase in intersex activism, encouraging intersex people to identify as intersex and celebrating the genitalia that nature intended them to have. After all, these variations are natural, so we can think of sex, like gender or sexual preference, falling on a spectrum rather than always appearing as a binary. Viewed this way, any sexual assignment surgery to a child would be a civil rights violation.

What is the result of this change?

By allowing a "blank" sex designation, parents can opt to skip "corrective" surgery until the child identifies as a gender, then opt for "corrective" surgery to reflect that gender, setting the sex on the birth certificate to match that gender. The parents may also opt to wait until the child is an adult and allow the intersex person to decide whether or not the surgery is corrective. This is important for hermaphrodites, to avoid the risk of destroying potentially functioning genitalia that matches their gender. However, this will also allow people who identify as intersex to have that identity reflected on their birth certificate, simply by continuing to leave the sex designation blank. This will not affect other documents that require a sex designation;for instance, some countries require that foreign passports list a sex, so passports may still require a designated sex.

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Since this is a change that applies to the original birth certificate, this does not take into account cases other than ambiguous genitalia at birth. Presentation of opposing sex features following puberty, a mismatch between presentation and genetics, and a wrongly "corrective" designation/surgery are not handled under these laws. These issues are all completely separate from transgender issues; hopefully, someone more versed in transgender or intersex issues than I am will comment with a clarification on the case where an inappropriate "corrective" surgery was performed. These laws do not affect people who identify as transgender. People who identify as transgender were not necessarily born with ambiguous genitalia and may be offended by assertions that they could be intersex, since this is usually a separate issue and shows lack of knowledge on the part of the speaker.

Note: since I am not an expert in intersex or transgender issues, I may have unintentionally used poor wording or presented inaccurate information above. If you see such a problem, please notify me so I can make appropriate corrections.