Image copyright EPA Image caption Intersex people can register themselves as such on birth certificates, passports and other official documents

Intersex people in Germany can now legally identify themselves as such under a new law adopted in December.

People who do not fit the biological definition of male or female can now choose the category "diverse" on official documents.

Those choosing the option will need a doctor's certificate to register.

Intersex people are born with both male and female sex characteristics, which can appear at birth or later in life.

Other countries have approved laws in recent years to help recognise intersex people.

Austria's constitutional court made a similar ruling to Germany's in June, while Australia, New Zealand, Malta, India and Canada have all passed measures to redress issues facing intersex citizens.

The UN says up to 1.7% of the world's population are born with intersex traits - about the same number of people with red hair.

This is separate from a person's gender identity or sexual orientation.

But many face stigma, legal discrimination or even forced surgery because of these characteristics.

Media playback is unsupported on your device Media caption Jeanette was 50 when she discovered the truth about her own body

Germany previously allowed intersex people to opt out of choosing either male or female as a gender in 2013.

But in 2017 the country's top court ruled it was discrimination to deny people a gender, after a person registered as female had a chromosome test confirming they were neither sex.

Germany's parliament approved the law change last month, to come into effect on 1 January.</s>Intersex people in Germany can now legally identify themselves as a third gender, under a new law adopted in December.

People who do not fit the biological definition of male or female can now choose the category "diverse" on official documents.

Those choosing the option will need a doctor's certificate to register.

Intersex people are born with both male and female sex characteristics, which can appear at birth or later in life.

Other countries have approved laws in recent years to help recognise intersex people.

Austria's constitutional court made a similar ruling to Germany's in June, while Australia, New Zealand, Malta, India and Canada have all passed measures to redress issues facing intersex citizens.

The UN says up to 1.7% of the world's population are born with intersex traits - about the same number of people with red hair.
• Should there be a third gender option on passports?

This is separate from a person's gender identity or sexual orientation.

But many face stigma, legal discrimination or even forced surgery because of these characteristics.

Germany previously allowed intersex people to opt out of choosing either male or female as a gender in 2013.

But in 2017 the country's top court ruled it was discrimination to deny people a gender, after a person registered as female had a chromosome test confirming they were neither sex.

Germany's parliament approved the law change last month, to come into effect on 1 January.

BBC Europe regional editor Danny Aeberhard says some people believe it is a step too far, while gender activists think the need for a doctor's certificate will make proof harder for intersex people without physical characteristics.
• The third gender of southern Mexico
• 'Now I have a new penis, I hope I will find love'</s>New York City residents who do not identify as male or female can now opt for a third gender on their birth certificates.

Under new rules that came into effect on New Year's Day, New Yorkers can choose 'X' instead of the traditional male or female.

The new law was approved by the New York City Council and Board of Health last September.

The revision also makes it easier for transgender people to change their gender as it removes the requirement for a doctor's note or health care provider's affidavit.

New York City's Democrat mayor Bill de Blasio said at the time that the change would 'allow transgender and gender non­conforming New Yorkers to live with the dignity and respect they deserve'.

Residents of New Jersey, California, Washington, and Oregon can already choose 'X' on their birth certificates, while Washington DC permits the designation on driver's licenses.

The change came into effect on the same day as Germany introduced a new 'diverse' option for intersex people.

The new law, passed last month, requires that people who want to identify as 'diverse' on official documents provide a doctor's certificate.

Until now, people who did not identify as male or female had to leave the gender category blank.

The law was changed after Germany's Federal Constitutional Court told the government it must either introduce a third gender category option or drop gender entries from official documents altogether.

Intersex people are born with sexual characteristics that are not typically male or female. According to the UN, up to 1.7 per cent of the world's population may be intersex.</s>In 2013, an intersex person in Germany launched a legal challenge to be allowed to change their gender in the country's birth registry. A little more than five years later, Germany's third gender law is going into effect, making it the first country in the European Union to offer a "third gender" option on birth certificates.

According to German broadcaster Deutsche Welle, roughly 80,000 people in Germany are intersex. Starting this year, they — along with parents of intersex babies — will be able to select a "divers" classification on birth certificates.

Since 2013, parents of intersex children have had the option to leave the gender box on birth certificates blank. This will remain an option under Germany's new law, CNN reported, but the country's top court ruled last year that this was not enough. In November 2017, Germany's constitutional court ruled that lawmakers must recognize a third sex from birth, arguing that providing only the binary "male" and "female" options is unconstitutional.

Lawmakers subsequently had until the end of 2018 to decide on what a third option would be, and to implement the necessary changes. As Business Insider pointed out, this ruling primarily affects intersex people in Germany — and not transgender people — because it is allowing people to select a nonbinary sex classification, rather than gender. As a result, LGBTQ rights advocates have called on Germany's new law to be more inclusive, according to CNN.

According to VICE, Germany's third gender law currently requires physicians to certify "gender variations" in order for a person to change their gender classification in the birth registry. Activists have called for this medical approval clause to be removed for several reasons. Intersex people have historically been subject to unnecessary and traumatic medical interventions, and requiring medical approval also prevents the third gender law from being more inclusive of transgender and nonbinary people who don't identify as men or women.

Advocates are nonetheless hopeful that the new law will create more visibility outside the gender binary and that it will serve as a first step to more inclusive gender laws, CNN reported. German advocacy group Dritte Option — translated as "Third Option" — has campaigned for a third gender option to be introduced on birth certificates, passports, and other official documents for years. According to Dritte Option's website, they supported this initiative "to create space and visibility for all genders."

Although Germany is the only country in the European Union to implement such a law so far, other European countries — Denmark, Malta, Ireland, Belgium, Portugal, and Norway — currently offer transgender individuals the option to retroactively change their gender markers on their birth certificates, although they do not have a third gender option on other official documents. Countries outside Europe, however — such as Australia, New Zealand, Canada, India, and Nepal — already have legislation in place similar to Germany's new gender law.

Advocates have heralded Germany's new law as progress, but are urging the country to go further by abolishing gender registration altogether, in order to be more inclusive of all genders and gender identities. They see the new law, which went into effect on Tuesday, as a first step toward that goal.</s>NEW YORK (AP) — New York City residents have a new option for denoting gender on their birth certificates: gender “X.”

A law allowing the choice of “X″ takes effect Tuesday. The measure passed earlier this year.

It allows people to change their birth certificates to “X″ by attesting that it reflects their “true gender identity.” Parents also can choose “X″ for newborns.

New York City is joining California, Oregon, Washington state in allowing an undesignated gender option on birth certificates. A similar provision takes effect in New Jersey in February.

In 2014, New York City eliminated a policy that allowed birth certificate gender changes only if people underwent gender reassignment surgery.

Instead, the city required an attestation from a medical or mental health professional. The new law nixes that requirement</s>A German law allowing intersex people to register a third gender on official documents has now gone into effect with the beginning of the new year.

Approved by parliament on 14 December, the law extends legal recognition to intersex individuals on documents such as birth certificates, making Germany the first country in the European Union to do so, reports CNN.

Germans have had the ability to leave the gender field blank on birth certificates since 2013, but they now have the option of identifying themselves as ‘divers’ (miscellaneous) rather than just male or female.

The new legislation came after a 2017 ruling that not allowing an intersex person named Vanja to change the gender marker on their birth certificate was unconstitutional

“I asked myself so many times what it means to be intersex; I often was upset when I had to decide which box to tick — male or female. I felt (like I was) being pushed into the corner, that I had to adjust non-voluntarily,” Vanja told CNN.

They plan to change their gender marker to ‘divers’ to celebrate the new law, saying they believe it will give them “a new feeling of peace”, but acknowledged that it was just one small step towards further intersex acceptance.

“Societal acceptance cannot be mandated by a court ruling, but it is a step in the right direction.”

The legislation has drawn criticism for requiring applicants who wish to be identified as ‘divers’ to undergo invasive medical examinations to prove they’re intersex.

Senior lecturer at London’s The City Law School, Grietje Baars, told CNN that subjecting intersex individuals to unnecessary medical examinations could potentially inflict further trauma on people who often have a history of “traumatic medical interference with their genitalia”.

Baars also believes it reinforces outdated views on gender being a biological trait.

“You can not simply decide gender by looking at people’s genitalia,” they said.

Baars stated that the German government should have abolished the gender field altogether.

“It’s like abolishing registering your religion or race on your ID or documents — it does not mean you can no longer be Catholic or black … those things are not the same. I am just saying that it is no business of the state to register and categorise people in that manner,” they said.

Criticism has also been aimed at the fact the legislation is limited only to intersex individuals, rather than anyone who doesn’t identify as male or female, such as trans or gender diverse people.

Speaking to the Thomson Reuters Foundation, a spokesman for the Lesbian and Gay Federation said, “For trans people, nothing has changed regarding the obstacles they face to change their registered name and gender.”

In Australia, gender recognition on official documents is generally the responsibility of state governments.

Australian passports allow the use of ‘X’ as a gender marker in situations where someone doesn’t identify as male or female, whereas driver’s licences in many states leave off gender altogether

In the Northern Territory it’s now possible to amend your birth certificate to reflect if you are intersex or gender diverse, while Tasmania’s lower house recently passed legislation which could give parents the option of leaving gender markers off of birth certificates.

Prime Minister Scott Morrison and federal Liberal MP Stuart Robert have both been vocally critical of the proposed changes in Tasmania, although their arguments have little to do with the contents of the actual legislation.</s>People in Germany can now legally identify themselves as a third gender if they do not fit biologically as either male or female.

The third option, divers – which roughly translates to various or miscellaneous – is included on official documents as of today, January 1.

It means intersex people will be able to register themselves as ‘various’ on driving licenses, passports and birth certificates.

Until now, their only option was to leave the gender entry blank.

The German government voted to introduce the third category in August, with both chambers of parliament approving the new law.

Last month, the Bundesrat upper house gave their backing to the third gender option.

The ruling will apply to babies born as intersex, with parents needing a doctor’s certificate to mark their child under the new category.

Adults registered as male or female will also need a medical certificate to change their gender marker.

The law change makes Germany the first EU country to allow parents to designate their intersex children as third gender.

But LGBT campaigners say the measure does not go far enough, as it requires a doctor’s certificate ‘proving’ a person is intersex.

They want new laws to make it easier for people who do not identify with the gender they were born with to change it on official documents.

Germany’s Association of Lesbians and Gays said: ‘If people feel seriously and sustainably not male or female, the law must allow them to legally register their status as they define it.’

It said lawmakers should make the third category open to any individuals who need it and want it without requiring medical statements.

Third Option – the campaign group that called for the change – said in a statement that the law ‘excludes many people who have been waiting’ for it, including trans people.

The introduction of the new category came after the Federal Constitutional Court called on lawmakers to enact legislation to either introduce a third category or dispense with gender altogether in official documents.

The ruling followed a court appeal brought by an intersex adult and said that courts and state authorities should no longer compel intersex people to choose between identifying as male or female.

Intersex people are born with a reproductive or sexual anatomy that do not fit the typical definitions for male or female bodies.

This can mean being born with both male and female genitalia, or have both XX and XY chromosomes in their cells.

For some intersex people, their condition is discovered at birth, but for others it is not discovered until puberty or when the person faces fertility issues as an adult.</s>New York City residents are about to have new option for denoting gender on their birth certificates: gender “X.”

A law allowing the choice of “X” takes effect Tuesday. The measure passed earlier this year.

It allows people to change their birth certificates to “X” by attesting that it reflects their “true gender identity.” Parents also can choose “X” for newborns.

New York City is joining California, Oregon, Washington state in allowing an undesignated gender option on birth certificates. A similar provision takes effect in New Jersey in February.- READ MORE</s>By the time Lynn D. turned 2, he had already undergone seven surgeries. His childhood memories — in the German states of Bavaria and Hesse — were shaped by monthly visits to the doctor, where he says up to 50 researchers would observe examinations of his naked body.

When he reached puberty, Lynn was given growth blockers and high doses of hormones; as a teenager, he started self-harming, developed post-traumatic stress disorder and became suicidal.

Lynn, 34 — who has asked CNN to identify him by his preferred name — was born with both male and female sex organs. His doctors and parents decided shortly after he was born that his sex would be female, so his penis and testicles were surgically removed. His ovaries were also removed.

Doctors had told Lynn’s parents the surgeries were preventative, citing concerns that he could develop cancer, but Lynn says there was no medical reason for him to be operated on and that the surgeries were carried out with a “dubious motivation.”

“The doctors advised my parents not to tell me about my sex and simply raise me as a girl,” Lynn told CNN. “And of course, it didn’t work — because I’m not a girl.”

Lynn is intersex, an umbrella term used to describe a variety of conditions in which a person is born with reproductive or sexual anatomy that does not fit into binary definitions of female or male.

“I was labeled a girl; I wanted to be a girl and fit in — but it did not work. I got along better with boys so I thought, ‘I’m a boy’. But then I realized that I’m not a boy either … boys also started to marginalize me. I did not have a good connection with my body and nobody helped me to establish a good connection with my body,” Lynn said.

Lynn only learned that he was intersex during a therapy session at the age of 20. It was a revelation for Lynn, who had struggled to fit in with his peers for so many years.

While it helped him to move forward with his relationship with his own body, Lynn says it damaged his relationship with his parents.

“My body was changed so much to fit in — whether it happened consciously or unconsciously. The whole experience broke my relationship with my parents. We still have not gotten over this yet,” Lynn said.

When he first learned he was intersex, Lynn said, “it felt like as if someone said I am an alien, you are from someplace else. You are a mutant.”

“It took me a while to come to terms with my diagnosis and for me to (come to) grips with it. But then I understood — everything made sense to me. I no longer felt restless. Suddenly I understood who I was.”

More than a decade later, Lynn said he has evolved into an “enormously happy” person, someone who is in a loving relationship with a woman, and who is fulfilled by a career in engineering and gigging in a punk band.

While Lynn said he accepts being called “him” for now, he wishes that there was a specific German pronoun to describe intersex people, and hopes that society will one day understand what it means to live outside of binary definitions of sex and gender — and to accept intersex people for who they are.

A change to the German constitution could be the first step toward that recognition.

On January 1, Germany will become the first country in the European Union to offer a “third gender” option on birth certificates.

Intersex people — and parents of intersex babies — will be able to register as “divers,” or miscellaneous, on birth certificates, instead of having to choose between male or female.

The law, passed in Germany’s Bundestag earlier this month, was hailed as a “small revolution” by some intersex activists. It came after the 2017 constitutional court ruling in favor of an intersex person’s right to change their birth certificate from female to “divers.”

The court ruled that Vanja — an intersex person who goes by a one-name pseudonym and uses the gender-neutral pronouns “they” and “them” — had their “right to positive gender recognition” violated and found that the current law was unconstitutional.

Vanja, whose case was supported by advocacy group, “Dritte Option” or, the Third Option, told CNN that having to decide between being a woman or a man on official documents left them feeling “left out and overlooked.”

While Vanja’s official identification documents said they were female, this led to “a lot of irritations with people” because they presented — or physically appeared in society — as male.

Vanja initially considered changing their documents to male, but eventually decided that decision would devalue their identity, which is intersex.

“I thought to myself, if I am going at lengths to change something within the red tape system in Germany, I want to have something that suits me,” they said.

Vanja plans to celebrate the new law by changing their birth certificate category to “divers” in the new year, calling it both a personal and a practical step.

“I asked myself so many times what it means to be intersex; I often was upset when I had to decide which box to tick — male or female. I felt (like I was) being pushed into the corner, that I had to adjust non-voluntarily. I think it will give me a new feeling of peace,” Vanja said, adding that they hope other countries in Europe will follow suit.

But, like many in the intersex community, Vanja believes the law is just a stepping stone.

“Societal acceptance cannot be mandated by a court ruling, but it is a step in the right direction,” Vanja said.

Lynn agrees. While he also plans to register as intersex — and to officially change his name to Lynn — he said there are still many steps that need to be taken for intersex people to be “fully integrated into society.”

Still, he is hopeful the new law will help to bring attention to the medical treatment of intersex people and open conversations for change.

Infants born with visible variations in their sexual characteristics, like Lynn, often undergo painful and irreversible surgery to give them the appearance of a conventional male or female gender, according to an Amnesty International report published last year.

The surgeries stem from a theory popularized in the United States in the 1960s by the psychologist John Money, who believed that an intersex person’s make-up was a product of abnormal processes. Money believed that intersex people ought to become either male or female and as a result, were in need of medical treatment.

Although that theory is no longer widely accepted in the medical community, its “echoes can still be found within the medical establishment today,” according to the Amnesty report, citing interviews with medical professionals across Denmark, Germany and the UK.

Those surgeries stripped Lynn of his bodily autonomy and left him with painful scars.

“When they (doctors and parents) talked about my body, I had to go out and leave the room. In hindsight, it was a practice I would now compare with a ritualized, sexualized violence. It was massively traumatizing,” Lynn says of his childhood visits to the doctor.

A group of United Nations and international human rights experts called for “an urgent end to human rights violations against intersex children and adults” in 2016, calling on governments to ban harmful medical practices and protect intersex people from discrimination.

Between 0.5% and 1.7% of the global population are born with intersex traits, and are at risk of human rights violations that include surgery, discrimination and torture, according to the UN.

In July, a group of European medical experts published a set of new guidelines that urge doctors to defer medically unnecessary surgeries on intersex children until they are old enough to consent. The European consensus said: “For sensitive and/or irreversible procedures, such as genital surgery, we advise that the intervention be postponed until the individual is old enough to be actively involved in the decision whenever possible.”

Grietje Baars, a senior lecturer at The City Law School in London, told CNN that while the new law demonstrates a “greater recognition of life beyond the binary,” the “third gender” option doesn’t go far enough to fully recognize gender diversity.

Under the new law, people wanting to change their birth certificate to read “divers” will only be able to do so with a medical certificate to prove it.

Baars — who also goes by the gender-neutral pronouns, “they” and “them” — says that requirement could subject intersex people, who often have a history of “traumatic medical interference with their genitalia” to additional trauma. Plus, Baars says, the medical requirement reinforces an antiquated definition of gender based solely on biology.

“You can not simply decide gender by looking at people’s genitalia,” they said, adding that it might be time to remove gender from official documents altogether. While Baars understands that this might sound radical, they argue that “abolishing gender registration does not mean abolishing gender as such.”

“It’s like abolishing registering your religion or race on your ID or documents — it does not mean you can no longer be Catholic or black … those things are not the same. I am just saying that it is no business of the state to register and categorize people in that manner,” they said.

Although German law has allowed parents to leave the gender box blank on birth certificates since 2013 — and this will still be an option under the new legislation — some experts say parents will still be inclined to choose a more traditional approach, noting that in the two years after the blank box option came into effect, only 12 children were registered without a sex marker in the birth registry.

Anike Krämer, a Ph.D. candidate in gender studies at Germany’s Ruhr-University Bochum, told CNN that she believes that parents of intersex children will have “difficulties” with the choices presented with the new law.

“The structure we have right now simply does not allow for parents to embrace this new law. The medical advice is still very conservative and advises to go with the binary system,” Krämer said.

Under German law, parents can not generally consent to “feminizing,” “masculinizing” or “disambiguation” surgeries, unless it is deemed medically necessary or life threatening, according to the German Inter-ministerial Working Group, IMAG.

However, the law currently does not ban these surgeries for children too young to consent, and leaves the often ambiguous question of what is deemed surgically necessary up to medical professionals who might continue to characterize intersex people’s bodily traits as disorders.

Krämer says that parents are more concerned with the every day questions their children will face in society: “How do I call my child; which pronoun should I use, what do I tell my neighbor, how do I educate my intersex child?

“Sociologically speaking, parents lack options for action. Apart from medical consultations they often lack alternatives. If there are true alternatives in place — to address the parents’ questions, fears, difficulties and options, to speak with other intersex individuals or other parents of intersex individuals — then that would make it easier for parents to perhaps choose the third option at the registry entry.”

“But Germany is not that far yet,” Krämer said, adding that the law’s medical requirements “misses a chance to create a wider law for more people,” and sidelines other individuals who are not intersex but do not identify as only male or female, such as members of the trans community.

And she is not alone.

Markus Ulrich, spokesman for the Lesbian and Gay Federation in Germany, told CNN that the law “does not go far enough to protect people of non-binary identities.”

Ulrich said that while the law was “a huge step forward in acknowledging more rights and … visibility for people beyond ‘man and woman,'” the government effectively ignored an alternative option proposed by the constitutional court last year to abolish gender registration all together — a more inclusive option for people whose birth sex doesn’t fit their gender identity.

A handful of German politicians, including members of the Green Party and the Social Democratic Party, have also criticized the law’s medical certificate stipulation, pointing to other countries that allow people who don’t identify in binary terms to change their official documents to match their gender identity.

In 2014, the Australian High Court ruled that the government should legally recognize a third gender. And in 2017, California became the second US state (after New York) to allow residents who don’t identify as male or female to change their birth certificates to match their gender identity.

Several other countries have provided gender-neutral options on passports and official documents such as the census or ID cards, including Argentina, Bangladesh, Canada, Denmark, India, Malta, Nepal, the Netherlands, New Zealand and Pakistan.

While intersex, trans and other human rights advocates continue to call for Germany’s new law to be made more inclusive, Lynn hopes that at least this first step will help society to understand intersex people better — and to not be afraid.

“We are all normal people and want to live our lives like others,” he said.</s>To all trans and non-binary New Yorkers: We see you, hear you and respect you. Starting in 2019, all New Yorkers will be able to change their gender on their birth certificate to M, F or X — without a doctor's note. pic.twitter.com/we4TbCVdhJ — NYC Mayor's Office (@NYCMayorsOffice) December 29, 2018

New York City residents have a new option for denoting gender on their birth certificates: gender "X."A law allowing the choice of "X'' took effect Tuesday. The measure passed earlier this year.It allows people to change their birth certificates to "X'' by attesting that it reflects their "true gender identity." Parents also can choose "X'' for newborns.New York City is joining California, Oregon, Washington state in allowing an undesignated gender option on birth certificates. A similar provision takes effect in New Jersey in February.In 2014, New York City eliminated a policy that allowed birth certificate gender changes only if people underwent gender reassignment surgery.Instead, the city required an attestation from a medical or mental health professional. The new law nixes that requirement.
A law recognising a third gender that can be administered for intersex people takes effect in Germany.