As of 2025, several U.S. states have implemented policies that allow individuals to designate a non-binary gender marker, typically represented as “X,” on official documents such as birth certificates. This change acknowledges the identities of individuals who do not exclusively identify as male or female, providing them with the opportunity to have documentation that accurately reflects their gender identity.
This article explains what non-binary gender markers are, which states permit their use, and how to update a birth certificate to include a gender-neutral “X” designation.
What Is a Non-Binary Gender Marker?
A non-binary gender marker is an option on legal documents that allows individuals to choose a gender identity that is neither exclusively male nor female. This marker is often represented by the letter “X.”
The “X” designation refers to a gender that is not limited to male or female. It reflects the gender identity of individuals who identify as non-binary, genderqueer, gender non-conforming, agender, intersex, androgynous, bigender, genderfluid, pangender, transgender, transsexual, unspecified, and other non-cisgender identities.
Having a non-binary gender marker available on official documents provides essential recognition for non-binary and other gender-diverse individuals. Including a non-binary option on birth certificates and similar documents is a significant step toward inclusivity, as it allows individuals to have documentation that accurately reflects their gender identity.
Why It Matters
For non-binary individuals, having a gender marker that aligns with their identity can reduce instances of discrimination, harassment, and the psychological distress associated with being misidentified. It not only affirms their identity legally and socially but also fosters a greater sense of belonging and recognition within society.
Accurate gender markers on identification documents are essential for various aspects of daily life, including accessing healthcare, employment, education, and travel. When the gender marker aligns with an individual’s identity, it can:
- Reduce misgendering and administrative confusion
- Improve mental health and self-validation
- Support legal and social recognition
States That Allow Non-Binary Markers on Birth Certificates (As of 2025)
As of 2025, the following states (and D.C.) have implemented policies permitting the use of a non-binary “X” gender marker on birth certificates:
- California
- Colorado
- New Jersey
- New York
- Oregon
- Washington
- Massachusetts
- Vermont
- Maine
- Utah
- Illinois
- Rhode Island
- New Mexico
- Nevada
- Michigan
- Connecticut
- Washington, District of Columbia (D.C.)
⚠️ Always verify with your state’s vital records office to confirm the most up-to-date policy, as legislation and administrative rules are subject to change.
States That Require Medical Documentation or Court Orders
As of 2025, states such as Georgia, North Carolina, Alabama, and Kentucky permit non-binary changes to birth certificates but require a medical provider’s certification before allowing the update. Non-binary individuals must provide documentation from a licensed healthcare provider confirming they have undergone “appropriate clinical treatment” for gender transition. While these states acknowledge non-binary identities by offering the “X” designation, they still maintain a medical gatekeeping process that requires proof of transition-related care. The definition of “appropriate treatment” is vague and varies by jurisdiction.
These states represent the middle ground between the more progressive states that allow self-attestation and those that do not permit non-binary recognition at all. The requirement for clinical documentation still poses a barrier for some individuals without access to gender-affirming healthcare or who choose not to pursue medical transition.
The non-binary “X” gender marker differs significantly from traditional policies that require individuals to undergo gender-confirmation surgery to change the sex listed on their birth certificate. States like Arizona and Nebraska may allow changes to a gender marker but require proof of gender-affirming surgery. These surgery-based policies often restrict updates to only “male” or “female” designations and require invasive evidence of medical procedures.
States That Do Not Currently Allow Non-Binary Markers
Several states, including Texas, Florida, Indiana, and Montana, still limit gender designation on birth certificates to male or female only and do not allow amending the gender marker on a birth certificate. In these cases, you may not be able to update your gender marker to “X” at this time. States that have banned the use of an “X” option on a birth certificate include West Virginia, Oklahoma, and North Dakota (ND has an exception if you’ve undergone genital surgery).
However, some of these states are facing legal challenges or have proposed legislation to expand gender options.
How to Update Your Gender Marker
Each state has a different process, but here’s a general outline of the steps:
- Check your state’s eligibility rules
- Complete a gender marker change application (state-specific)
- Provide required documentation (ID, proof of residence, a notarized statement, court/medical forms if needed)
- Submit your application to the state vital records office
Some states allow you to request an amended certificate rather than replacing the original.
How Vital Records Online Can Help
While Vital Records Online (VRO) doesn’t handle gender marker amendments directly, we help you:
- Secure a certified copy of your existing birth certificate
- Understand the requirements for your state
- Begin the documentation process for amendments
✅ Request a certified birth certificate copy here to start the process.
Final Thoughts
The introduction of non-binary gender markers on birth certificates represents an important step toward inclusive legal recognition. Although this option is not yet available in all states, many have taken measures to allow individuals to accurately reflect their true identity on one of the most significant legal documents they will possess. Click here for an up-to-date MAP on each state’s status with gender marker laws. If you’re ready to begin the process—or need a copy of your current birth certificate to get started—Vital Records Online (VRO) is here to guide you.