The Gender Selected on This Person's Birth Certificate Is Making History

December 30th 2016

Almie Rose

A U.S. birth certificate usually comes with two options for gender: male or female. But one person was just issued the first known "intersex" birth certificate in the United States.

Sara Kelly Keenan, who uses female pronouns, was born with male DNA, but female genitalia, along with "mixed internal reproductive organs," NBC Out reports.


Intersex means a person has been born with genitals or reproductive organs that don't match the gender assigned at birth. Usually, someone whose intersex physically appears to be one sex but might have the anatomy of the opposite sex or may have genitals that " seem to be in-between the usual male and female types," or "a person may be born with mosaic genetics, so that some of her cells have XX chromosomes and some of them have XY," according to the Intersex Society of North America

In the past, intersex people were referred to as "hermaphrodites," which is now recognized as a non-accurate term.

The need for a third option.

Like many intersex people, Keenan was born without knowing she was intersex. When she was born she was labeled a boy for three weeks and then issued a birth certificate with the sex of female. 

When she was 16, she was told she was "a girl that can't make hormones." It wasn't until 2012 that her father revealed the truth.

"Not all intersex people will choose to identify legally as intersex and not all parents will choose to have their intersex child identified as intersex on birth documents. But for those who do, the option must exist," Keenan told NBC.

Now that she has the option, she says having an accurate birth certificate is "both shocking and empowering." Before getting the intersex certificate, Keenan was the second U.S. citizen to ever be granted the "non-binary" gender.

Alesdair Ittelson, an attorney with interACT, "advocates for Intersex youth," and expalined to NBC Out why Keenan's newly issued gender is so big. "As far as interACT is aware, [Keenan's] is the first birth certificate with the designation 'intersex.' We are aware of one other reissued birth certificate that reads 'hermaphrodite' and several that do not have a sex specified," Ittelson said. 

How common is being intersex?

Intersex Society of North America is careful about who classifies as "intersex," and breaks data down into different categories (like those born "Not XX and not XY") so it's difficult to determine just how many people in the United States are intersex.

Female Karyotype

But it estimates that the total number of people in the United States with bodies different from the "standard male or female" to be one in 100 births, with the total number of those who get surgery to "normalize genital appearance" at one or two in 1,000 births.

[H/T NBC News]