Washington state will allow residents to change the sex on their birth certificates to a nonbinary option called “X.” “Social norms are changing,” state registrar and Center for Health Statistics director Christie Spice told ABC News today. “When a person’s gender designation on their birth certificate doesn’t match how people present themselves, it opens the door to harassment and intimidation. ”The new rule, announced Thursday and effective Jan. 27, also removes the need for medical approval from a primary

physician for adults who want to change the sex status on their birth certificate. Minors who don’t identify male or female and want to change their sex designation still need written consent from a parent or legal guardian and medical input. The difference now is that the list of health care professionals who can approve the change has expanded for minors to include primary physicians, physician assistants, psychologists, psychiatrists, social workers and mental health counselors, according to the state Department of Health. READ MORE