Why The First Intersex Birth Certificate In The United States Is So Important
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More than 50 years after she was born, Sarah Kelly Keenan finally has a birth certificate that accurately reflects her gender — intersex. In a major victory for gender rights, New York City's Department of Health and Mental Hygiene has issued what is believed to be the United State's first intersex birth certificate.

The term "intersex" is used to identify "a variety of conditions in which a person is born with reproductive or sexual anatomy that doesn't seem to fit the typical definitions of female or male," according to the Intersex Society of North America. In Keenan's case, she was born with male genes, female genitalia, and mixed internal reproductive organs, NBC News reports.

Although Keenan, who was issued a birth certificate identifying her as female after living her first three weeks of life classified as a boy, began hormone replacement therapy at age 16, she was unaware of her intersex condition until her father revealed the full details of her birth in 2012. The Intersex Society of North America says it's not uncommon for someone with intersex anatomy to live a majority of their life (if not their entire life) without knowing. According to the Guardian, up to 1.7 percent of people worldwide are born with intersex traits.

While Keenan is believed to have been issued the first U.S. intersex birth certificate, she is not the first person in the country to have been issued a birth certificate listing a third-gender option. According to NBC, a person in Ohio was able to use a 1987 state law prohibiting transgender residents from changing the gender on their birth certificate to obtain one that identified their gender as "hermaphrodite" in 2012.

However, Keenan's case is still a major milestone for the third-gender movement. Apart from making history, New York City's decision to issue a birth certificate with a third-gender option is a crucial gain for non-binary and intersex people. Moreover, the relative ease with which Keenan was reportedly able to obtain a reissued intersex birth certificate shows the nation's perspective on gender is changing. Interestingly, Keenan is also the second person in the United States to legally change their gender to non-binary, according to New York Magazine.

Yet Keenan's case is not significant merely because it represents the first known intersex birth certificate to be issued in the United States, thus opening the door for other states to also expand the traditional male and female options on birth certificates to include a third-gender option. Rather what makes her case so significant is that it is forcing other state and federal government agencies to quickly follow suit in legally accommodating third-gender options on a variety of other identity documents, including driver's licenses and passports.

"Not all intersex people will choose to identify legally as intersex," Keenan told NBC Out, "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."