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Fifty-five-year-old Sara Kelly Keenan is the first American to receive a birth certificate that states "intersex" in the gender category.
According to NBC News, Keenan, who was born intersex -- with male DNA but female genitalia -- received the certificate from the nation's largest city on Tuesday.
"Not all intersex people will choose to identify legally as intersex," Keenan told NBC, "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 -- who opts for female pronouns to describe herself -- said she was not even told of her intersex nature until late in her adult life because her parents and doctors agreed to keep it secret. Upon birth in New York City, she was first classified as a boy for a few weeks, then received a female birth certificate.
At age 16 she began hormone treatment after being told that she was simply "a girl that can't make hormones." But, in 2012, her father revealed that doctors had suggested that she undergo penis-construction surgery so that her genitalia would match her male genetics. He declined the surgery. After her father related this news, Keenan underwent endocrinological testing to confirm her intersex status, NBC said.
According to Keenan, she accepts and embraces her intersex identity and hopes for a "legal way for other intersex people who choose to embrace it in the same way to do so with a legally recognized sex marker."
Paul Castillo is an attorney for the LGBT advocacy group Lamba Legal. He said, "In the United States, birth certificates often provide access to a wide range of public services and critical identity documents, such as state IDs and passports. Having birth certificates with gender designations other than male or female provides an enormous sense of validation for a number of non-binary and intersex people."
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