Amendment of the General Vital Statistics Provisions (Sec. 207.05 of Article 207 of the NYC Health Code)

Adopted Rules: Closed to Comments

Effective Date: 
Tuesday, January 1, 2019
Download Copy of Adopted Rule (.pdf): 

Statement of Basis and Purpose


Amendments to sex designation on Birth Records

            In 1971, the Board of Health amended Section 207.05 of the Health Code to allow the Department to file a new birth certificate with a corrected gender marker of male or female for a person who both obtained a court order changing his or her name and who underwent “convertive” surgery. The Department had, generally but not exclusively, interpreted the requirement for convertive surgery to mean genital surgery. As a result, transgender applicants requesting new birth certificates were required to submit medical records demonstrating that they had undergone genital surgery to change sex and the number of requests for a corrected birth certificate was relatively small. For example, in 2012, the number of new birth certificates approved and issued to transgender applicants was 20 and, in 2013 only 22 new birth certificates were issued.

            In 2014, the Board of Health amended Section 207.05(a)(5) to eliminate the requirement for convertive surgery. This amendment allowed applicants to request a new birth certificate with a changed gender marker of male or female based on an affirmation from a physician licensed to practice in the United States, or an affidavit from a doctoral-level psychologist clinical social worker, physician assistant, nurse practitioner, marriage and family therapist, mental health counselor, or midwife, licensed to practice in the United States. Eliminating the requirement to demonstrate genital surgery led to a dramatic increase in requests for new birth certificates; from January 2015, when the amendment became effective, through February 2018, the Department issued 1,047 new birth certificates to transgender applicants.

            Most recently, the Department, in discussion with other states and advocates, found that having practitioners affirm or attest to a person’s gender identity is both a potential barrier and does not add sufficient value in the process of deciding whether a new birth certificate should be issued. Anecdotal evidence suggests that practitioners simply comply with their patients’ requests when asked to affirm or attest to a patient’s request for a change of gender. 

            The Board is now (1) eliminating the requirement that a person requesting a change to the sex designation on a birth certificate present proof from a health professional and instead allow applicants to self-attest as to their gender, and (2) approving “X” as an additional sex designation gender option that is not exclusively female or male for birth certificate sex change requests. The sex designation on the US Standard Certificate of Live Birth is completed by the hospital or attendant at the time of birth. The four choices are male, female, unknown and undetermined. These are “sex” categories and not gender categories. The original public health data reported by the hospital is not changed under this amendment.  “Gender” categories are only applied on the birth certificate during an amendment process. When the gender on a birth certificate is amended the original record is placed under seal and a new record is created. There is no indication on the record of the amendment history. A sex designation of “X” will be allowed for those applicants who want a designation other than female or male on their birth certificate.

Health Code Amendment

            The Board is eliminating the requirement that a person requesting a change to the sex designation on a birth certificate present proof from a health professional. Instead, applicants will be able to self-attest as to their gender. Additionally, the Board has approved “X” as an additional designation for persons who do not identify as exclusively female or male.  The Department believes that the amendments are important steps in enabling people to obtain official documents that accurately reflect their gender identity.  The Board is making these amendments effective January 1, 2019.       

Statutory Authority

           Pursuant to section 556(c) of the Charter and section 17-166 of the Administrative Code, the Department is responsible for supervising and controlling the registration of births and deaths that occur in New York City. Section 558(c) of the Charter requires the Board to include in the Health Code provisions related to maintaining a registry of births and deaths, as well as provisions related to changes or alterations of any birth or death certificate upon proof satisfactory to the Commissioner of Health and the manner in which these certificates may be issued and otherwise examined.  Section 17-167.1 of the Administrative Code and Health Code section 207.05 delineate the requirements to change the sex designation on birth records  Section 558(b) of the Charter specifically authorizes the Board to add to, alter, and amend the Health Code.