An X gender marker is a third option on identification documents, alongside M and F, for people who are nonbinary, intersex, or otherwise outside the male-female binary. As of 2025, you can no longer get an X on a U.S. passport or change the sex designation on your Social Security record, but roughly 22 states and the District of Columbia still offer X on driver’s licenses, state ID cards, and birth certificates. Whether the option is available to you now depends entirely on which document you need and which state issued it.
What Changed Federally in 2025
On January 20, 2025, the president signed an executive order titled “Defending Women From Gender Ideology Extremism And Restoring Biological Truth To The Federal Government.” It directed federal agencies to define sex as an “immutable biological classification as either male or female” and instructed the Secretaries of State and Homeland Security to require government-issued IDs to reflect the holder’s sex under that definition.1The White House. Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government
The State Department no longer issues U.S. passports or Consular Reports of Birth Abroad with an X marker, and only issues passports with an M or F marker matching the applicant’s biological sex at birth.2U.S. Department of State. Sex Marker in Passports If you apply for an X marker or a marker different from your birth sex, the department warns you may face delays, get a request for more information, and ultimately receive a passport matching your biological sex at birth based on prior records. The DS-11 application now instructs applicants to select M or F “that corresponds with your biological sex at birth,” with no X option shown.3U.S. Department of State. DS-11 Application for a U.S. Passport
The Social Security Administration followed on January 31, 2025, with guidance prohibiting changes to the sex designation on Social Security records. A federal court in Massachusetts issued a preliminary injunction against the passport policy in Orr v. Trump, but on November 6, 2025, the U.S. Supreme Court stayed that injunction while the case continues on appeal. The restrictive federal policy is what applies right now.
If You Already Have an X Passport
A U.S. passport already issued with an X marker remains valid for travel until it expires, you replace it, or it is invalidated under federal regulations. The State Department has confirmed there are no restrictions on using a currently valid passport, subject to the destination country’s own rules.2U.S. Department of State. Sex Marker in Passports Any renewal, however, will be issued with an M or F marker matching your sex at birth under current policy.
The practical takeaway: don’t voluntarily surrender or renew an X passport early if you want to keep the designation as long as possible. Early renewal only shortens the time you hold the current document.
States That Offer X on Driver’s Licenses and ID Cards
State-issued IDs are governed by state law, and roughly 22 states plus the District of Columbia currently allow residents to select M, F, or X on a driver’s license or state ID card. These include California, Colorado, Connecticut, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, Virginia, and Washington.
What you need to provide varies. Some states use self-certification, meaning you check the X box on the application without medical documentation or a court order. California allows a gender marker change on a driver’s license without either. Other states still require a physician’s statement, sometimes sworn under penalty of perjury, confirming appropriate clinical treatment, or a court order, or some combination. Check your state motor vehicle agency’s current requirements before starting, because state policies can and do change through legislation in either direction.
An X designation on a state driver’s license meets REAL ID requirements. Federal REAL ID rules require a gender designation on compliant IDs, and an X satisfies that requirement.4Pennsylvania Department of Transportation. Gender Designation Options You should be able to use an X marker license for domestic air travel and entry into federal buildings that require REAL ID.
States That Offer X on Birth Certificates
A similar list of states allows X on birth certificates: California, Colorado, Connecticut, Illinois, Massachusetts, Michigan, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, Virginia, Washington, plus the District of Columbia and Hawaii. The process varies more widely than for driver’s licenses.
Some states handle amendments through the vital records office with a simple application. Michigan, for example, requires an application to correct or change a birth record along with a Sex Designation Form, a copy of a government-issued photo ID, and a $50 fee. Standard processing takes about six weeks, with expedited service available for an additional $25. Other states require a court order before vital records will amend the certificate, which adds legal fees and time.
Birth certificates matter because they are foundational documents used to support applications for other IDs. A state-issued birth certificate with an X marker can still support state-level applications, but its usefulness at the federal level is now limited by the 2025 executive order.
Traveling Internationally With an Existing X Passport
The International Civil Aviation Organization, which sets the standards for machine-readable travel documents, recognizes X as a valid designation in the sex field. In the visual inspection zone of a passport, ICAO specifies F, M, or X for unspecified.5International Civil Aviation Organization. ICAO Doc 9303 Machine Readable Travel Documents Part 7 – Machine Readable Visas International scanning systems are built to process the designation without technical errors.
ICAO standards govern document format, not how foreign governments treat the people carrying those documents. Entry into any country is subject to that nation’s laws. Some countries do not legally recognize nonbinary gender identities and may question or refuse entry to travelers with an X marker passport. Research your destination’s policies before booking. The passport itself is technically valid; how border officials respond varies.
When Your Documents Don’t Match
With federal documents now restricted to M or F and some state documents still offering X, many people will end up with mismatched markers across their IDs. A state driver’s license might show X while a passport shows M or F. That mismatch is not illegal and does not prevent you from using either document for its intended purpose. Airport security does not require your gender marker to match across documents or to match your appearance.
The U.S. Constitution’s Full Faith and Credit Clause requires each state to give full faith and credit to the public acts, records, and judicial proceedings of every other state.6Congress.gov. Constitution Annotated – ArtIV.S1.1 Overview of Full Faith and Credit Clause In practice, a driver’s license from one state is accepted as valid ID in another, even where the second state doesn’t itself offer X. For everyday uses like buying age-restricted goods, checking into a hotel, or a traffic stop, an X license from any state should function normally nationwide. Whether a state will affirmatively update its own records to match another state’s X designation depends on the receiving state’s laws.
The real risk from mismatched documents is administrative confusion in systems that cross-reference federal and state databases. Social Security records feed into IRS systems and federal benefits programs, so the freeze on SSA changes can have downstream effects on tax filings and benefits if records don’t line up. Keep copies of any court orders, amended birth certificates, or agency correspondence documenting your changes. A clear paper trail is the fastest way to resolve a bureaucratic conflict.
Health Insurance and Sex-Specific Care
A gender marker mismatch between your ID and your insurance record can cause claim denials. Insurance company systems often flag sex-specific procedures that don’t match the sex marker on file. A prostate exam billed for a patient listed as female, or a gynecological visit for a patient listed as male, can trigger an automatic denial even when the care is covered.
Most insurers still use only binary sex designations internally. If you hold an X on your state ID, your insurer may have recorded you as M or F based on whatever data they had when you enrolled. Updating your name with an insurer can sometimes trigger an unwanted change to the sex designation as well.
When a denial happens because of a marker mismatch, your provider can usually resolve it through billing codes. Practitioners can append modifier KX to sex-specific procedure or diagnosis codes, and institutional providers can use condition code 45 to indicate the apparent conflict is not an error. If you get a denial, contact the insurer or ask your provider’s billing department to resubmit with the appropriate modifier. Don’t change your sex designation back to a previous marker just to access sex-specific services. If a representative suggests that, ask for a supervisor or file a complaint.
Selective Service Is Based on Birth Sex
Selective Service registration turns entirely on sex assigned at birth, not on your current gender marker or identity. If you were assigned male at birth, you must register within 30 days of your 18th birthday, regardless of any later transition or an X marker on state documents.7Selective Service System. Who Must Register If you were assigned female at birth, you are not required to register regardless of your current gender.
This distinction affects federal financial aid, government employment, and naturalization. If you were assigned female at birth and are asked to prove your exemption, you can request a Status Information Letter from the Selective Service with supporting documentation such as a birth certificate showing your birth-assigned sex.8Selective Service System. Request a Status Information Letter If your birth certificate has been amended, include documentation reflecting the original designation. People assigned male at birth who have registered must notify Selective Service of any legal name change within ten days.