Germany will now allow babies born with both sex traits to be designated as neither male nor female.
The Telegraph reports that German parents will be allowed to leave the gender blank on birth certificates, which will create a "third sex" option. Later, the children will be allowed to chose an X option on their passport instead of the typical M or F.
The legislation, which went into effect on Friday Nov. 1, was enacted in order to give parents and children more time before making life-changing sex reassignment decisions. Germany is the first European nation to offer the third gender designation.
The Intersex Society of North America reports that as many as 1 in 1,500 to 1 in 2,000 babies worldwide are born intersex, meaning they have parts of both sex's genitalia.
Intersex, which was formerly known as hermaphroditism, includes many conditions where external and internal genitals do not match the same sex.
This includes "XX intersex," or people born with female XX chromosomes and ovaries, but have external genitals that look like male. Others are people with male XY chromosomes with internal fully formed or partial testes, but have external female-like genitals, called "XY intersex." People characterized as "true gonadal intersex" have both ovarian and testicular tissue, as well as male, female or indeterminate external genitals. There are also some individuals with undetermined intersex disorders, that have no discrepancy between their internal and external genitalia, but they may have chromosomes that are different configurations besides the typical 46 pairs of XX or XY.
Dr. Hertha Richter-Appelt, a sexual scientist at the University Medical Center Hamburg-Eppendorf in Germany explained to Der Spiegel that forcing a certain gender on a baby may create issues that for that child later on in life. While many people who have sex reassignment surgery as an infant are okay with the decision, some intersex people may not agree with the sex their parents chose for them. Richter-Appelt said it's best to wait until the child hits puberty before considering sexual reassignment treatments and surgery.
"When the issue is definitively deciding what is truly better for the children, we have to be honest and say that we often don't know," Richter-Appelt said.
Silvan Agius of IGLA-Europe, a human rights group focused on lesbian, gay, bisexual, transsexual and intersex issues, told the BBC that more needs to be done than the passage of this law.
"While on the one hand it has provided a lot of visibility about intersex issues... it does not address the surgeries and the medicalization of intersex people and that's not good -- that has to change," he said.
Lucie Veith, an intersex person from the northern German city of Hamburg, explained to the AFP that the legislation was a good first step, but that it skirted the main issue that Association of Intersexed People in Germany were lobbying for.
"That we forbid cosmetic genital surgeries for newborns, that is our first demand," Veith, who heads the organization, explained.
Other countries like Australia and New Zealand already allow X sex designations on passports, and Bangladesh allows an "other" gender category on the document, the BBC reported. Nepal has a third gender designation on their census forms, and Pakistan lets people to use a third option on national identity cards. India also has a third gender designation on their voting forms.