Content warning: This article contains mentions of suicide.
Transgender people born in North Carolina will now be able to change the sex designation on their birth certificates without the requirement of gender-affirming surgery per a decision by the United States District Court for the Middle District of North Carolina in late June.
The change is a result of a lawsuit filed in November 2021 on behalf of adult plaintiff Lillith Campos and two minors identified as C.B. and M.D who were all born in the state and identify as transgender. C.B. is represented by his parent Shelley Bunting and M.D. is represented by her parent Katheryn Jenifer.
Dr. Mandy Cohen, former secretary of the North Carolina Department of Health and Human Services, Mark Benton, deputy secretary for health at the NCDHHS, and Clarlynda Williams-Devane, state registrar, were the defendants in the lawsuit.
“The state was telling me that they know who I am better than I know who I am, or my friends and colleagues and my support system,” Campos said.
Lambda Legal, a civil rights organization that focuses on the LGBTQ+ community and those living with AIDS, alongside two other firms, challenged the state’s policy for being discriminatory.
Omar Gonzalez-Pagan, counsel for Lambda Legal, said that birth certificates are foundational identity documents that must accurately represent the individual. He said that the state cannot decide a person's identity.
Gonzalez-Pagan added that the surgery requirement was “antiquated” because many do not need, want or have the means to receive surgery due to medical, financial or age factors.
Campos said she was unable to receive surgery because the health insurance provided by her employer includes a categorical exclusion of gender-affirming healthcare. She said she is unable to independently afford surgery, as she is the primary provider for three children.
Because most types of gender-affirming surgery are not recommended for minors, plaintiffs C.B. and M.D. did not have access to accurate birth certificates before the consent judgment.
Queer People of Faith President and rising UNC junior Atlas Rodgers, who came out in October of 2021 as a nonbinary transgender man, said he has begun the process of changing his name but learned from friends that changing his birth certificate before surgery would not be possible. Rodgers said they are currently saving money for top surgery.
“Gender-affirming health care, gender-affirming legal resources, including being able to change the sex on your birth certificate greatly decrease the risk of suicide and other mental health issues in trans people,” Rodgers said.
According to the 2015 U.S. Transgender Survey, 40 percent of respondents have attempted suicide in their lifetime — nearly nine times the rate of the U.S. population, which is 4.6 percent. The survey also found that 32 percent of individuals who showed identity documents that conflicted with their perceived gender faced discrimination, harassment and assault.
Gonzalez-Pagan said accurate identity documents allow people to not disclose their transgender status and prevent them from being exposed to harm.
Only 11 percent of survey respondents reported that all their IDs and records listed their preferred name and gender.
Despite the efforts of Lambda Legal and other activists, anti-transgender legislation has been introduced across the country this year. In North Carolina, bills targeting transgender youth were introduced this session but not passed.
Lambda Legal’s victory came the day before Roe v. Wade was overturned.
In his concurring opinion for the decision, U.S. Supreme Court Justice Clarence Thomas said the court should reconsider several cases, including Obergefell v. Hodges, which established the right to gay marriage.
Gonzalez-Pagan was also a part of the legal team in that landmark case.
“We celebrate it with our clients, we celebrate that moment,” Gonzalez-Pagan said. “And then a few hours later, sometimes a few minutes later, or maybe just the next day we turn back and we go back to work because these attacks are relentless.”
When they heard the news about Lambda Legal’s victory, Rodgers told his mom it felt like the only “remotely good thing” that has happened for transgender people this year.
They said that activism can feel ineffective – like a “hamster spinning in a wheel” – but that transgender people have to stay vocal and leaving the country is not the answer.
“If I have the resources, the money, the time to move to another country and move to a place where I have more rights, great," Rodgers said. "There's still all of these trans people who came before me, and who are coming after me that are not going to have those resources that are still going to be stuck with this.”
Lambda Legal has successfully challenged restrictions on accurate birth certificates for transgender people in many states, including New York, Idaho and Kansas.
Campos said that she has received numerous emails from people in other states asking for advice about changing similar laws.
“I didn't have anybody when I first came out,” Campos said. “I had to do a lot of stuff on my own and build my own support system and find my own tribes and groups of people. And to be able to do something for the community that did help me — for these youth especially — it's really a great feeling.”
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