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Sex assignment

Sex assignment (also known as gender assignment[1][2]) is the discernment of an infant's sex, usually at birth.[3] Based on an inspection of the baby's external genitalia by a relative, midwife, nurse, or physician, sex is assigned without ambiguity in 99.95% of births. In the remaining cases (1 in 2000), additional diagnostic steps are required and sex assignment is deferred.[4] Sex also may be determined prior to birth through prenatal sex discernment.[5]

This article is about sex assignment in humans. For sex assignment in other animals, see sexing.

The number of births where the baby is intersex—where their sex characteristics do not fit typical definitions of male and female—is estimated to be between 0.018% and 1.7%.[6][7][8] While some intersex conditions can lead to genital ambiguity (about 0.02% to 0.05% of births[4]), in others genitalia can clearly be identified as either male or female.[9] In the latter cases, an intersex condition might not be recognized at birth.[10]


Generally, parents and society, as well as governments and healthcare systems, assume that a person's gender identity will develop according to the sex assigned at birth; this is known as being cisgender. While this is the case for a majority of people, for a significant number assigned sex and gender identity do not align; this is known as being transgender.[2][11]


The sex assignment of an intersex individual may also contradict their future gender identity.[12] If available, knowledge about the gender identity that a majority of people with the specific intersex condition develop is considered in sex assignment.[13] Assignments might later be adjusted as a person grows up.[2] Reinforcing sex assignments through surgical or hormonal interventions without informed consent is considered by the Office of the United Nations High Commissioner for Human Rights to violate the individual's human rights.[14][15]

Challenges to requirements for sex assignment[edit]

In recent years, the perceived need to legally assign sex is increasingly being challenged by transgender, transsexual, and intersex people.[35][36] A report for the Dutch Ministry of Security and Justice states "Gender increasingly seems to be perceived as a 'sensitive' identity feature, but so far is not regarded, nor protected as such in privacy regulations".[35] Australian government guidelines state that "departments and agencies that collect sex and/or gender information must not collect information unless it is necessary for, or directly related to, one or more of the agency's functions or activities"[37]


Sex registration was introduced in the Netherlands in 1811 due to gender-specific rights and responsibilities, such as military conscription.[35] Many gender-specific provisions in legislation no longer exist, but the provisions remain for rationales that include "speed of identification procedures".[35]