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Something as small as the sex designation field of a driver’s license can go almost

unnoticed by most of the population. Yet for many members of the transgender community, the

M or F that follows the word Sex on an identification card can be the source of both minor

inconveniences and devastating strife. Given that legally male and female citizens in Ontario

have equal rights, there is no reason to differentiate on identification cards. For cisgender

individuals, those who identify with the sex assigned to them at birth, although they get no

benefit from their sex designation field, they also would not see any negative connotations

attached to it either. However, sex designation on identification can create restrictive barriers for

the transgender community in many areas, including accessing safe and reliable health care,

support for mental health struggles, and navigating government imposed red tape. The seemingly

harmless single M or F next to Sex is anything but that; it is an easily eliminated source of

struggle and stress for one of the more marginalized populations in Ontario preventing many

from access to rights that are supposed to be made available to everyone.

Only having identification that suggests a different gender from the individual in question

can cause barriers to accessing safe and reliable health care for transgender people. Whether a

medical issue is related to transition or not, if an individual has a health card with a listed sex

different from their gender presentation, they are potentially opening themselves up to

discrimination. Through a survey of trans Ontarians completed in 2009-2010, it has been

“estimated that 37.2% of transmasculine and 38.1% of transfeminine persons had prior trans-

specific negative experiences with family physicians” (Bauer, Zong, Scheim, Hammond, &

Thind, 2015b, 11). This does not take into account experiences with access to healthcare outside

of a primary family physician but given the prevalence of negative experiences with a doctor that

has a history with the patient already, these issues are enough to lead to “some trans persons
reporting avoidance of health care due to fears of discrimination” (Bauer et al., 2015b, 2).

Although a lot needs to be done to ensure safe access to medical care for trans individuals, and to

combat transphobia within the medical industry, the removal of sex designation on identification

is a step in the right direction. It would eliminate the need for numerous discussions ranging

from unnecessary to intrusive or harmful regarding an individual’s transition related history that

may have little to nothing to do with someone’s medical visit in the first place. This could make

the difference for someone who is uncomfortable seeking health care in situations where it is

required. This struggle is a common one within the transgender community, placed upon it

entirely by outside expectations of what that sex designation of M or F should mean for the

person who possesses it.

Simply knowing that the sex listed on a piece of identification is not congruent with a

trans person’s gender can cause significant sources of stress and anxiety; the unique barriers

faced by the transgender community results in limited support for their mental health struggles.

When analyzing the results of the 2009-2010 survey focussing on those participants who had

reported on suicide outcomes, it was determined that “[h]aving one or more identity documents

concordant with lived gender was significantly associated with reductions in past-year [suicide]

ideation” (Bauer, Scheim, Pyne, Travers, & Hammond, 2015a, 7). Further, it indicated that

70.7% of respondents reported suffering childhood physical or sexual abuse and 19.1% report

suffering a major mental health disorder (Bauer et al., 2015a, 12). Not only does the transgender

community have a strong need for support regarding their mental health, but there is also a

strong correlation between having a matching sex designation and gender and improvements in

said mental health. Although there is a process in place to have sex designation updated, the

benefits cannot be seen or felt until that update is made. The process does little to help those who
have yet to go through it or those who cannot or choose not to. This could prove very difficult for

nonbinary individuals, those who may identify with both, neither, or other gender(s). They would

be forced to chose M or F, erasing part of their identity, or the proposed X which can open them

up to discrimination as that can stand out just as much as an improperly assigned M or F (Yang,

2017). Simply eliminating the field can alleviate the struggle of getting identity documents

updated and allow transgender individuals more freedom to access support for their mental

health struggles.

All the barriers imposed on the trans community by the incorrect sex designation on their

identification can seem even more punishing when the process to get the field amended can

create even more challenges navigating government imposed red tape. Currently, the only option

available to transgender Ontarians who are not content with the current designation on their

identification is to complete a series of steps that can be “onerous, expansive or invasive” (Yang,

2017). For one individual, the process to update the gender linked to her social insurance number

turned into a struggle spanning five years and a human rights case, indicating that the current

process is clearly not adequate (Yang, 2017). This becomes further alienating for the trans

community when the results may be just as limiting as the previous designation, forcing

everyone to confine themselves to a binary identity that may not align with who they are. Gender

and sex are two very different categories that often get classified to mean the same thing,

especially within government documents. Gender is something very personal, and for some,

fluid, and sex is not restricted to a binary, despite often cited but now outdated scientific

evidence (Yang, 2017). There is no reason for the government to continue to display the Sex

category on identification documents, particularly when the category is interpreted

interchangeably for two completely different concepts.

With nothing more than a perceived mismatched sex designation on their identification,

members of the trans community can face restrictive barriers to accessing safe and reliable health

care, support for mental health struggles, and navigating government imposed red tape. The

impact of all these factors can be dramatically lessened, if not completely avoided by something

as simple as removing the field from government records. If the removal of this single letter from

a piece of identification could improve, or in some cases prevent such damaging impacts

ravaging the transgender community, while offering no notable benefits to society as a whole or

the cisgender population on an individual basis, there should be no reason to justify keeping it.

Bauer, G. R., Scheim, A. I., Pyne, J., Travers, R., & Hammond, R. (2015a). Intervenable factors
associated with suicide risk in transgender persons: a respondent driven sampling study in
Ontario, Canada. BMC Public Health, 15(525), 1-15.
Baur, G. R., Zong, X., Scheim, A. I, Hammond, R., & Thind, A. (2015b). Factors Impacting
Transgender Patients’ Discomfort with Their Family Physicians: A Respondent-Driven
Sampling Survey. PLoS ONE, 10(12), 1-16.
Yang, J. (2017, January 26). Transgender activists herald landmark case: Federal government
reviews the use of sex information for all identity documents. Toronto Star. Retrieved