M, F or X: New York City birth certificates now have a gender-neutral option Anyone born in the city will be able to select M, F or X on birth certificates.

New York City has joined a growing number of cities and states that allow people to choose a gender-neutral marker on their birth certificates.

Beginning on Jan. 1, anyone who was born in New York City has the ability to have the gender marker on their birth certificate changed to X, rather than simply male (M) or female (F), and are able to do so without a doctor's note or medical assessment.

New York City Mayor Bill de Blasio signed the measure into law on Tuesday, marking a milestone in a years-long battle for advocates.

"To all trans and non-binary New Yorkers: We see you, hear you and respect you. Starting in 2019, all New Yorkers will be able to change their gender on their birth certificate to M, F or X — without a doctor's note," the mayor's office tweeted.

“It felt really monumental to me,” said Ethan Rice, a senior attorney at Lambda Legal, a civil rights group that advocates for LGBTQ individuals, and a co-chair of the advisory board that worked with city officials to create the law. "It’s great to have something like this come to fruition."

Rice said that the fact that no doctor's note is required is important and represents more than just eliminating an extra step in the process.

He said that self-attestation essentially shows “that the government is recognizing that transgender people, as citizens, are the ones who know what their identity is and are able to tell the government that really, rather than the other way around.”

The New York City law doesn’t allow parents to select X at birth, but they will have the ability to change the gender marker on the certificate any time before the child is 18 years old, Rice explained. People over the age of 18 have the ability to make the change themselves.

While Rice said he believes New York City “is at the forefront” of the issue, gender-neutral identifiers are not available state-wide yet, meaning that while someone may be able to change their gender marker on their birth certificate, the same is not yet true of their New York state driver’s license.

According to the National Center for Transgender Equality’s ID Documents Center, there are currently seven states and jurisdictions that have gender-neutral drivers’ licenses available: Arkansas, Colorado, Maine, Minnesota, Oregon, Washington D.C., and as of Tuesday, California.

New York City is now the fourth place – after California, Oregon and Washington state – to have a gender-neutral option on birth certificates, and New Jersey is set to join the list on Feb. 1.