Nevada has become the 10th state to permit gender-neutral IDs for transgender, nonbinary and intersex residents.

Starting Monday, residents of the Silver State can obtain “X” gender markers on driver's licenses and state ID cards, in addition to the traditional “M” and “F” markers for male and female.

According to Alexandra Walden, public information officer at the Nevada Department of Motor Vehicles, the efforts have been years in the making.

“The Nevada DMV staff have been working diligently for quite some time in order to offer the nonbinary or ‘gender X’ option to Nevadans,” Walden told NBC News in a statement.

Nevada also offers gender-neutral birth certificates for residents.

The new state IDs come on the heels of a progressive policy change last June that allowed applicants to update their ID gender marker without a court order, doctor’s note or corrected birth certificate proving their lived gender identity. That policy of allowing trans people to effectively self-identify their gender now applies to those seeking “X” gender markers, as Walden confirmed.

The changes are the result of the efforts of advocacy and education organization Transgender Allies Group, which asked the DMV to consider a series of policy updates around IDs for trans people.

“Up until recently, the gender binary was the norm throughout our society,” Brooke Maylath, the group’s president, said. “That leaves a lot of people out. You want an identification system that is authentic on a bureaucracy point, but also is flexible enough that it allows people to tell the bureaucracy who you are.”

Since Nevada first added gender identity to a list of protected categories in employment discrimination back in 2011, the state’s DMV said it has been working diligently to expand the means by which trans and nonbinary identities can be fully recognized.

In 2016, the Nevada Department of Public and Behavioral Health announced it would begin allowing transgender people to update their birth certificates from male to female or vice versa by submitting a sworn affidavit testifying to their gender identity — waiving the surgical requirement common in other states. It could also be written on their behalf by someone who knows them.

“We had intended all along to add the gender marker X, but it was a matter of computer programming,” Kevin Malone, DMV public information officer, said.

Prior to Monday’s rollout, DMVs across the state were sent a memo on the new policy. The instructions reminded government employees who issue licenses and IDs that gender and sex are protected classes under Nevada law “but also a personal choice.”

“It is not the responsibility of the DMV to question an applicant’s gender choice,” it states. “As we all know, we cannot assume a person’s gender based on a person’s appearance.”

Ray Mcfarlane, the transgender and gender diversity program manager at the LGBTQ community space The Center in Las Vegas, said Nevada’s new ID policy should serve as a “model for the rest of the country.” By lifting the requirement of a court order or birth certificate, Mcfarlane noted, it ensures that trans and nonbinary people are able to access affirming documentation without a costly and time-consuming legal process.

“All states should let people self-identify,” Mcfarlane said. “The process should be accessible. It should be easy. It should be low cost.”

Of the nine other states and Washington, D.C., that permit a third gender option on state IDs and driver’s licenses, only Oregon and the District of Columbia allow applicants to self-identify their gender. Mcfarlane said it costs about $270 to obtain a court order, an often prohibitive expense.

Trans individuals are twice as likely as the average American to live in poverty, according to the National Center for Transgender Equality. Easing the burden of updating their IDs will help trans and nonbinary people navigate the process of correcting all their documentation. The center’s 2015 U.S. Transgender Survey found that only 11 percent of respondents had their preferred name and gender on all of their IDs.

“Being able to change the gender marker on your ID is one of the most accessible first steps that people can advocate for themselves,” Mcfarlane claimed. “Depending on where your birth certificate is, that costs more and takes longer. Sometimes the paperwork is across state lines.”

Jane Heenan, the founder and clinical director for Gender Justice Nevada, suggested the state could further simplify the gender-marker process by removing gender from IDs and driver’s licenses altogether.

“While I do intend to go and have my license changed to reflect this new designation, I wonder what the state's interest is in labeling anybody in a sex and gender context on identity documents,” Heenan told NBC News. “I don't understand the state's interest in doing so. It wasn't that long ago that the state required persons to list an ethnic label on driver's licenses.”

Walden said the state has to keep gender markers on IDs due to federal requirements, but otherwise agrees with Heenan. But until those requirements are waived, she explained, “Whatever they put on the paper is what we put in the system.”

“Truthfully, why make it difficult?” Walden asked. “Who are we to stand in the way?”

Nevada now joins D.C., Arkansas, California, Colorado, Indiana, Maine, Minnesota, Oregon, Utah and Vermont in permitting gender-neutral driver’s licenses and other state IDs (Vermont’s policy will roll out this summer). Gender-neutral birth certificates are now permitted in New York City and several states, including California, New Jersey, Oregon, Washington and Nevada.

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