The Massachusetts Senate passed a bill on Thursday that would allow someone to check "X" instead of male or female on their driver's license and other state identity cards.

"Not everyone in this world fits neatly into the traditional categories of what we have been thinking of as male or female," said Senate Ways and Means Committee Chairwoman Karen Spilka, D-Ashland, the lead sponsor of the bill. Spilka said people can face discrimination, harassment and other challenges when the gender identity they were born with "doesn't match their truly lived gender identity."

The bill passed the Senate on a 36-1 vote. It will now go to the House for consideration.

Sen. Don Humason, R-Westfield, was the lone no vote.

Humason said after the vote that he has not heard from a single constituent or advocacy group about this being an issue. He worries that the bill involves government-issued identifications, and it will allow the registrar of motor vehicles to create additional designations for gender other than "X," male or female, as long as that designation "appropriately reflects the gender identity of applicants."

"Where does it all stop? How many different possible identities could there possibly be?" Humason said.

Humason said the designations are based solely on self-identification, with no agreed-upon standards, and there are practical implications. The bill explicitly prohibits requiring any documentation.

"How can we expect our police officers or other government officials to keep up with this ever changing and ever expanding list of gender expression designations?" Humason said.

Spilka said her inspiration for the bill was Ella, now a rising high school junior living in Spilka's district. Ella, who declined to provide a last name, identifies as nonbinary. Ella wrote to Spilka that applying for a license was stressful because of the need to choose a gender.

Speaking at a press conference Thursday, Ella said their identity since coming out "has been a balancing act." "Of the things like public accommodations that are separated by male or female, I don't necessarily fit," Ella said. "Often times I have to pick and choose depending how I appear that day."

"I don't want the validity of my license being questioned because of how I appear," Ella said. "I want it to correspond to how I live my life."

Spilka said passing the bill is a way of "validating people's right to live their lives the way that they feel most comfortable."

Oregon, California, Maine and Washington D.C. already have laws allowing a gender neutral option on state licenses.

Several countries also legally recognize a third option for gender, including Canada, Germany, Australia, New Zealand, Nepal, Pakistan and Bangladesh.

Senate President Harriette Chandler, D-Worcester, said in Massachusetts, "We pride ourselves on personal choice, and there is nothing more fundamental than the right to self identify your gender as you see fit."

The federal REAL ID Act, which sets standards for federally acceptable identification, requires that state identification cards include gender. But Spilka said the federal government allows states to define gender, so the bill would not affect compliance with REAL ID.

A Massachusetts Department of Transportation spokeswoman confirmed that the Registry of Motor Vehicles computer system already has the capability to allow for another option for gender.

The bill could help people who are intersex, which means they do not have the sex characteristics, either hormones or reproductive anatomy, that are consistent with male or female. It could also help people who are transgender or who do not identify as a man or woman.

Andrew Beckwith, president of the socially conservative Massachusetts Family Institute, which opposes the bill, said identification documents like driver's licenses "are legal documents, intended to reflect objective facts," such as biological sex.

Beckwith said last week, "I'm sure plenty of people would rather not have their true height or age listed on the license. It's irrelevant, it should be objective facts."