New York City has issued the first known birth certificate in the United States that reads "intersex" in the gender field.

The birth certificate was issued to 55-year-old Sara Kelly Keenan, who currently uses female pronouns. She was born intersex, which means that she has male genes and female genitalia. At the time of her birth, intersex people were called "hermaphrodites."

Girl Who Can't Make Hormones

Keenan, who was adopted by a couple from Long Island, was marked as a boy on her birth certificate but was issued a female birth certificate three weeks after her birth. At the time, doctors recommended surgery to people like her so they could conform to either one of the two genders.

"The notion was that the main thing you had to do in cases of intersex was to get the gender assignment settled early, so kids would grow up to be good (believable and straight) girls and boys," the Intersex Society of North America explained.

Keenan said that she is not sure if she underwent genital surgery during the first three weeks of her life, which typically happened to intersex children at the time, but she grew up having gender issues. She realized she was a girl but did not want to wear dresses.

By ninth grade, she was not showing signs of puberty, a problem addressed with a surgical operation a month after she turned 16. She was told that surgeons removed the ovaries that never developed although it was a testicular tissue that had developed where ovaries in females should be. She started female hormone therapy after the surgery.

Her parents and the doctors kept her being an intersex a secret and had been instilled the idea that she was a girl who could not make hormones.

"That lie stood for 30 more years, until I was 49 or 50 years old and used the Internet and a visit to an endocrinologist to confirm the truth," Keenan said.

More than half a century after her birth, Keenan received her corrected birth certificate as an intersex in the mail on Tuesday.

2,000 Sexually Ambiguous Children Born Each Year

Figures from the Intersex Society of North America show that about one in 2,000 children who are born in the U.S. per year are sexually ambiguous enough to be labeled as intersex. Unfortunately, American birth certificates traditionally only offer two options for gender: male or female, which means that about 2,000 children are incorrectly identified every year.

Keena's birth certificate is hailed to have historic significance particularly for intersex people.

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