Media playback is unsupported on your device Media caption The BBC's Stephen Evans in Berlin says that it's not yet clear what this will mean for German law on marriage 
 
 Germany has become Europe's first country to allow babies with characteristics of both sexes to be registered as neither male nor female. 
 
 Parents are now allowed to leave the gender blank on birth certificates, in effect creating a new category of "indeterminate sex". 
 
 The move is aimed at removing pressure on parents to make quick decisions on sex assignment surgery for newborns. 
 
 However, some campaigners say the new law does not go far enough. 
 
 As many as one in 2,000 people have characteristics of both sexes. 
 
 'Bruised and scarred' 
 
 Media playback is unsupported on your device Media caption Sarah Graham, intersex woman and counsellor: "This pink and blue thing is a nonsense" 
 
 They are known as "intersex" people because they have a mixture of male and female chromosomes or even genitalia which have characteristics of both genders. 
 
 The intense difficulty for parents is often that a gender has to be chosen very quickly so that the new child can be registered with the authorities, the BBC's Steve Evans in Berlin reports. 
 
 Sometimes surgery is done on the baby to turn its physical characteristics as far as possible in one direction or the other, our correspondent says. 
 
 The law in Germany has been changed following a review of cases which revealed great unhappiness. 
 
 In one case, a person with no clear gender-defining genitalia was subjected to surgery. The person said many years later: "I am neither a man nor a woman. I will remain the patchwork created by doctors, bruised and scarred." 
 
 German passports, which currently list the holder's sex as M for male or F for female, will have a third designation, X, for intersex holders, according to the interior ministry. 
 
 Media playback is unsupported on your device Media caption Silvan Agius, ILGA-Europe: "It does not address the surgeries... and that's not good" 
 
 It remains unclear what impact the change will have on marriage and partnership laws in Germany. 
 
 Current laws define marriage as a union between a man and a woman, and civil partnerships are reserved for same-sex couples. 
 
 Silvan Agius of IGLA-Europe, which campaigns for the rights of lesbian, gay, bisexual, transsexual and intersex people, said the law needed to go further. 
 
 "While on the one hand it has provided a lot of visibility about intersex issues... it does not address the surgeries and the medicalisation of intersex people and that's not good - that has to change," he told the BBC. 
 
 While Germany is the first country in Europe to legally recognise a third gender, several other nations have already taken similar steps. 
 
 Third gender recognition Australia - passport applications since 2011 
 
 Bangladesh - passport applications since 2011 
 
 Germany - on birth certificates from 2013 
 
 India - electoral roll since 2009 
 
 Nepal - census since 2007 
 
 New Zealand - passport applications since 2012 
 
 Australians have had the option of selecting "x" as their gender - meaning indeterminate, unspecified or intersex - on passport applications since 2011. A similar option was introduced for New Zealanders in 2012. 
 
 In South Asia, Bangladesh has offered an "other" gender category on passport applications since 2011. 
 
 Nepal began recognising a third gender on its census forms in 2007 while Pakistan made it an option on national identity cards in 2011. 
 
 India added a third gender category to voter lists in 2009. 
 
 While transgender or intersex people have long been accepted in Thailand and are officially recognised by the country's military, they do not have any separate legal status. 

 Gender X: Germany to allow third indeterminate gender option at birth 
 
 By Agence France-Presse 
 
 Wednesday, October 30, 2013 10:46 EST 
 
 Germany on Friday will become the first European country to allow babies born with characteristics of both sexes to be registered as neither male nor female. 
 
 Parents will be allowed to leave the field for gender blank on birth certificates, effectively creating a category for indeterminate sex in the public register. 
 
 “This will be the first time that the law acknowledges that there are human beings who are neither male nor female, or are both — people who do not fit into the traditional legal categories,” University of Bremen law professor Konstanze Plett told AFP. 
 
 The change is intended to remove pressure on parents to quickly make a decision about controversial sex assignment surgeries for newborns. 
 
 But even as the law takes effect November 1, there are questions about what it will mean to live with no legal gender. 
 
 German passports, which currently bear an “M” for male or “F” for female, will soon be allowed to have an “X” in the gender field, according to a spokesman for the interior ministry. 
 
 According to Plett, a specialist in human rights for intersex people, regulations for other personal documents will need to follow suit. 
 
 “We will have fellow human beings with no sex registered,” Plett said. “They can’t be forced into either one of the traditional sexes in these other contexts.” 
 
 Lawmakers have yet to make clear how the change will impact marriage and partnership laws. 
 
 In Germany, marriage is reserved for a man and a woman, and civil partnerships are reserved for two people of the same sex. 
 
 The law’s narrow focus is targeted at parents of newborns and “is not adequate to fully resolve the complex problems of intersex people”, including marriage and civil partnerships, according to the interior ministry spokesman. 
 
 A more immediate concern for intersex advocates is how children “outed” at birth will fare in a world that operates largely on a gender binary. 
 
 “Schools have toilets for boys and toilets for girls. Where will the intermediate child go?” said Silvan Agius, policy director at ILGA Europe, a lesbian, gay, bisexual, trans and intersex rights group. 
 
 “There are separate sports activities for boys and for girls, and so many other things like this,” Agius said. 
 
 “The law doesn’t change that. It does not immediately create a space for intersex people to be themselves.” 
 
 Europe lags behind on gender identity rights, Agius said. 
 
 Earlier this year Australia began allowing individuals to identify as intersex on personal documents, and added gender identity as a protected category under federal anti-discrimination laws. 
 
 The German law follows a 2012 report by the Ethics Council, an independent body of experts, concluding that people with ‘Differences of Sex Development’ suffer in the face of “widespread societal ignorance” and “a lack of respect on the part of the medical profession.” 
 
 Personal testimony from the report quoted a subject born in 1965 with no clear gender-defining genitalia who was castrated as an infant without parental consent. 
 
 “I am neither a man nor a woman,” the person said. 
 
 “I will remain the patchwork created by doctors, bruised and scarred.” 
 
 Experts estimate the population of intersex people at one in 1,500 to 2,000 births. But advocates say the number is much larger partly due to difficulties in defining intersexuality physically or hormonally. 
 
 The new law has already raised the profile of this small population, which could prompt increased awareness, but, some fear, could also trigger discrimination. 
 
 “It is an absolute must that parents, teachers and doctors be educated about the lives of intersex people,” said Lucie Veith, head of an intersex support group in Germany. 
 
 “The government must take measures to ensure that no children are discriminated against because of this new law.” 

 Germany on Friday will become only the second country, after Australia, to allow parents to leave the gender blank on a child's birth certificate, as people born without a clear sex gain more rights and recognition, especially in Europe. 
 
 The European Union cited so-called intersex people in June for the first time in its antidiscrimination guidelines. A month later, Australia adopted guidelines saying people filling out any official forms should be able to choose male, female or "X." 
 
 Growing Recognition Rights being granted or raised: SCOTLAND: Outlaws violence due to bias against identity "not standard male or female. (June 2009) SWITZERLAND: Bioethics commission says gender equality "also applies to people whose sex cannot be unequivocally determined." (Nov. 2012) UNITED NATIONS: Special Rapporteur on Torture calls on nations to reject "forced genital-normalizing surgery." (Feb. 2013) FINLAND: National Ombudsman for Equality declares "not everyone can be unambiguously defined as a woman or a man." (June 2013) EUROPEAN UNION: Intersex people included in antidiscrimination guidelines. (June 2013) AUSTRALIA: People can choose male, female or X on official forms. (July 2013) GERMANY: Allows parents to leave sex blank on a newborn's birth certificate. (November 2013) 
 
 Switzerland's bioethics commission last year said gender equality "also applies to people whose sex cannot be unequivocally determined." 
 
 While the U.S. hasn't granted formal recognition, American surgeons, like their European counterparts, are increasingly holding off on some operations designed to immediately assign a gender to babies born with what doctors call ambiguous genitalia, opting to wait until the child can make a choice. 
 
 That is the biggest demand of intersex activists, who scored what they considered a victory in February when the United Nations Special Rapporteur on Torture called on countries to reject "forced genital-normalizing surgery." 
 
 Activists are less enthusiastic about the new German law, which they worry might backfire. 
 
 An Interior Ministry spokesman in Berlin said the goal of the legislation, which passed the Bundestag unanimously in February, is "to take the pressure off parents to commit themselves to a gender immediately after birth," so that they don't feel compelled to seek surgery right away. 
 
 But activists say the law appears to actually require parents to leave the gender blank if it is ambiguous. 
 
 The law states that if a child "cannot be assigned to the female nor the male gender," the status "shall be entered without such information in the register of births." 
 
 Activists say parents in that situation, fearing stigma, may actually pursue surgery more avidly. "Our main criticism is that this will increase the pressure on parents," said Markus Bauer, an activist based in Switzerland. 
 
 The ministry spokesman didn't respond to a question about the criticism. 
 
 The condition is fairly rare: Heino Meyer-Bahlburg, professor of clinical psychiatry and psychology at Columbia University, estimated that one person in 2,000 to 4,000 is born with ambiguous genitalia. 
 
 About half of the cases result from an identifiable abnormality in the genetic makeup. Others have a murkier genetic foundation, or stem from another factor like drugs taken by the mother during pregnancy. 
 
 The German government expects only a small number of people will be affected, so other statistics or calculations are unlikely to be affected, the ministry spokesman said. 
 
 Almost everyone born with the condition is assigned a gender for official purposes at birth, based on the parents' and doctors' best calculation. 
 
 While "surgeons have become more reluctant" to operate on mild cases, "in more severe cases, at a minimum because it looks very unusual, people are less likely to hold off," Dr. Meyer-Bahlburg said. 
 
 Most people end up keeping the assigned gender, though some switch and a small number decline to identify with either gender at all. 
 
 Laurence Baskin, chief of pediatric urology at Benioff Children's Hospital in San Francisco, said incidents in which surgeons guess wrong on a person's ultimate sexual identity are rare, but they are not unheard-of. 
 
 "Physicians are human and not godly," Dr. Baskin said. "They do the best they can." 
 
 Some people view the trend toward greater recognition of intersex status with alarm. "I think providing any option other than male or female is dehumanizing and medically inaccurate," said Rob Schwarzwalder, senior vice president of the Family Research Council, a conservative Christian group. 
 
 Activists like Del LaGrace Volcano of Sweden, who lived as a female for 37 years but "came out" as intersex in 1995, reject such attitudes. 
 
 "If you're not male or female, what are you? You're an 'it.' You remain a monstrosity," the activist said. "I overcame that." But for most of society, "there's a huge way to go." 
 
 Write to Naftali Bendavid at naftali.bendavid@wsj.com
– Baby boy or baby girl? As of today, parents in Germany have the option of choosing neither, leaving the gender spot on their newborn's birth certificate blank if the baby's sex can't be determined. As many as one in 2,000 people are born with ambiguous genitalia, and the new law basically creates a third gender category for "indeterminate" or "intersex" people, the BBC reports. Currently, passport holders in the country are listed as either M (male) or F (female); with this change, a third option will be added: X (intersex). Individuals whose gender is left blank at birth can choose later to become male or female, or can remain intersex, Der Spiegel reports. Germany, the first European country to make such an allowance, reviewed cases of intersex babies and found that many who were subjected to sex assignment surgery at a young age ended up unhappy. The law is an attempt to relax the pressure on parents, who may feel forced to make a quick decision about gender and surgery. But the Wall Street Journal explains the law's wording could actually have the unplanned effect of pushing parents toward surgery. It reads that if a male or female gender can't be assigned, the child "shall be entered without such information in the register of births." Some fear that might lead stigma-wary parents to request surgery that would allow for a definitive determination of sex. Another fear: that intersex people won't have "a space ... to be themselves," as one LGBT activist points out to AFP, noting that schools separate things like bathrooms and sports activities by gender.