The United States has issued its first passport with an “X” gender marker, which denotes that someone is neither exclusively male nor female, the State Department said Wednesday.

This marks a milestone for nonbinary and intersex Americans, who make up an estimated 1.2 million and 4 million Americans, respectively, according to the Williams Institute at the UCLA School of Law, and interACT, an intersex advocacy group. An increasing number of intersex, nonbinary and gender-nonconforming people have come out in recent years, but most of them have been unable to obtain IDs that accurately reflect who they are due to a patchwork of state laws across the country.

The State Department said that it expects to be able to offer the “X” designation to more people early next year.

The U.S.’ special diplomatic envoy for LGBTQ rights, Jessica Stern, called the moves historic and celebratory, saying they bring the government documents in line with the “lived reality” that there is a wider spectrum of human sex characteristics than is reflected in the previous two designations.

“When a person obtains identity documents that reflect their true identity, they live with greater dignity and respect,” Stern said.

The department did not announce to whom the passport was issued. A department official declined to say whether it was for Dana Zzyym, an intersex Colorado resident who has been in a legal battle with the department since 2015, saying the department does not usually discuss individual passport applications because of privacy concerns.

But Lambda Legal, the LGBTQ legal nonprofit representing Zzyym, confirmed that the organization’s client was the first person to receive a passport with an “X.”

“I almost burst into tears when I opened the envelope, pulled out my new passport, and saw the ‘X’ stamped boldly under ‘sex,’” Zzyym, who first filed the lawsuit in 2015, said in a statement. “I’m also ecstatic that other intersex and nonbinary U.S. citizens will soon be able to apply for passports with the correct gender marker. It took six years, but to have an accurate passport, one that doesn’t force me to identify as male or female but recognizes I am neither, is liberating.”

Zzyym (pronounced Zimm) was denied a passport for failing to check male or female on an application. According to court documents, Zzyym wrote “intersex” above the boxes marked “M” and “F” and requested an “X” gender marker instead in a separate letter.

Zzyym was born with ambiguous physical sexual characteristics but was raised as a boy, according to court filings. Zzyym later came out as intersex while working and studying at Colorado State University, and uses gender-neutral pronouns. The department’s denial of Zzyym’s passport prevented them from being able to travel to a meeting of Organization Intersex International in Mexico.

The State Department announced in June that it was moving toward adding a third gender marker but said it would take time because it required extensive updates to its computer systems. A department official said the passport application and system update with the “X” designation option still need to be approved by the Office of Management and Budget, which approves all government forms, before they can be issued.

The department now also allows applicants to self-select their gender as male or female, no longer requiring them to provide medical certification if their gender does not match that listed on their other identification documents.

The United States joins a handful of countries, including Australia, Canada, Germany, India, Nepal and New Zealand in allowing its citizens to designate a gender other than male or female on their passports.

Stern said her office planned to talk about the U.S.′ experience with the change in its interactions around the world and she hopes that might help inspire other governments to offer the option.

“We see this as a way of affirming and uplifting the human rights of trans and intersex and gender-nonconforming and nonbinary people everywhere,” she said.

It’s unclear how the policy change will affect state laws that do not recognize “X” gender markers. Twenty states and D.C. allow residents to use an “X” marker on their driver’s licenses, according to the Movement Advancement Project, a nonprofit think tank.

States also have a mix of laws that regulate how someone can request a gender marker change on an ID. Twenty-two states allow people to decide what gender markers are appropriate for them — which is now the policy that the State Department will use — according to MAP.

That process, known as self-attestation, allows trans and nonbinary people to keep themselves safe, said Arli Christian, a campaign strategist for the American Civil Liberties Union, which has been pressuring the Biden administration to allow “X” gender markers on passports and advocates for laws that allow people to attest to their own gender.

“That is hands down the best policy for ensuring that all people have the most accurate gender marker on their ID,” Christian said.

The remaining states either require medical provider certification in order to update a gender marker, a court order and proof of genital surgery or they have an unclear law.

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