People who were born in New York City and do not identify as male or female can now select the gender-neutral designation of X on their birth certificates. Mayor Bill de Blasio signed the provision into law last week. In 2014, the city passed a law that removed the requirements of surgery and legal name-change for transgender people who wished to change the gender designated on their birth certificate from female to male or male to female. Now, gender nonconforming or non-binary transgender people can also choose an option they say honors their identities, also without surgery or legal name-change.The law gives New Yorkers the freedom to "tell the government who they are and not the other way around," de Blasio said."As a non-binary trans person, I intimately understand the discrimination our communities face as a result of mismatched or inaccurate identity documents," said Ashe McGovern, Director of the NYC Unity Project in a statement. "With this move, the Mayor is signaling clearly that New York City sees us, hears us, and deeply supports our fundamental right to self-determination." Trans activists say requiring treatment or letters from physicians are medical and administrative barriers for some people wishing to obtain legal documentation that matches their identity. Four states — California, Oregon, Washington and New Jersey — have passed similar third category birth certificate laws with a variety of requirements; for example, New Jersey requires people wishing to change their birth certificate to obtain a certificate from a licensed physician. New York City is the first municipal government with such legislation. Those living in the city but not born there do not fall under its law.Maine, California, Oregon and the District of Columbia offer driver's licenses with gender-neutral options.Changing one's designated gender on a passport requires more footwork than New York City's birth certificate law. The federal government requires a doctor to confirm a person has undergone "appropriate clinical treatment for transition" — the doctor determines what that appropriate clinical treatment is; surgery is not a requirement. Passports only have male or female gender designations.New York City's law will go into effect on January 1, 2019. Copyright 2018 NPR. To see more, visit http://www.npr.org/.