Separating anatomy from what it means to be a man or a woman, New York City is moving forward with a plan to let people alter the sex on their birth certificate even if they have not had sex-change surgery.

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Joann Prinzivalli, 52, a lawyer for the New York Transgender Rights Organization, a man who has lived as a woman since 2000, without surgery, said the changes amount to progress, a move away from American culture’s misguided fixation on genitals as the basis for one’s gender identity.

“It’s based on an arbitrary distinction that says there are two and only two sexes,” she said. “In reality the diversity of nature is such that there are more than just two, and people who seem to belong to one of the designated sexes may really belong to the other.”