Germany has some of the most liberal laws in Europe when it comes to "transgender" and "intersex" rights. But activists are hoping for still broader gender identity freedoms in the eyes of the state and society at large.
"The most important thing to keep in mind when it comes to this issue is: No one should have a right to look into people's underpants – especially not the state," said Katrin Alter, chairwoman of the German Society for Transidentity and Intersexuality (DGTI).
Alter was referring to a law in Germany that provides people with the means to officially change the gender on their birth certificate, but requires them to have a sex-change operation first.
New York currently has the same caveat: Only people who show proof of surgery qualify for a revised birth certificate. But the new plan puts the city at the forefront of efforts to redefine sexual identity, allowing people who can prove they have been living as a different gender to make the change without an operation.
"Sometimes they say 'Whoops!'"
Like many transgender activists, Alter is hoping Germany will catch up with New York. In addition to trying to raise awareness and providing legal advice, her organization has been lobbying the government to make gender more a question of personal identity than of genitalia.
"The first thing people notice after the birth of the baby is the sex," she said. "They look between the legs and say: 'It's a boy' or 'It's a girl.' But sometimes they say: 'Whoops,' -- when the genitals are either undefined, or both sets are present."
Eighty-six kinds of gender?
Alter added that key aspect of her work at DGTI is to educate the public that gender is not as black and white as most people believe.
"There are 86 different human genders," she said, with defining markers running from inner and outer genitalia, through chromosomes, hormones, identity development, and social reflection.
"The determinations 'male' and 'female' are cultural-religious dogma," she said. "There are people born with XX chromosomes but they are male. And XYs who are women, and people wo are XXY… not to mention people whose gender is unclear at first but develops later."
Arguing against operations
Alter estimates around one million Germans fall under the variously interpreted and broadly used terms "intersex" (indeterminable gender) or "transgender" (having genitals of one gender, but identifying with another.)
But, she said, its is impossible to guess the true numbers of transgenders or intersex, because in the vast majority of cases in Germany, doctors and parents routinely decide to "assign" a gender to an ambiguously-sexed child directly after birth and then raise the child as that gender.
The process necessarily includes invasive, often repeated, surgeries: Very often the children who grow up that way wind up feeling like something is not quite right – they just don't know what it is, activists complain.
For Alter, and others who would like to stop this practice, it is a question of human rights.
"The first article of the German basic law says: 'Human dignity is inviolable,'" she said. "The second says: 'Every person has the right to physical integrity.'"
Thus, forcing someone to undergo a sex-change operation in order to change genders under the law is a breach of human rights, Alter said.
A question of human rights
"I am not basically against sex-change operations – for some people it may be just the right thing," she added. "But people should not be forced to decide. The state cannot decide that."
Deborah Campbell, a lawyer at a German law firm that specializes in transgender rights, said that the current German transgender law was "extremely liberal" when it was passed in 1980, but "it has since become quite outdated."
Elsewhere in Europe, England and Spain were recently forced by the European Court of Human Rights to update their transgender laws. Activists hope that the German legislature will pass new laws by next summer that could eliminate the need for a person to have a sex-change operation in order to change the sex designation on his or her birth certificate.
"Changing your gender gives you all the legal rights and responsibilities associated with that gender, like marriage," Campbell said. "But the psychological aspects are much more important. To be able to say: 'I feel like a man, or a woman, and now I get the legal recognition for that from the state.'"
While Campbell said she's not especially optimistic that it will happen, she hopes the new law will do away with the current requirement to have a psychologist determine whether or not a person is really the gender they claim to be.
"I think seeing a psychologist is probably important, but it should not be mandatory," she said. "A psychologist cannot look inside me and tell me who I am. It's all about human rights. In a legal sense, it is part of my overall personal right to decide about my sexual identity."