Lambda Legal Sues North Carolina to End Birth Certificate Discrimination for Transgender People

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November 16, 2021

Today, Lambda Legal, alongside the firms Baker Botts LLP and Brooks Pierce McLendon Humphrey & Leonard LLP, filed a federal lawsuitchallenging the State of North Carolina’s discriminatory policy requiring transgender people to have undergone “sex reassignment surgery” in order for them to obtain an accurate birth certificate reflecting who they are. 

“It’s dehumanizing and demoralizing being denied a birth certificate that reflects who I am. I cannot afford surgery and do not have access to surgery through my health insurance. It is wrong for North Carolina to require that I obtain surgery in order for them to recognize me as the woman I am. As a trans woman, having incorrect documentation makes me feel like a second-class citizen because I am denied the same rights as the rest of the population. It just makes me feel like I am ‘less than’ before the eyes of the state.” said plaintiff Lillith Campos, a transgender woman born in North Carolina. 

Lambda Legal, Baker Botts LLP and Brooks Pierce McLendon Humphrey & Leonard LLP filed the lawsuit in the U.S. District Court for the Middle District of North Carolina on behalf of three plaintiffs: Lillith Campos, who is an adult, and two minor teenagers: C.B., through his parent Shelley K. Bunting; and M.D., through her parent Katheryn Jenifer. Lillith, C.B., and M.D. were all born in North Carolina but are unable to obtain a birth certificate accurately reflecting their identity due to the state’s discriminatory surgical requirement.

“Birth certificates are essential and foundational identity documents critical for people navigating life.  North Carolina’s policy explicitly requiring transgender people have surgery to affirm their identity is not only discriminatory but arbitrary and inconsistent with standard medical practice. This discriminatory requirement presents a significant barrier, sometimes insurmountable, to many transgender people, particularly those who may not be able to afford gender confirmation surgery, or who may not want or need it,” said Omar Gonzalez-Pagan, Senior Attorney and Health Care Strategist at Lambda Legal. “North Carolina is out of step with the rest of America and trails behind the majority of states that permit transgender persons to correct the sex designation on their birth certificates without a surgical requirement.” 

The lawsuit argues that denying transgender North Carolinians the ability to obtain accurate birth certificates unless they undergo ”sex reassignment surgery” discriminates against them on the basis of sex and transgender status, invades their privacy, and violates their rights to liberty and medical autonomy. In addition, the lawsuit argues that forcing transgender people to hold essential documentation with an inaccurate sex designation infringes on their free speech under the First Amendment, and also prevents transgender people from accurately expressing their gender identity. 

“My daughter is a 14-year-old girl and the state’s requirement for surgery is unrealistic and creates a barrier for my child to have a normal childhood. Not having an accurate birth certificate has exposed my daughter to discriminatory treatment and exclusion in school, sports, and other places. No child should go through knowing the state doesn’t recognize as who she is and that’s why I am supporting my daughter in this lawsuit”, said Katheryn Jenifer, mother of plaintiff M.D.

“Baker Botts is proud to be a longtime supporter of Lambda Legal and looks forward to advancing the civil rights of transgender North Carolinians. This engagement with Lambda Legal reflects a strengthening of Baker Botts’s long-standing commitment to pro bono and a further expansion of our advocacy for LGBTQ civil rights,” said Derek McDonald, Partner at Baker Botts.

The North Carolina’s surgical requirement also stands in contrast to North Carolina’s own policy permitting transgender persons to correct the sex designation on their driver’s licenses and state identification cards to accurately reflect their sex, consistent with their gender identity, without any requirement that they undergo surgical procedures.  

Lambda Legal has already successfully challenged discriminatory restrictions on transgender people’s ability to obtain accurate birth certificates reflecting who they are in Idaho (FV v. Jeppesen), Kansas (Foster v. Andersen), New York (MHW v. Cuomo), Ohio (Ray v. McCloud), and Puerto Rico (Arroyo v. Rossello).  A challenge to Tennessee’s discriminatory policy is currently pending in federal court (Gore v. Lee). Lambda Legal has also successfully challenged discriminatory policies pertaining to other forms of identification, such as driver’s licenses (Saba v. Cuomo) and passports (Zzyym v. Pompeo). 

Handling the case on behalf of Lambda Legal are Senior Attorney Omar Gonzalez-Pagan and Staff Attorneys Carl Charles and Avatara Smith-Carrington.  They are joined by Derek McDonald, Maddy Dwertman, and Brandt Thomas Roessler who lead the team for Baker Botts LLP, and Sarah M. Saint and Eric David of Brooks Pierce McLendon Humphrey & Leonard LLP.


“Meet the Plaintiffs” 

Lillith Campos is a 45-year-old woman of transgender experience who was born and currently resides in Jacksonville, North Carolina. Lillith wishes to correct her birth certificate, but her employer’s health insurance plan does not provide coverage for sex reassignment surgery. Lillith cannot independently afford the surgery, particularly since she is the primary provider for three minor children. Ms. Campos is employed at a local snack company, which provides self-funded health care that includes a categorical exclusion of coverage for gender confirming health care. Ms. Campos is very involved in her local LGBTQ community and is a “safe zone” trainer who educates others on how to provide a welcoming environment for LGBTQ people, including over seventy-six social workers from a variety of organizations, city agencies, and shelters throughout the city. 

C.B. is a 16-year-old young man who was born and currently resides in Chapel Hill, North Carolina. C.B. does not currently have plans to undergo gender-affirming surgery. Moreover, most types of gender-affirming surgery are not recommended for minors under the prevailing standards of care. C.B. is a high school student, who enjoys swimming, video games, cars, and hanging out with his friends.  In school, he particularly enjoys studying psychology and is considering it as a career path. C.B. already possesses a U.S. passport and a driver’s license with an accurate name and sex designation. 

M.D. is a 14-year-old girl who was born in North Carolina and currently resides in Carrboro, North Carolina with her mother, father, and sister. M.D. knew she was a girl from an early age, when she would wear her older sister’s princess costumes, and most of her friends were other girls.  She vehemently resisted leaving the house dressed as a boy.  At the age of four, M.D. verbalized how she felt and told her parents that she was a girl. Not having a correct birth certificate has caused discriminatory treatment of M.D. and exclusion from such activities as participating in the town’s girls softball league. 

Read the complaint here:

Read more about the case here:

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Samy Nemir | | 202-672-4877