West Virginia Democrats aligned with Republicans in the House of Delegates on Friday to pass a bill, HB 4233, that bars the term “nonbinary” from appearing on birth certificates and mandates the inclusion of a person’s sex (male/female) on the document.

While West Virginia already prohibited changing the gender marker on birth certificates to nonbinary, LGBTQ advocates condemned the Democrats who voted in favor of the bill, saying that their votes revealed where they stand on transgender rights.

“This isn’t even a thing -you can change birth certificates but NOT to non binary soooo the dems who will say it’s a do nothing bill- done DID something to their voter base,” West Virginian author and ACLU-WV staff member Jamie Miller said on social media. “It speaks volumes to the people in West Virginia that you disregard while voting for your own interests.”

The Democrats who voted for the bill include Hollis Lewis, Joey Garcia, Kayla Young, Ric Griffith, Sean Hornbuckle, and self-proclaimed “Lefty” Shawn Fluharty.

By approving this bill, Democrats not only disregard the identities of nonbinary and gender nonconforming West Virginians but also overlook the existence of intersex people within their state. According to the United Nations Office of the High Commissioner for Human Rights (OHCHR), an estimated 1.7 percent of people are born with intersex traits or atypical sex characteristics.

Laws like this reinforce the dangerous yet prevalent practice of forcing intersex children to undergo surgeries to alter their gonads, internal reproductive organs, and genitals to conform more closely to stereotypical male or female characteristics. These surgeries can cause psychological distress in children who grow up to identify as a gender different than the one their bodies were surgically altered to be more like.

“Critics, often liberal Democrats, may question why the nonbinary birth certificate ban draws condemnation when seemingly few people care about the issue. Perhaps these critics should consider that standing on the side of the oppressor sends a harmful message,” Morgantown City Council member Brian Butcher wrote on his blog in response to the vote. “Intersex individuals are born at roughly the same rate as red-haired individuals. By endorsing this bill you have just told every constituent who was born intersex or with intersex children that they simply do not exist in the eyes of the law.”

In one study on intersex people, 81 percent of participants had been subjected to surgeries due to their intersex status, 50 percent of whom developed psychological problems. Because of this, human rights organizations have denounced this practice, asserting that such procedures are medically unnecessary and pose the risk of causing lifelong suffering.

While the ACLU-WV opposed this bill, advocates criticized LGBTQ groups, including Fairness WV, that didn’t track its progression.

“The ACLU of WV alongside LGBTQ+ activists and organizers made it clear [this bill] would cause direct harm to the trans community in West Virginia,” transgender activist Ash Orr said on social media. “Wild that there was silence from other major LGBTQ+ adjacent organizations in this state.”

West Virginia lawmakers have advanced an additional 25 anti-LGBTQ bills since the start of this year. In total, more than 400 anti-LGBTQ bills have been introduced in state legislatures across the country since January 1.