Sex assignment

Sex assignment or gender assignment is the discernment of an infant's sex, typically made at birth based on an examination of the newborn's external genitalia by a healthcare provider such as a midwife, nurse, or physician. In the vast majority of cases (99.95%), sex is assigned unambiguously at birth. However, in about 1 in 2000 births, the baby's genitals may not clearly appear male or female, necessitating additional diagnostic steps, and deferring sex assignment. In most countries, healthcare providers submit a record of the infant's assigned sex and other details of the birth to the government for later issuance of a birth certificate and for other legal purposes.

The prevalence of intersex conditions, where a baby's sex characteristics do not conform strictly to typical definitions of male or female, ranges between 0.018% and 1.7%. While some intersex conditions result in genital ambiguity (approximately 0.02% to 0.05% of births), others present genitalia that are distinctly male or female, which may delay the recognition of an intersex condition until later in life. When assigning sex to intersex individuals, some healthcare providers may consider the gender identity that most people with a similar intersex condition eventually develop, although such assignments may be revised as the individual matures.

The use of surgical or hormonal interventions to reinforce sex assignments in intersex individuals without informed consent is considered a violation of human rights, according to the Office of the United Nations High Commissioner for Human Rights.

Societally and medically, it is generally assumed that a person's gender identity will align with their assigned sex, making them cisgender. However, for a minority, assigned sex and gender identity do not coincide, leading to transgender identity experiences.