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*sb0626*
SENATE BILL 626
J1, R4 6lr3585
SB 314/25 – FIN & JPR CF HB 1589
By: Senator Lam
Introduced and read first time: February 5, 2026
Assigned to: Finance and Judicial Proceedings
Committee Report: Favorable
Senate action: Adopted with floor amendments
Read second time: March 6, 2026
CHAPTER ______
AN ACT concerning 1
Sex Designation on Certificates of Birth, Licenses, and Identification Cards – 2
Sex Designation and Birth Information Histories 3
(Birth Certificate Modernization Act) 4
FOR the purpose of requiring the Secretary of Health to keep and maintain a birth 5
information history for each individual for whom a certificate of birth is issued under 6
a certain provision of law; requiring the Secretary to maintain a database of birth 7
information histories that may be accessed by governmental entities for a certain 8
purpose under certain circumstances; altering the circumstances under which the 9
Secretary of Health is required to make a new certificate of birth due to the change 10
of a sex designation of an individual; establishing requirements and a prohibition 11
related to the making of new certificates of birth; altering the options for indicating 12
an individual’s sex designation on a license, identification card, and moped operator’s 13
permit issued by the Motor Vehicle Administration; and generally relating to the 14
issuance of certificates of birth, licenses, and identification cards , and birth 15
information histories. 16
BY adding to 17
Article – Health – General 18
Section 4–208.1 19
Annotated Code of Maryland 20
(2023 Replacement Volume and 2025 Supplement) 21
BY repealing and reenacting, with amendments, 22
Article – Health – General 23
2 SENATE BILL 626
Section 4–211 1
Annotated Code of Maryland 2
(2023 Replacement Volume and 2025 Supplement) 3
BY repealing and reenacting, with amendments, 4
Article – Transportation 5
Section 12–305(a) and (b) 6
Annotated Code of Maryland 7
(2020 Replacement Volume and 2025 Supplement) 8
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 9
That the Laws of Maryland read as follows: 10
Article – Health – General 11
4–208.1. 12
(A) THE SECRETARY SHALL KEEP AND MAINTAIN A BIRTH INFORMATION 13
HISTORY FOR EACH IND IVIDUAL FOR WHOM A C ERTIFICATE OF BIRTH IS ISSUED 14
UNDER § 4–208 OF THIS TITLE. 15
(B) (1) THE BIRTH INFORMATION HISTORY FOR AN INDIV IDUAL SHALL 16
CONTAIN A HISTORICAL RECORD OF: 17
(I) THE INDIVIDUAL’S BIRTH DATE; 18
(II) THE INDIVIDUAL’S NAME; 19
(III) THE INDIVIDUAL’S SEX DESIGNATION AT BIRTH; AND 20
(IV) ANY OTHER INFORMATION RE GARDING THE INDIVIDU AL 21
THE SECRETARY REQUIRES. 22
(2) THE SECRETARY SHALL ADOPT STANDARD PROCEDURES FOR 23
ADDING UPDATED INFOR MATION TO AN INDIVID UAL’S BIRTH INFORMATION 24
HISTORY. 25
(C) UPDATED BIRTH INFORMATION HISTORY: 26
(1) IS SEALED; 27
(2) MAY BE ACCESSED ONLY THROUGH THE PROCESS DESCRIBED 28
UNDER § 4–211(G) OF THIS SUBTITLE; AND 29
(3) IS NOT SUBJECT TO THE PUBLIC INFORMATION ACT. 30
SENATE BILL 626 3
4–211. 1
(a) Except as provided in subsection [(d)] (E) of this section, the Secretary shall 2
make a new certificate of birth for an individual if the Department receives satisfactory 3
proof that: 4
(1) The individual was born in this State; and 5
(2) Regardless of the location, one of the following has occurred: 6
(i) The previously unwed parents of the individual have married 7
each other after the birth of the individual; 8
(ii) A court of competent jurisdiction has entered an order as to the 9
parentage, legitimation, or adoption of the individual; or 10
(iii) If a parent who did not give birth to the individual is not named 11
on an earlier certificate of birth: 12
1. The parent who did not give birth to the individual has 13
acknowledged [himself or herself] by affidavit to [be] BEING a parent of the individual; and 14
2. The mother [of the individual ] OR PARENT LISTED ON 15
THE INDIVIDUAL ’S BIRTH CERTIFICATE has consented by affidavit to the 16
acknowledgment. 17
(b) Except as provided in subsection [(d)] (E) of this section, the Secretary shall 18
make a new certificate of birth for an individual if the Departm ent receives satisfactory 19
proof that: 20
(1) The individual was born in this State; and 21
(2) Regardless of the location, one of the following has occurred: 22
(i) [1. IF THE INDIVIDUAL IS A MINOR OR DISABLED PERSON 23
UNDER GUARDIANSHIP: 24
A. A licensed health care practitioner who has treated or 25
evaluated the individual has determined that the individual’s sex designation should be 26
changed because the individual has undergone treatment appropriate for the purpose of 27
sex transition or has been diagnosed with an intersex condition; 28
2.] The individual, or if the individual is a minor or disabled 29
person under guardianship, the individual’s parent, guardian, or legal representative, has 30
made a written request, UNDER PENALTY OF PERJURY, for; AND 31
4 SENATE BILL 626
B. THE INDIVIDUAL ’S PARENT , GUARDIAN, OR LEGAL 1
REPRESENTATIVE HAS M ADE A WRITTEN REQUES T FOR A NEW CERTIFIC ATE OF 2
BIRTH WITH A SEX DESIGNATION THAT DIFFERS FROM THE SEX DESIGNATED ON THE 3
ORIGINAL CERTIFICATE OF BIRTH; OR 4
2. IF THE INDIVIDUAL IS NOT A MINOR OR DISAB LED 5
PERSON UNDER GUARDIA NSHIP, THE INDIVIDUAL HAS S UBMITTED AN AFFIDAVI T 6
REQUESTING a new certificate of birth with a sex designation that differs from the sex 7
designated on the original certificate of birth THAT INCLUDED AN ATTESTATION UNDER 8
PENALTY OF PERJURY T HAT THE REQUEST IS N OT BEING SUBMITTED F OR A 9
FRAUDULENT OR UNLAWFUL PURPOSE; [and 10
3. The licensed health care practitioner has signed a 11
statement, under penalty of perjury, that: 12
A. The individual has undergone surgical, hormonal, or other 13
treatment appropriate for the individual, based on generally accepted medical standards; 14
or 15
B. The individual has an intersex condition and, in the 16
professional opinion of the licensed health care practitioner, based on generally accepted 17
medical standards, the individual’s sex designation should be changed accordingly;] 18
(ii) A court of competent jurisdiction has issued an order indicating 19
that the sex of an individual born in this State has been changed; or 20
(iii) Before October 1, 2015, the Secretary, as provided under 21
regulations adopted by the Department, amended an original certificate of birth on receipt 22
of a certified copy of an order of a court of competent jurisdiction indicating the sex of the 23
individual had been changed. 24
(c) EXCEPT AS PROVIDED IN SUBSECTION (E) OF THIS SECTION , THE 25
SECRETARY SHALL MAKE A NEW CERTIFICATE OF BIRTH FOR AN INDIVIDUAL IF THE 26
DEPARTMENT RECEIVES SATISFACTORY PROOF THAT: 27
(1) THE INDIVIDUAL WAS BORN IN THIS STATE; AND 28
(2) REGARDLESS OF THE LOCATION , A COURT OF COMPETENT 29
JURISDICTION HAS ISS UED AN ORDER INDICAT ING THAT THE NAME OF A PARENT 30
LISTED ON THE CERTIFICATE OF BIRTH HAS BEEN CHANGED. 31
(D) Except as provided in subsection [(d)] (E) of this section, the Secretary may 32
make a new certificate of birth for an individual who was born outside the United States if 33
one of the following occurred in this State: 34
SENATE BILL 626 5
(1) The previously unwed parents of the individual have married each 1
other after the birth of the individual; 2
(2) A court of competent jurisdiction in this State has entered an order as 3
to parentage or legitimation; or 4
(3) The parent who did not give birth to the individual acknowledged 5
[himself or herself ] by affidavit to [be] BEING a parent of the individual and the mother 6
OR PARENT LISTED ON THE BIRTH CERTIFICAT E of the individual has consented by 7
affidavit to the acknowledgment. 8
[(d)] (E) The Secretary may not make a new certificate of birth in connection 9
with an order of a court of competent jurisdiction relating to the adoption of an individual, 10
if one of the following so directs the Secretary: 11
(1) The court that decrees the adoption; 12
(2) The adoptive parents; or 13
(3) The adopted individual, if an adult. 14
[(e)] (F) A new certificate of birth shall be prepared on the following basis: 15
(1) The individual shall be treated as having at birth the status that later 16
is acquired or established and of which proof is submitted. 17
(2) (i) If the parents of the individual were not married and parentage 18
is established by legal proceedings, the name of the parent who did not give birth to the 19
individual shall be inserted. 20
(ii) The legal proceeding should request and report to the Secretary 21
that the surname of the subject of the record be changed from that shown on the original 22
certificate, if a change is desired. 23
(3) If the individual is adopted, the name of the individual shall be that set 24
by the decree of adoption, and the adoptive parents shall be recorded as the par ents of the 25
individual. 26
(4) The new certificate of birth shall contain wording that requires each 27
parent shown on the new certificate to indicate [his or her] THE PARENT’S own Social 28
Security number. 29
[(f)] (G) (1) When a new certificate of birth is made under subsection (b) of 30
this section: 31
6 SENATE BILL 626
(i) The sex designation of the individual on the new certificate of 1
birth shall be the sex designation for which satisfactory proof has been submitted in 2
accordance with subsection (b) of this section; and 3
(ii) If the name of the individual has been changed at any time, the 4
name of the individual on the new certificate of birth shall be the name that was last 5
established and for which appropriate documentation has been submitted to the 6
Department. 7
(2) A new certificate of birth made under subsection (b) of this section may 8
not: 9
(i) Be marked “amended”; or 10
(ii) Show on its face that a change has been made to: 11
1. A sex designation; or 12
2. If applicable, a change of name. 13
(3) (I) WHEN ISS UING A NEW CERTIFICA TE OF BIRTH UNDER 14
SUBSECTION (B) OF THIS SECTION, THE SECRETARY SHALL ALLOW AN INDIVIDUAL 15
TO DESIGNATE THE SEX OF THE INDIVIDUAL AS: 16
1. FEMALE; 17
2. MALE; OR 18
3. UNSPECIFIED OR ANOTHER. 19
(II) IF AN INDIVIDUAL INDI CATES A SEX DESIGNATION OF 20
UNSPECIFIED OR ANOTHER ON AN APPLICATION FOR A NEW CERTIFICATE OF BIRTH, 21
THE SECRETARY SHALL ENSURE THAT THE NEW CERTI FICATE OF BIRTH DISPLAYS 22
AN “X” IN THE LOCATION THAT INDICATES THE INDIVIDUAL’S SEX. 23
(H) (1) WHEN A NEW CERTIFICAT E O F BIRTH IS MADE UNDE R 24
SUBSECTION (C) OF THIS SECTION , IF THE NAME OF THE P ARENT HAS BEEN 25
CHANGED AT ANY TIME: 26
(I) THE NAME OF THE PAREN T ON THE NEW CERTIFI CATE OF 27
BIRTH SHALL BE THE N AME THAT WAS LAST ES TABLISHED AND FOR WH ICH 28
APPROPRIATE DOCUMENTATION HAS BEEN SUBMITTED TO THE DEPARTMENT; AND 29
(II) EXCEPT ON REQUEST OF THE INDIVIDUAL , OR, IF THE 30
INDIVIDUAL IS A MINO R OR DISABLED PERSON UNDER GUARDIANSHIP , THE 31
SENATE BILL 626 7
INDIVIDUAL’S PARENT , GUARDIAN, OR LEGAL REPRESENTAT IVE, THE NEW 1
CERTIFICATE OF BIRTH MAY NOT INCLUDE ANY PRIOR LEGAL NAME OF THE PARENT. 2
(2) A NEW CERTIFICATE OF BIRTH MADE UNDER SUBSECTION (C) OF 3
THIS SECTION MAY NOT: 4
(I) BE MARKED “AMENDED”; OR 5
(II) SHOW ON ITS FACE THAT A CHANGE HAS BEEN MADE TO: 6
1. A SEX DESIGNATION; OR 7
2. IF APPLICABLE, A NAME. 8
[(g)] (I) (1) If a new certificate of birth is made, the Secretary shall: 9
(i) Substitute the new certificate of birth for any certificate then on 10
file; and 11
(ii) Place the original certificate of birth and all records that relate 12
to the new certificate of birth under seal. 13
(2) The seal may be broken only: 14
(i) On order of a court of competent jurisdiction; 15
(ii) If it does not violate the confidentiality of the record, on written 16
order of a designee of the Secretary; or 17
(iii) In accordance with Title 5, Subtitle 3A or Subtitle 4B of the 18
Family Law Article. 19
(3) A certified copy of the certificate of birth that later is issued shall be a 20
copy of the new certificate of birth, unless: 21
(i) A court of competent jurisdiction orders the issuance of a copy of 22
the original certificate of birth; or 23
(ii) Title 5, Subtitle 3A or Subtitle 4B of the Family Law Article 24
provides for the issuance of a copy of the original certificate of birth. 25
[(h)] (J) Each clerk of court shall send to the Secretary, on the form that the 26
Secretary provides, a report of: 27
(1) Each decree of adoption; 28
8 SENATE BILL 626
(2) Each adjudication of parentage, including the parent’s Social Security 1
number; and 2
(3) Each revocation or amendment of any decree of adoption or 3
adjudication of paternity that the court enters. 4
[(i)] (K) Upon receipt of a report or decree of annulment of adoption, the original 5
certificate of birth shall be restored to its place in the files, and the adoption certificate and 6
any accompanying documents are not subject to inspection except upon order of a court of 7
competent jurisdiction or as provided by regulation. 8
[(j)] (L) If no certificate of birth is on file for the person for whom a new birth 9
certificate is to be established under this section, and the date and place of birth have not 10
been determined in the adoption or paternity proceedings: 11
(1) A delayed certificate of birth shall be filed with the Secretary as 12
provided in § 4–210 of this subtitle before a new certificate of birth is established; and 13
(2) The new birth certificate shall be prepared on the delayed birth 14
certificate form. 15
[(k)] (M) (1) The Secretary shall, on request, prepare and register a certificate 16
in this State for an individual born in a foreign country and who was adopted: 17
(i) Through a court of competent jurisdiction in this State; or 18
(ii) 1. Under the laws of a jurisdiction or country other than the 19
United States and has been granted an IR –3 or IH –3 visa by the U.S. Citizenship and 20
Immigration Services under the Immigration and Nationality Act; and 21
2. By an adopting parent who is a resident of this State. 22
(2) Except as provided in paragraph (3) of this subsection, the certificate 23
shall be established on receipt of: 24
(i) A certificate of adoption from the court decreeing the adoption; 25
(ii) Proof of the date and place of the child’s birth; and 26
(iii) A request from the court, the adopting parents, or the adopted 27
person if 18 years of age or over that the certificate be prepared. 28
(3) If the child was adopted under the laws of a jurisdiction or country other 29
than the United States and has been granted an IR–3 or IH–3 visa by the U.S. Citizenship 30
and Immigration Services under the Immigration and Nationality Act, the certificate shall 31
be established on receipt of: 32
SENATE BILL 626 9
(i) An official copy of the decree from the jurisdiction or country in 1
which the child was adopted; 2
(ii) A certified translation of the foreign adoption decree; 3
(iii) Proof of the date and place of the child’s birth; 4
(iv) Proof of IR–3 or IH–3 visa status; 5
(v) A request from the court, the adopting parents, or the adopted 6
person if 18 years of age or over that the certificate be prepared; and 7
(vi) Proof that the adopting parent is a resident of this State. 8
(4) The certificate shall be labeled “Certificate of Foreign Birth” and shall 9
show the actual country of birth. 10
(5) A statement shall also be included on the certificate indicating that it 11
is not evidence of United States citizenship for the child for whom it is issued. 12
Article – Transportation 13
12–305. 14
(a) An application for a license, an identification card, or a moped operator’s 15
permit shall allow an applicant to indicate that the sex the applicant identifies as is: 16
(1) Female; 17
(2) Male; or 18
(3) Unspecified or [other] ANOTHER. 19
(b) The Administration shall ensure that the license, identification card, or moped 20
operator’s permit of an applicant who has indicated an unspecified or [other] ANOTHER 21
sex on an application displays an “X” in the location on the license, identification card, or 22
moped operator’s permit that indicates the applicant’s sex. 23
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 24
October 1, 2026. 25