The Maryland House of Delegates rejected additional record-keeping requirements Wednesday and approved changes to Senate Bill 626, sending the measure back to the Senate where its future remains uncertain with only days left in the 2026 legislative session.
The bill would allow adults to change the sex designation on their birth certificates without physician documentation, which is currently required, and add a new “X” marker for nonbinary individuals. It aligns the process with self-selection already permitted on driver’s licenses and state identification cards.
The Senate passed the bill on March 23 by a 24-16 vote, one more than needed. Senators added a floor amendment requiring the Secretary of Health to maintain a separate record of gender marker changes. The House Health Committee removed that provision earlier this week after advocates expressed concerns that such records could make transgender individuals easier to identify during a politically charged period.
On Wednesday, the full House defeated an amendment from Del. April Miller, R-Frederick, that would have restored the Senate’s record-keeping language. It also rejected an amendment from Del. Lauren Arikan, R-Harford, that would have required logging an individual’s sex designated at birth in the state’s medical information-sharing system known as CRISP, the Chesapeake Regional Information System for our Patients.
Arikan said the CRISP change would ensure emergency room doctors have sufficient information about gender transitions for proper medical care. Del. Ashanti Martinez, D-Prince George’s, opposed both amendments. He noted that the state already keeps original copies of altered documents and argued that creating additional lists of transgender individuals could endanger the community.
“This is focused on a particular community of Marylanders who have a hard time making sure their documents reflect their reality,” Martinez said. “This bill is going to allow them to no longer have to fill up doctor’s offices to get a letter to say who they are. Instead, they’ll be able to self-select the same way they’re able to do with their licenses.”
The House passed the amended bill 91-36 and returned it to the Senate. If senators do not accept the House version, the chambers have until Monday to reach a compromise or the bill dies when the session ends.
The legislation, known as the Birth Certificate Modernization Act, also addresses updates for parents who have changed their names to appear accurately on their children’s birth certificates. Supporters say it reduces administrative burdens on medical providers and low-income transgender residents while bringing Maryland in line with practices in other states.
Opponents raised concerns about the removal of tracking mechanisms. The narrow Senate margin and tight deadline mean any disagreement could end the bill’s progress this year.
Southern Maryland legislators participated in the vote, though specific district breakdowns were not detailed in session reports. The bill’s outcome could affect residents in St. Mary’s, Charles and Calvert counties who seek to update vital records through the Maryland Department of Health.
