North Dakota Gov. Doug Burgum signed HB1139, defining birth-record sex as biological and fixed at birth
On April 7, 2023, North Dakota Gov. Doug Burgum signed HB1139, amending the state's Health Statistics Act to define "sex" as the biological state of being female or male based on a person's sex organs, chromosomes, and hormone profiles at birth. The law requires every birth record to designate a child as male or female and bars a "not yet determined" entry unless sex is genuinely undeterminable on that biological basis. The measure passed 81-11 in the House and 42-5 in the Senate, codifying a binary conception of sex fixed at birth into North Dakota's vital-records law.