Soo.... just something of interest related to my work (since I maintain initial claims software for SSA).
There had been a push during the Biden years to accommodate Gender X values (beyond the M or F values). Part of this was because various states were supporting alternate / additional codes for sex and our systems needed to also be able to handle them, because a lot of the intake comes through states. I'm not knowledgeable on Medicare and Medicaid, but I guess what is covered and the payments are done via individual state too and/or they have their own approaches?
(Obviously this is tossed now, this project is GONE -- and I knew that was going to happen because Biden's administration didn't really prioritize it or make sure it was a done deal before he left office, it just sat and festered for 2-3 years.)
As typical, they are making this "HA HA NOW ALL SEX = M OR F AND NOTHING ELSE" sound simple by the wording of the EO, but frankly it's not that simple at all.
- Federal datastores are passed data from all the different states + covered territories (like Puerto Rico).
- The proofs used by fedgov and stored in our system or proving coverage by federal programs are provided by, again, all the different states + territories.
- States and territories each have their own rules for how they treat and prove sex. They have their own separate policies on how birth certificates are created, stored, and modified. Many of them seal the records once changes are made.
You can probably see where I am going with this.
Maybe the fed gov can try to mandate that only M and F are acceptable values, but it doesn't matter because of all the state data.
Fedgov systems have to be able to accommodate what is sent to us by all of these different states.
And the fedgov can't just 'throw out" data that doesn't match a M or F template because we have no idea whether it "should be" an M or an F. What would we change it to? We don't know. We would just be randomly assigning a gender. I suppose you could try to base it on the name, but what if the name was also changed? We would not know.
Also, the fedgov has no separate "proofs" aside from passports and similar, where the sex is typically based on the state's proofs -- birth certificates, driver's license. If your state says you are male, then you are male; same for female; and then if your state offers alternatives, well, that's your gender potentially as well. The fedgov is not the source for sex/gender; the state is.
Sooooooo..... to implement this plan, fedgov needs to either negotiate with every state / leverage power of some kind (punishment? incentive?) to get all separately on board the rigid binary train. And I think some states are prepared to resist that kind of coercion.
At the very least, this kind of enforcement of sex/gender marker will take quite awhile and it might not even be possible, since the sex/gender of citizens is not localized within the fedgov, it is localized within each separate state.
At least, that's my first thought about this, with the knowledge I have. (There might be something related to the master file, so that's something to think about I suppose... if a fedgov record was kept at birth and they could compare... but I don't work with that and don't know the details of what is stored and whether it's traceable.)