CINCINNATI -- Activist and podcaster Callie Wright knows exactly who she is, but the state of Ohio isn't on the same page.
The Buckeye State remains one of just three in the union -- the other two being Kansas and Kentucky -- that does not allow transgender people such as Wright to alter their birth certificates to reflect their identities.
Proponents of this practice insist that a person's assigned sex at birth is information that should be collected and preserved.
Opponents, including four transgender people who filed suit against the state through the American Civil Liberties Union, say it not only invalidates their existences but forces them into protracted bureaucratic headaches in everyday life.
These headaches can include being forced to present mismatched identity documents to employers, thereby unwillingly "outing" oneself as transgender, and trudging through the already-onerous process of getting a passport with extra complications caused by the odd-birth-certificate-out, Wright -- who is not part of the suit -- said.
"We're not hurting anybody," she said. "We're just trying to live our lives as the people that we know we are. We're not a threat to anyone."
Being "out" in an unsafe environment, however, can be a threat to transgender people. One of the ACLU's plaintiffs, who called the lack of an accurate birth certificate "humiliating," said one of her co-workers threatened her with violence after overhearing she was transgender.
Nationally, the Human Rights Campaign recorded 23 murders of transgender women in 2017, some involving "clear anti-transgender violence;" some homicide cases have invoked a "trans panic" defense in which a defendant claims they killed a victim because learning the victim's was transgender made them angry.
"It's not just a practical concern with paperwork," Wright said. "It's also a matter of literal safety."
Aaron Baer, president of the conservative Christian organization Citizens for Community Values, said he believes "people with gender dysphoria" deserve "love and respect," but altering birth certificates was the wrong way to provide it.
"The ACLU is putting political ideology over medical accuracy with this lawsuit," he said. "There are certain procedures that men need. There are certain procedures that women need, and having a medically accurate birth certificate is important to help those professionals know what situation they're stepping into."
Wright said she believed there was "no practical reason" a doctor would prefer legal documents containing a patient's assigned sex over medical records or a conversation with the patient in question.
"If you're going to a doctor, generally speaking, a doctor's probably already going to know that," Wright said. "If you're going to a hospital for something, they're going to have their medical records."
The ACLU's lawsuit comes just weeks after a federal judge ruled Idaho's bar against changing one's sex on a birth certificate violated equal protections guaranteed by the U.S. Constitution.
In her March 6 ruling, U.S. Magistrate Judge Candy Dale said the rules by the Idaho Department of Health and Welfare served no rational government purpose and put transgender people at risk by forcing them to disclose their gender statuses when they present identification documents.
Most states allow people to change their birth certificates to reflect their gender identity rather than the gender they were assigned at birth.