The proposal to have a third sex designation option on Washington birth certificates attracted a standing room only crowd to a Tuesday public hearing.

Currently, birth certificates only have two options for sex: male and female.

Under the proposal, someone could select “X” as their sex.

State health officials heard from critics and supporters Tuesday, although those in favor greatly outnumbered those opposed.

“I’m grateful to be living in a time when transpeople are being treated with fairness, understanding, and compassion,” said Tumwater resident Tobias Gurl.

Several members of the transgender community testified a third birth certificate option would alleviate confusion and frustration.

Others testified the change could create more problems.

“We think there are a lot of unintended consequences that have not been considered and in an emotional rush to try to make people feel welcome and included, we’re going to create a lot more victims in the process,” said Kaeley Triller Haver, co-founder of the Hands Across the Aisle Women’s Coalition.

She said it could make state statistics unreliable and would cause problems in emergency rooms and in high school sports for girls.

Washington State Secretary of Health John Weisman is expected to make a decision on the proposed change by the end of the year.

If approved, changes could come to birth certificates in Washington by February of 2018.