Quebec greenlights X gender markers for driver’s licences, health cards in policy U-turn

The Quebec government has pulled a 180 on its policy for X gender markers. 

In a surprise decision, the province has approved the use of gender markers that reflect the identity of trans and non-binary people on provincial driver’s licences and health insurance cards.

The François Legault government had vowed not to make any decisions regarding the X marker until its new gender identity committee submitted its final report in winter 2025.

In a written statement, Quebec Family Minister Suzanne Roy said the decision came after committee experts made the recommendation.

“In light of the consensus reached … the Quebec government agrees that the X marker can now be added to health insurance cards and driver’s licences, as is already the case for birth certificates and other [civil status] documents issued,” Roy wrote in a statement. 

“The X marker can now be used by people who request it.” 

Since 2022, trans and non-binary people in Quebec have been able to legally obtain the letter X rather than M or F on their civil status documents such as birth or marriage certificates, but not health-care cards or driver’s licences.

In an interview with Radio-Canada, Diane Lavallée, head of the government’s gender identity committee, confirmed that a consensus was quickly reached on the question of the X marker after various meetings with concerned organizations.

Lavallée said she informed the government in February that the committee’s position would remain the same, whether or not the government waited for the final report in 2025.

“Not moving forward called into question respect for the rights of non-binary people and was not in accordance with the law that had been passed in June 2022,” she said.

“If our work, our comments, allowed for quicker decision-making, we’re delighted for the people concerned.”

Despite the green light from the government, Lavallée said there are still some internal issues to be resolved at the province’s health insurance board, the Régie de l’assurance maladie du Québec (RAMQ), regarding the X marker, as she says a patient’s biological sex remains an important piece of data. 

Until now, Quebec was the only Canadian province not to allow the X marker on driver’s licences. As for the health insurance card, Quebec and Alberta were the only two provinces not to authorize the marker. Ontario has simply not included gender on health cards since 2016.