Section 146-16-2 - GENDER MARKERS ON BIRTH RECORDSA.Assigning X at time of birth. At the time the birth record is created, X may be designated as the gender marker on the birth certificate. Parents listed on the birth certificate must demonstrate mutual consent by signing the birth worksheet, unless the requirement that both parents sign the birth worksheet is waived upon a showing of good cause to the State Registrar in writing. Good cause may be established by demonstrating that the other parent is deceased, cannot be located or has abandoned the child as evidenced by legal documentation showing the applicant has sole parental rights and responsibilities ( 19-A MRS §1501 ), or is otherwise unable to provide a signature. If the State Registrar is satisfied that good cause has been shown, then the birth record may reflect X as the gender marker without the absent parent's signature.B.Issuance of new birth record to align gender marker with gender identity. Requests for a new birth record reflecting the appropriate gender marker must be submitted on forms prescribed by the Department. When the State Registrar grants the request, a new birth record will be established. When a new birth record is established pursuant to this rule, all copies of the original certificate shall beheld confidential and only the registrant or the registrant's legal representative shall have access to the original record, except by court order. 1. Adult or emancipated registrants. Registrants age 18 and older or an emancipated minor may submit an individual notarized attestation on the form prescribed by the State Registrar to request a new birth record reflecting the appropriate gender marker without court order, if the application is for the purpose of affirming gender identity.2. Registrants under the age of 18. The parent(s) recorded on the birth certificate or the legal guardian(s) must submit a notarized attestation on the form prescribed by the State Registrar to request a new birth record reflecting the appropriate gender marker without court order. The application prescribed by the Department for this request requires the signature of a licensed physician or licensed mental health care provider who, within the scope of their license and through a bona fide patient-provider relationship, affirms that the requested gender marker is consistent with the minor's gender identity. a. All parents listed on the birth certificate must consent and sign the application. Both signatures must be notarized. The requirement that both parents sign the application may be waived upon a showing of good cause made to the State Registrar in writing. Good cause may be established by demonstrating that the other parent is deceased, cannot be located or has abandoned the child as evidenced by legal documentation showing the applicant has sole parental rights and responsibilities ( 19-A MRS §1501 ), or is otherwise unable to provide a signature. If the State Registrar is satisfied that good cause has been shown, then the new birth record will be issued without the absent parent's signature.b. Legal guardian(s) other than parent(s) named on the original birth certificate acting on behalf of the minor must attach a certified court order as proof of legal guardianship to any request pursuant to this section.C.Issuance of new birth record to align given names with gender identity. A registrant who is 18 years of age and older or an emancipated minor, or parent(s) acting on behalf of a minor child, may submit an individual notarized attestation on the form prescribed by the State Registrar to request that a new birth record issued pursuant to Section 2(B) reflect the first name and middle name of the registrant's or applicant's choosing, if such a request is made for the purpose of aligning the record with the registrant's gender identity. When such a request is made, the new birth record issued pursuant to Section 2(B) will reflect the given names requested by the registrant or applicant(s). Alternatively, a name change may be completed in accordance with the Correction and Completion of Vital Records Rule, at 10-146 CMR chapter 2.10- 146 C.M.R. ch. 16, § 2