Five-second answer
Claim we investigated
It bans parents from using birth certificates.
Misleading. The text never mentions birth certificates; it requires a provider's verification, which an original birth record might arguably support. The filed text limits the provider to three bases and never mentions birth certificates; the Attorney General says students would need a medical evaluation; and Washington's rules let a parent change a minor's birth-certificate sex designation, so a certificate shows the current designation, not necessarily biological sex.
Quote or cite this fact-check
FactHub rates the claim “It bans parents from using birth certificates” Misleading (moderate confidence): The text never mentions birth certificates; it requires a provider's verification, which an original birth record might arguably support. Reviewed October 23, 2026. https://facthub.org/n/article/wa-i638-birth-certificates/4
One-minute summary
What the evidence establishes
- Established. I-638 requires a statement signed by the girl's personal health care provider, relying only on reproductive anatomy, genetic makeup or testosterone; a parent can't submit a birth certificate in its place.
- Established. In Washington, the sex on a birth certificate can be changed. Since 2018, a parent can change a minor's designation to male, female or X with a provider's statement that the change is consistent with the child's identity; an adult needs only a notarized application.
- Context. So a Washington birth certificate shows the current designation, which may not match biological sex. Our inference, not stated by the sponsors, is that this is why the drafters relied on anatomy, genetics and testosterone instead.
- Not shown. The text never mentions birth certificates or parents and prohibits nothing; 'bans' overstates what it says.
- Context. An original, unamended birth certificate records the sex observed at birth, so a provider could arguably rely on it as a record of reproductive anatomy. That reading is untested, and no implementing guidance exists.
- Established. Eleven of 28 other state laws rely on the birth certificate, and those that specify name the original certificate issued at or near birth, such as Kentucky's 'original, unedited birth certificate'.
- Established. The Yes campaign's description is Mixed: medical history is in effect a record of anatomy, but birth records are not a listed basis and can be amended in Washington.
It bans parents from using birth certificates.
Context: Refers to the measure's list of the only bases a provider may rely on; birth certificates are not on it.
Source: Washington Secretary of State, 2026 General Election voters' pamphlet (statewide edition) · View in the dataset
The evidence
The conclusion rests on the combined record. Expand each item to see its role and limitations.
| Method | Institution / country | Year(s) | What it shows | Key limitation | Primary links |
|---|---|---|---|---|---|
| Primary legal text review | Washington Secretary of State United States | 2025 | Section 3(2) requires a health examination and consent form or other statement signed by the student's personal health care provider that verifies the student's biological sex, relying only on one or more of reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels. The text does not mention birth certificates or parents. Section 1, a statement of findings with no operative effect, says routine physicals already include documentation of the student's sex assigned at birth. | The text does not define 'reproductive anatomy' or say whether a provider may rely on earlier records of it; implementing rules do not exist yet. The measure's own findings assert that physicals already document sex assigned at birth, which suggests its drafters expected existing records to play some role. | Washington Secretary of State |
| State administrative rule review | Washington State Department of Health United States | 2017, 2018 | WAC 246-490-075, adopted by the Department of Health (WSR 18-02-048, effective January 27, 2018), lets an adult, or the parent or legal guardian of a minor, apply to change the sex designation on a Washington birth certificate to male, female or X. A minor's application must include a signed statement by the minor's licensed health care provider that the change is consistent with the minor's identity; an adult's must be notarized and signed under penalty of perjury, with no medical documentation required. A Washington birth certificate therefore shows the current designation, which may not match biological sex. States that use the birth certificate for girls' sports name the original certificate issued at or near birth; Washington's rule means a birth-certificate test would not track biological sex here, which we infer is why I-638 relies on anatomy, genetics and testosterone instead. | The rule says who may apply and what the application needs; it does not say whether a reissued certificate shows that the designation was changed, and we found no count of changes for minors. Why I-638's drafters left birth certificates out is our inference; the sponsors have not explained it. | Washington State Legislature (Washington Administrative Code) |
| Official explanatory statement review | Washington Attorney General's Office United States | 2026 | The Attorney General's explanatory statement in the 2026 voters' pamphlet says the verification would have to be based on reproductive anatomy, genetic makeup or testosterone levels, and that students would thus have to undergo some type of medical evaluation of their sex. It does not mention birth certificates. | The explanatory statement is a neutral summary written by the state, not a court ruling, and like any summary it can be wrong about how the text will be applied. | Washington Secretary of State |
| Comparison with other state laws | FactHub Research Team, Kentucky General Assembly United States | 2022, 2026 | Of the 28 state laws and regulations limiting girls' school sports to students of female sex, 11 rely on the birth certificate, 14 state no method, and three use other documents. Kentucky lets the student use either the original birth certificate or a sworn affidavit from the provider who did her sports physical. I-638 gives no birth-certificate option. | Other states' choices show that a birth-certificate rule was available to I-638's drafters, not why they left it out. | FactHub Research Team Kentucky General Assembly |
| News reporting with interviews of physicians and the WIAA | KUOW Public Radio United States | 2026 | KUOW reported in June 2026 that Erica Li, a pediatrician who supports the measure and is a co-author of the Yes argument, said doctors could use findings from earlier well-child checkups to confirm sex without a separate exam, and that a doctor could review a student's birth records, though the initiative's language does not mention that alternative. The WIAA's assistant executive director said sports participation does not now require a doctor to sign off on a student's birth sex. | Interviews reflect a few clinicians' views before any guidance exists; the pediatrician quoted signed the Yes argument and the family physician quoted supports the No campaign. | KUOW Public Radio |
| Clinical form review | American Academy of Pediatrics United States | 2019, 2026 | The standard Preparticipation Physical Evaluation history form, published by the American Academy of Pediatrics with five other medical societies, asks for sex assigned at birth, filled in by the athlete and parents, and is meant to stay in the medical file. So a provider usually has a self-reported record of sex, but I-638 requires the provider's verification to rest on anatomy, genetics or testosterone. | The history form is filled out by the family, not verified by the provider, and is kept in the medical file rather than sent to the school. Washington providers may use other versions. | American Academy of Pediatrics |
| Campaign statement review | No Hate in WA State, Washington Secretary of State (voters' pamphlet) United States | 2026 | The No campaign's website says nothing in I-638 allows parents to use birth certificates and that, while backers say parents can use hospital birth records, nothing in the initiative says so. The Yes pamphlet argument says a licensed professional would verify sex based on the student's birth records, medical history and/or a standard, non-invasive physical exam. | Both are advocacy; the No campaign's website and the Yes pamphlet argument each describe the text in the light most favorable to their side. | No Hate in WA State |
1. The text lists three bases, and a birth certificate is not one Primary legal text review
Section 3(2) requires a health examination and consent form or other statement signed by the student's personal health care provider that verifies the student's biological sex, relying only on one or more of reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels. The text does not mention birth certificates or parents. Section 1, a statement of findings with no operative effect, says routine physicals already include documentation of the student's sex assigned at birth.
Limit: The text does not define 'reproductive anatomy' or say whether a provider may rely on earlier records of it; implementing rules do not exist yet. The measure's own findings assert that physicals already document sex assigned at birth, which suggests its drafters expected existing records to play some role.
Verify: Initiative Measure No. IL26-638, filed text (filed June 2, 2025)
- The provider relies only on anatomy, genetic makeup or testosterone; a birth certificate is not a listed basis. Washington Secretary of State
- The student must provide a statement signed by her personal health care provider that verifies her sex. Washington Secretary of State
- The measure's non-operative findings say physicals already document sex assigned at birth, suggesting the drafters expected records to play a role. Washington Secretary of State · Qualifies
2. In Washington, the sex on a birth certificate can be changed State administrative rule review
WAC 246-490-075, adopted by the Department of Health (WSR 18-02-048, effective January 27, 2018), lets an adult, or the parent or legal guardian of a minor, apply to change the sex designation on a Washington birth certificate to male, female or X. A minor's application must include a signed statement by the minor's licensed health care provider that the change is consistent with the minor's identity; an adult's must be notarized and signed under penalty of perjury, with no medical documentation required. A Washington birth certificate therefore shows the current designation, which may not match biological sex. States that use the birth certificate for girls' sports name the original certificate issued at or near birth; Washington's rule means a birth-certificate test would not track biological sex here, which we infer is why I-638 relies on anatomy, genetics and testosterone instead.
Limit: The rule says who may apply and what the application needs; it does not say whether a reissued certificate shows that the designation was changed, and we found no count of changes for minors. Why I-638's drafters left birth certificates out is our inference; the sponsors have not explained it.
- A parent or legal guardian may apply to change the sex designation on a minor's Washington birth certificate. Washington State Legislature (Washington Administrative Code) · Qualifies
- The designation requested may be male, female or X. Washington State Legislature (Washington Administrative Code) · Qualifies
- For a minor, a licensed provider must attest that the change is consistent with the minor's identity, not with anatomy. Washington State Legislature (Washington Administrative Code) · Qualifies
- An adult's application needs only notarization and a signature under penalty of perjury. Washington State Legislature (Washington Administrative Code) · Qualifies
3. The Attorney General reads it as requiring a medical evaluation Official explanatory statement review
The Attorney General's explanatory statement in the 2026 voters' pamphlet says the verification would have to be based on reproductive anatomy, genetic makeup or testosterone levels, and that students would thus have to undergo some type of medical evaluation of their sex. It does not mention birth certificates.
Limit: The explanatory statement is a neutral summary written by the state, not a court ruling, and like any summary it can be wrong about how the text will be applied.
- The Attorney General says the provider's verification would have to be based on anatomy, genetics or testosterone. Washington Secretary of State
- The Attorney General says students would need some type of medical evaluation, not a document. Washington Secretary of State
4. Other states that wanted birth certificates wrote them in Comparison with other state laws
Of the 28 state laws and regulations limiting girls' school sports to students of female sex, 11 rely on the birth certificate, 14 state no method, and three use other documents. Kentucky lets the student use either the original birth certificate or a sworn affidavit from the provider who did her sports physical. I-638 gives no birth-certificate option.
Limit: Other states' choices show that a birth-certificate rule was available to I-638's drafters, not why they left it out.
Verify: How state K-12 laws determine sex (saved analysis) KRS 156.070
- Of 28 state laws, 11 rely on the birth certificate, 14 state no method, and three use other documents; none uses I-638's routine provider check. FactHub Research Team
- Kentucky's law names the original birth certificate as one way to determine sex, alongside a provider affidavit. Kentucky General Assembly
5. A pediatrician who backs the measure says records could be used, but the text is silent News reporting with interviews of physicians and the WIAA
KUOW reported in June 2026 that Erica Li, a pediatrician who supports the measure and is a co-author of the Yes argument, said doctors could use findings from earlier well-child checkups to confirm sex without a separate exam, and that a doctor could review a student's birth records, though the initiative's language does not mention that alternative. The WIAA's assistant executive director said sports participation does not now require a doctor to sign off on a student's birth sex.
Limit: Interviews reflect a few clinicians' views before any guidance exists; the pediatrician quoted signed the Yes argument and the family physician quoted supports the No campaign.
- A pediatrician who supports the measure said doctors could use earlier well-child exam findings instead of a new inspection. KUOW Public Radio · Qualifies
- The same pediatrician said a doctor could review birth records, and KUOW noted the initiative does not mention that option. KUOW Public Radio
- The WIAA says sports participation does not now require a doctor's sign-off on birth sex, so verification would be new. KUOW Public Radio
6. Today's sports-physical history form asks sex assigned at birth, by self-report Clinical form review
The standard Preparticipation Physical Evaluation history form, published by the American Academy of Pediatrics with five other medical societies, asks for sex assigned at birth, filled in by the athlete and parents, and is meant to stay in the medical file. So a provider usually has a self-reported record of sex, but I-638 requires the provider's verification to rest on anatomy, genetics or testosterone.
Limit: The history form is filled out by the family, not verified by the provider, and is kept in the medical file rather than sent to the school. Washington providers may use other versions.
Verify: Preparticipation Physical Evaluation: History Form (PPE 5th edition, revised)
- The standard history form asks the family to report sex assigned at birth and stays in the medical file, so providers usually have a self-reported record. American Academy of Pediatrics · Qualifies
7. What each campaign says about birth certificates Campaign statement review
The No campaign's website says nothing in I-638 allows parents to use birth certificates and that, while backers say parents can use hospital birth records, nothing in the initiative says so. The Yes pamphlet argument says a licensed professional would verify sex based on the student's birth records, medical history and/or a standard, non-invasive physical exam.
Limit: Both are advocacy; the No campaign's website and the Yes pamphlet argument each describe the text in the light most favorable to their side.
Verify: About I-638
- The No campaign's basis for the claim: nothing in the text allows birth certificates, and nothing mentions hospital birth records. No Hate in WA State
During a private, consented visit, a licensed medical professional would verify sex based on the student's birth records, medical history and/or a standard, non-invasive physical examination.
Context: The Yes side's account of what a provider would rely on; compare the three bases the measure's Section 3(2) lists.
Source: Washington Secretary of State, 2026 General Election voters' pamphlet (statewide edition) · View in the dataset
Common questions
“During a private, consented visit, a licensed medical professional would verify sex based on the student's birth records, medical history and/or a standard, non-invasive physical examination.”
Significant parts hold: the text calls for a provider's statement with a 'health examination and consent form'; a child's medical history is in effect a record of her anatomy, one of the three bases; and an anatomy check can be visual and non-invasive. But 'birth records' is not a listed basis, the text says the provider relies 'only' on anatomy, genetics or testosterone, and in Washington a birth certificate's sex designation can be changed at a parent's request with a provider's attestation of the child's identity. KUOW noted the initiative does not mention birth records even as a Yes co-author suggested using them.
- The provider relies only on anatomy, genetic makeup or testosterone; a birth certificate is not a listed basis. Washington Secretary of State
- A pediatrician who supports the measure said doctors could use earlier well-child exam findings instead of a new inspection. KUOW Public Radio · Qualifies
- The same pediatrician said a doctor could review birth records, and KUOW noted the initiative does not mention that option. KUOW Public Radio
- For a minor, a licensed provider must attest that the change is consistent with the minor's identity, not with anatomy. Washington State Legislature (Washington Administrative Code) · Qualifies
“A birth record documents the anatomy seen at birth, so relying on it is relying on 'reproductive anatomy'.”
Short answer: Arguably, if original
For an original, unamended birth record, that reading is plausible, and the measure's findings suggest its drafters expected existing documentation to matter. But the operative text neither says so nor excludes it, and in Washington the certificate a family holds may show a changed designation. Until guidance is written, a family cannot count on a birth record being accepted. FactHub's check of the Yes claim that pediatric care already verifies sex, rated Mostly true, covers medical records of anatomy.
- The measure's non-operative findings say physicals already document sex assigned at birth, suggesting the drafters expected records to play a role. Washington Secretary of State · Qualifies
- For a minor, a licensed provider must attest that the change is consistent with the minor's identity, not with anatomy. Washington State Legislature (Washington Administrative Code) · Qualifies
- A pediatrician who supports the measure said doctors could use earlier well-child exam findings instead of a new inspection. KUOW Public Radio · Qualifies
“Why would the drafters leave birth certificates out?”
Short answer: Likely because WA's can be changed
The sponsors have not said; this is our inference. Washington lets an adult, or a parent for a minor, change the sex designation on a birth certificate, so a birth-certificate rule here would test the current designation rather than biological sex. States that use birth certificates avoid that by requiring the original issued at or near birth.
- A parent or legal guardian may apply to change the sex designation on a minor's Washington birth certificate. Washington State Legislature (Washington Administrative Code) · Qualifies
- An adult's application needs only notarization and a signature under penalty of perjury. Washington State Legislature (Washington Administrative Code) · Qualifies
- Kentucky's law names the original birth certificate as one way to determine sex, alongside a provider affidavit. Kentucky General Assembly
“Parents can still show the birth certificate to the doctor.”
Short answer: Yes, but it isn't a basis
Nothing stops a parent from showing it, but the provider's statement must rest only on anatomy, genetics or testosterone, so the certificate alone cannot be the reason the provider signs.
- The provider relies only on anatomy, genetic makeup or testosterone; a birth certificate is not a listed basis. Washington Secretary of State
“Most states with these laws use birth certificates.”
Short answer: 11 of 28, the original
Eleven of the 28 rely on the birth certificate, and those that specify name the original certificate issued at or near birth; 14 state no method. In Washington, where the designation can be changed, only an original record would track biological sex.
- Of 28 state laws, 11 rely on the birth certificate, 14 state no method, and three use other documents; none uses I-638's routine provider check. FactHub Research Team
- Kentucky's law names the original birth certificate as one way to determine sex, alongside a provider affidavit. Kentucky General Assembly
Conclusion
Part of the No campaign's sentence is accurate. Section 3(2) of I-638 requires a statement signed by the student's personal health care provider, relying only on one or more of three things: reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels. A parent cannot hand the school a birth certificate in place of that statement. The Attorney General's explanatory statement reads the requirement the same way: students would have to undergo some type of medical evaluation of their sex. But 'bans parents from using birth certificates' leaves a wrong impression. The text never mentions birth certificates or parents and forbids nothing. An original, unamended birth certificate records the sex a clinician observed at birth, which is a record of anatomy, so a provider could arguably rely on it as evidence of 'reproductive anatomy'. That reading is untested, and no implementing guidance exists to settle it. The measure's own findings say physicals already document sex assigned at birth, which suggests its drafters expected existing records to play some role. The most important context is Washington's own rule on birth certificates. Since January 27, 2018, WAC 246-490-075 has let an adult, or a parent or guardian for a minor, change the sex designation on a Washington birth certificate to male, female or X. For a minor, the application needs a licensed health care provider's statement that the change is consistent with the minor's identity; an adult needs only a notarized application signed under penalty of perjury, with no medical documentation. So a Washington birth certificate shows the current designation, which may not match biological sex. Other states that use birth certificates for this purpose guard against that by naming the original certificate issued at or near birth, as Kentucky's 'original, unedited birth certificate issued at the time of birth' does. Our inference, which the sponsors have not stated, is that this is why I-638 relies on anatomy, genetics and testosterone instead: in Washington, a birth-certificate rule would not track biological sex. Read that way, leaving birth certificates out is a choice about what the document shows, not a restriction aimed at parents. We therefore rate the sentence Misleading: it is accurate that a birth certificate cannot replace the provider's statement, but 'bans' implies a prohibition the text does not contain, and it omits both that an original birth record might still support a provider's verification and that a Washington birth certificate's sex designation can be changed. The Yes campaign's description is Mixed. 'Medical history' is in effect a record of anatomy, and FactHub's separate check rates the Yes claim that pediatric care already verifies sex Mostly true for that reason. 'A standard, non-invasive physical examination' fits a visual check. But 'birth records' is not one of the three bases, and in Washington a birth certificate's sex designation can be amended. The ratings differ because a doctor's chart records anatomy the doctor observed, one of the bases the text allows, while a birth certificate is a vital record whose designation Washington lets families change. Confidence is Moderate: the text is clear on what it requires, but how providers, the WIAA and the state superintendent would treat original birth records under 'relying only on' is unsettled.
How we checked
- Defined the claim: whether a parent can use a birth certificate to establish a girl's eligibility under I-638, and separately whether the Yes campaign's description of verification matches the text.
- Read Sections 1 and 3 of the filed text.
- Read the Attorney General's explanatory statement in the 2026 voters' pamphlet.
- Compared with the verification methods of the 28 other state laws of this kind, from FactHub's coded dataset of their official texts.
- Reviewed KUOW's reporting, which interviewed physicians on both sides and the WIAA, and the standard sports-physical history form.
- Read each campaign's own statements on birth certificates and recorded the limits of each line of evidence.
- Read Washington's rule on changing the sex designation on a birth certificate (WAC 246-490-075) in the official Washington Administrative Code.
Editorial note: Scope: this article rates the No campaign's statement that I-638 bans parents from using birth certificates and, as a rated objection, the Yes campaign's description of how a provider would verify sex. Our explanation of why the drafters left birth certificates out is labeled as inference; the sponsors have not stated it. Whether medical records of anatomy can satisfy the text, and how many girls lack such records, is examined in FactHub's separate check of the Yes claim that pediatric care already verifies sex. No external specialist review has been recorded.
Expert-review status
No external specialist review has been recorded.
Funding and conflicts
Funding: No external funding for this piece.
Ownership: Published by the FactHub Research Team.
Conflicts: None known.
Sources
Sources are labeled by kind, with what this fact check takes from each, so readers can check the evidence independently.
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Government
Washington Secretary of State.
Initiative Measure No. IL26-638, filed text (filed June 2, 2025)
The full text of the measure as filed.
Reliability: The official filed text posted by the Secretary of State. It is the measure itself; the sponsor wrote it.
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The student must provide a statement signed by her personal health care provider that verifies her sex.
What the source says
a health examination and consent form or other statement signed by the student's personal health care provider that verifies the student's biological sex,
Sec. 3(2) -
The provider relies only on anatomy, genetic makeup or testosterone; a birth certificate is not a listed basis.
What the source says
relying only on one or more of the following: The student's reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels.
Sec. 3(2) -
Qualifies: The measure's non-operative findings say physicals already document sex assigned at birth, suggesting the drafters expected records to play a role.
What the source says
Existing Washington state law and school district policies require students to undergo a routine physical examination prior to participation in interscholastic sports, which includes documentation of the student's sex assigned at birth;
Sec. 1(1)
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Government
Washington Secretary of State.
2026 General Election voters' pamphlet (statewide edition), Initiative Measure IL26-638, Explanatory Statement by the Office of the Attorney General, p. 21
The Attorney General's neutral explanation of the measure, printed in the voters' pamphlet.
Reliability: Written by the Attorney General's Office as the state's neutral explanation; it is not a ruling on how the text will be applied.
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The Attorney General says the provider's verification would have to be based on anatomy, genetics or testosterone.
What the source says
That form must be signed by the student's personal health care provider. The verification would have to be based on the student's reproductive anatomy, genetic makeup, or normal endogenously produced testosterone levels.
p. 21, The Effect of the Proposed Measure if Approved -
The Attorney General says students would need some type of medical evaluation, not a document.
What the source says
Students would thus have to undergo some type of medical evaluation of their sex to participate in interschool sports designated for female students only.
p. 21, The Effect of the Proposed Measure if Approved
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News report
KUOW Public Radio.
Transgender ballot initiative could require genital exams for WA secondary school students (Sarah Mizes-Tan, June 4, 2026)
Interviews with physicians on both sides and the WIAA about how verification would work.
Reliability: Public radio reporting. FactHub's media audit found this story describes the text's 'reproductive anatomy' basis as a visual genital exam; the passages used here are direct interviews.
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Qualifies: A pediatrician who supports the measure said doctors could use earlier well-child exam findings instead of a new inspection.
What the source says
Doctors could use this information to confirm birth sex without conducting a separate visual inspection for the sports physical, she said.
Paragraphs quoting Erica Li · Erica Li, pediatrician and co-author of the Yes argument -
The same pediatrician said a doctor could review birth records, and KUOW noted the initiative does not mention that option.
What the source says
She also said a doctor could review a student’s birth records, though language in the initiative does not mention that alternative.
Paragraphs quoting Erica Li · Erica Li, pediatrician and co-author of the Yes argument -
The WIAA says sports participation does not now require a doctor's sign-off on birth sex, so verification would be new.
What the source says
Sports participation does not require students to have a doctor sign off on their birth sex to play a sport, said Justin Kesterson, assistant executive director of the Washington Interscholastic Activities Association, which oversees middle and high school sports.
Paragraph quoting Justin Kesterson · Justin Kesterson, assistant executive director, WIAA
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Academic
American Academy of Pediatrics.
Preparticipation Physical Evaluation: History Form (PPE 5th edition, revised)
The standard sports-physical history form from the six-society PPE monograph.
Reliability: Published by the American Academy of Pediatrics as part of the 2019 multi-society Preparticipation Physical Evaluation monograph.
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Qualifies: The standard history form asks the family to report sex assigned at birth and stays in the medical file, so providers usually have a self-reported record.
What the source says
Sex assigned at birth (F, M, or intersex):
History form, page 1
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Government
Kentucky General Assembly.
KRS 156.070
Kentucky's statute on interscholastic athletics, which lets families prove sex by birth certificate or provider affidavit.
Reliability: Official statute text published by the Legislative Research Commission.
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Kentucky's law names the original birth certificate as one way to determine sex, alongside a provider affidavit.
What the source says
A student's biological sex as indicated on the student's original, unedited birth certificate issued at the time of birth; or
KRS 156.070(2)(g)2.a.
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Party to the dispute
No Hate in WA State.
About I-638
The No campaign's explanation of its arguments.
Reliability: Has a stake in this finding. The committee opposing I-638, which wrote the No argument in the voters' pamphlet.
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The No campaign's basis for the claim: nothing in the text allows birth certificates, and nothing mentions hospital birth records.
What the source says
Nothing in I-638 allows parents to use birth certificates. While backers of this initiative claim parents can use hospital birth records, there is nothing in the initiative saying this.
Answer to 'Why can't parents use birth certificates'
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FactHub record
FactHub Research Team.
How state K-12 laws determine sex (saved analysis)
Our count of state girls'-sports laws by verification method.
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Of 28 state laws, 11 rely on the birth certificate, 14 state no method, and three use other documents; none uses I-638's routine provider check.
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Government
Washington State Legislature (Washington Administrative Code).
WAC 246-490-075, Changing sex designation on a birth certificate (WSR 18-02-048, effective January 27, 2018)
The Department of Health rule that lets the sex designation on a Washington birth certificate be changed.
Reliability: The official text of a Department of Health rule, as published in the Washington Administrative Code.
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Qualifies: A parent or legal guardian may apply to change the sex designation on a minor's Washington birth certificate.
What the source says
Only the parent or legal guardian of a minor may apply to change sex designation on the minor's birth certificate.
WAC 246-490-075(3) -
Qualifies: The designation requested may be male, female or X.
What the source says
Sex designation requested (male, female, or X);
WAC 246-490-075(4)(g) -
Qualifies: For a minor, a licensed provider must attest that the change is consistent with the minor's identity, not with anatomy.
What the source says
The sex designation change application of a minor must include a signed statement by the minor's licensed health care provider attesting that: (a) The minor identified on the application is under the care of the provider; and (b) The provider has determined the request to change sex designation on the birth certificate is consistent with the minor's identity.
WAC 246-490-075(7) -
Qualifies: An adult's application needs only notarization and a signature under penalty of perjury.
What the source says
The sex designation change application of an adult must be notarized and signed under penalty of perjury pursuant to chapter 9A.72 RCW.
WAC 246-490-075(6)
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FactHub dataset
Initiative 638: the campaigns' claims in their own words
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It bans parents from using birth certificates.
Committee for the argument against Initiative IL26-638 (Justin Gill, APRN, and five co-authors), Authors of the official voters' pamphlet argument against IL26-638, · In the dataset -
During a private, consented visit, a licensed medical professional would verify sex based on the student's birth records, medical history and/or a standard, non-invasive physical examination.
Committee for the argument for Initiative IL26-638 (Alesha Perkins and five co-authors), Authors of the official voters' pamphlet argument for IL26-638, · In the dataset
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Update history
- First version.
- Version 2. Changed the rating from Mostly true (High confidence) to Misleading (Moderate): a birth certificate cannot replace the provider's statement, but the text never mentions birth certificates, and an original birth record might support a provider's verification of anatomy. Added Washington's rule (WAC 246-490-075, effective 2018) letting the sex designation on a birth certificate be changed, as a key point, an evidence item and in the conclusion, with our labeled inference that this is why the drafters left birth certificates out. Re-rated the Yes 'birth records, medical history' sentence from Misleading to Mixed. Updated the link to FactHub's pediatric-care check, now version 2 and rated Mostly true, and explained why its rating differs from this one.
- Updated related links to the final versions of sibling articles.
- Updated related links to the final versions of sibling articles.
Cited by
- Article A doctor's checkbox could satisfy I-638 for most girls; the box is new.
- Article Few mainstream I-638 news stories reported the facts that answer opponents
- Article Girls' sports participation rose in states that passed laws like I-638.
- Article Individuals fund most of I-638's Yes side; a foundation and unions fund No.
- Article Initiative 638 requires sex verification for girls, not an invasive exam.
- Article Most girls could meet I-638's sex verification rule at a no-cost checkup.
- Article Most state girls'-sports laws reach further than I-638, except in verifying every girl.
- Article Pediatric checkups already document sex, though many Washington girls lack a regular provider.
- Article The IOC, World Athletics, the WTA and federal policy now restrict the female category.
- Article The Yes campaign's 269 girls'-event placements check out, from ten athletes.
- Article Washington's rules let transgender girls compete in girls' school sports.
- Briefing I-638: what it does, and what each side claims
Version details
The exact citing versions, and the version of this article each cites.
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Article
wa-i638-yes-campaign-claims— version 2 (published)cites version 4 -
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wa-i638-media-coverage-omissions— version 6 (published)cites version 4 -
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girls-sports-participation-after-state-laws— version 6 (published)cites version 4 -
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wa-i638-campaign-funding— version 5 (published)cites version 4 -
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wa-i638-officials-exam-claims— version 3 (published)cites version 4 -
Article
sex-verification-test-costs— version 2 (published)cites version 4 -
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wa-i638-most-extreme— version 4 (published)cites version 4 -
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wa-i638-pediatric-care-verifies-sex— version 4 (published)cites version 4 -
Article
wa-i638-world-sports-policies— version 4 (published)cites version 4 -
Article
wa-i638-girls-event-placements— version 5 (published)cites version 4 -
Article
wa-i638-current-rules— version 4 (published)cites version 4 -
Briefing
wa-i-638— version 5 (published)cites version 4 -
Briefing
wa-i-638— version 4 (published)cites version 4
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{"@context":"https://schema.org","@type":"ClaimReview","url":"https://facthub.org/n/article/wa-i638-birth-certificates/4","datePublished":"2026-10-23","dateModified":"2026-10-23","author":{"@type":"Organization","name":"FactHub","url":"https://facthub.org/"},"claimReviewed":"It bans parents from using birth certificates.","reviewRating":{"@type":"Rating","alternateName":"Misleading"},"image":"https://facthub.org/node-assets-v2/article/wa-i638-birth-certificates/4/exam-room/social-1200x630.jpg"}
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