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The health insurance board, known as the RAMQ, said it learned of the decision by the province's families minister Monday morning and planned to immediately begin work to make the change.

"RAMQ welcomes this decision, which will help meet the needs expressed by some of its customers," a spokesperson wrote in an email. "We will work as of today to establish a precise timetable in collaboration with our various partners to implement this decision."

Both the RAMQ and the auto insurance board, or the SAAQ, said clients who have requested a non-binary marker on their cards would be contacted shortly to discuss the next steps in the process.

Quebec allows a non-binary gender marker on birth and death certificates, but unlike other provinces, it has not offered the option on health cards or driver's licences until now.

Quebec's minister for the status of women, who oversees the government office dedicated to the fight against homophobia and transphobia, said last year that an interdepartmental committee was studying the gender marker issue but didn't say when the X option might be offered.

Celeste Trianon, a Montreal-based transgender rights activist, describes the addition of an X gender option as "wonderful and long overdue."

In a phone interview, Trianon said it's essential for people to have identification cards that accurately represent them.

"It's who they are in the eyes of the state, and to enable more discrimination on this end would be really harmful," she said. "And that's exactly the case right now when it comes to the lack of an X marker on IDs."

Trianon noted that the decision is especially important since it comes at a time when transgender people are facing "more and more" discrimination. "It's good news," she said. "It really helps make so many people feel more at ease and more safe living in society, participating within it at the end of the day."

The policy change comes after years of efforts by advocates, including a non-binary Montrealer who undertook a hunger strike outside RAMQ offices in Quebec City last year.

Trianon noted that a Quebec Superior Court decision in 2021 ordered the government to change the province’s Civil Code to allow transgender and non-binary people to adequately change their sex and gender identification on civil documents, such as birth certificates.

This report by ºÃÉ«tvwas first published March 4, 2024.