In November 2019, Massachusetts residents first got a third gender option to put on their driver’s licenses. The “X” marker is commonly used by nonbinary people, though it can be selected by anyone and doesn’t require any sort of documentation.

In those five years, a lot has changed. Residents can get the “X” gender marker on any state documents after a new bill was signed into law this summer.

Advocates say they’re glad the option exists for anyone who chooses to use it, but also urge people to be cautious when they’re considering how to identify themselves on government-issued ID that will be used in travel and interactions with law enforcement.

And, still, it’s rarely used. Just 0.1% of all licenses issued last year had the “X” gender marker — fewer than 1,500 in total — according to MassDOT data obtained through a public records request. That’s about equal to the number requested the prior year. Overall, data show fewer than 5,500 licenses have been issued with the “X” gender marker since that option became available.

“At least at Trans Emergency Fund, we haven’t seen a huge demand for gender ‘X,’” said Sam Montaño, the organization’s executive director, who is also a state representative for parts of Boston. Trans Emergency Fund helps pay for housing, medication and other necessities, as well as name and gender changes on government identification in Massachusetts.

Advocates, including Montaño, worry that people may be putting themselves in a vulnerable position by getting this gender marker on their IDs, especially when traveling out of state.

Shaplaie Brooks, the executive director of the Mass. Commission for LGBTQ Youth, specifically worries about Black queer youth being disproportionately targeted by law enforcement.

“They’re stopping you because you’re Black, and now they’re looking at your license, or your ID, and it has an ‘X’: that’s an additional way, or additional layer, of marginalization,” Brooks said.

“While it has been a sense of comfort in many ways for young people — and just people across the commonwealth — to be able to identify themselves in a way that they feel comfortable,” Brooks added, “every community doesn’t have the same protections from it, and do not feel fully protected by it.”

Brooks says she doesn’t have specific advice for young Black people who are considering the “X” gender marker, but that can be a family conversation — much like the one she’s had with her two children, who are young adults.

“Any Black person will tell you this. ... There’s another set of conversations that we have before they’re even able to drive on how to interact with law enforcement,” Brooks said. “Should a young person choose to have an ‘X’ marker on their driver’s license, then we would have more conversations about just protecting yourself as a queer person.”

Kelsey Grunstra, the deputy director of the Massachusetts Transgender Political Coalition, says it’s up to each individual person to make a choice that’s safe and affirming for them.

“We do tell people: Think critically, think cautiously, about where you may travel, who may see this ID,” Grunstra said.

Montaño is also looking toward the future as transgender rights have become a prominent and divisive issue. They don’t want to put out unfounded fears about what could happen during a second Donald Trump presidency, but Montaño worries about potential tracking of people who’ve opted to change their gender identification on government documents.

“The concern we all have is: what’s going to happen federally? And what will having a gender ‘X’ marker mean for you as you’re traveling outside of Massachusetts?” Montaño said. “A lot of folks who are trans who have changed their name legally, and maybe have their their ID reflecting their correct name and correct gender, are assumed to be in the clear. But we never know.”