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According to Marie Claire, Keenan was born with male genes, female genitalia, mixed reproductive organs. At birth, she was labeled as male on her birth certificate, then weeks later, the classification was changed to female. Raised as a girl, she didn’t know she was intersex until adulthood. Since discovering her true gender in 2012, she has advocated to make third gender birth certificates more widely available.

“Not all intersex people will choose to identify legally as intersex,” she told NBC Out. “And not all parents will choose to have their intersex child identified as intersex on birth documents. But for those who do, the option must exist.”

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This isn’t the first historic progress Keenan has made this year. In September, she successfully changed her gender to non-binary in California where she now resides. She is the first person in California to do so and the second person in the U.S., following trailblazer Jamie Shupe, who successfully petitioned to have their gender classified as non-binary in the state of Oregon in June 2016.