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And for that reason I think it's important to only list gender on passports and other identification. But your birth certificate has nothing to do with that.
Depends on the country how often those documents are actually used. In some places (like Canada or the UK for instance) your birth certificate needs to match those other documents or else you are SOL getting your passport and driver's license updated. Otherwise as a document it can also play a role in applying for government services or schooling in a lot of places which means you can get misgendered during times where you are already under duress or opens you up to being forcefully outed to post secondary administrators and teachers.
Medical records are usually better served with more accurate information because if you've transitioned your reactions to medication are more closely linked to your horomones meaning the dosages you receive by any trans health untrained doctor may be off and it is actually safer in most emergencies to have their first instinct be to treat someone as their listed gender and not their birth sex.
From a beaurcratic standpoint listing the sex of someone on their birth certificate isn't exactly useful past a point either. The main purpose of the things is to establish a time or location of the person's birth for determining nationality. That's why you can change your name regardless of what you were called at birth, so it remains a reflection of your current state... Also census data logs everything at your registration so later changes don't impact anything significant. The other reason birth certificates exist is for enthusiasts to track genealogy.
There isn't exactly a compelling reason to disallow people some autonomy over how they are recorded for posterity sake... aside from a lack of empathy.