Changing sex on birth certificates in the US
These are guidelines for acquiring a new birth certificate in the United States with the name and/or gender marker corrected or amending the information on your current one.
In order to change your name entry on a birth certificate, typically you'll only need a certified copy of your court order to your change name as well as a small fee to obtain a new copy. This article, for now, is focused on how to change the sex marker.
In states that require a court order (or in other states, as an alternative method to a medical statement) to change the sex marker on your birth certificate, you usually need a copy of your surgeon's letter (post-GRS) to be placed into evidence before an order is issued. What constitutes sufficient evidence for a judge to issue an order, will depend of the state that the petition takes place in, and the presiding judge over the case.
Americans born out of the country who have been issued a Consular Report of Birth Abroad Certificate need to submit to the State Department a doctor's letter regarding their transition and a copy of Form FS-240 This is similar in requirement as the procedure to change gender in a passport book. 
Summary of the states
This is a simplified version of the requirements that states impose on persons born in that state to change the sex marker on their Birth Certificate. Some states are duplicated due to multiple ways of obtaining change.
The following states require a valid court order of competent jurisdiction. It is possible to obtain a valid court order in another state, assuming the applicant abides by the regulations of that state, in order to bypass difficult requirements in another state. This does not typically make the process of changing the Birth Certificate record(s) easier.
The following states require some form of medical statement.
|Massachusetts||Michigan||Mississippi||Nebraska||New Jersey||New Mexico||New York|
|North Carolina||North Dakota||Oklahoma||Rhode Island||South Carolina||Washington||West Virginia|
Will not amend
The following states will NOT allow the amending of the sex marker on the certificate of birth at this time.
State by state
As laws vary in each state, be sure to verify the laws of your state before starting the process.
Alabama will issue an amended birth certificate upon court order. The fact that the sex designation on the birth certificate has been changed by court order is noted on the document. You will need an original or certified copy of the court order for your name change. 
Alaska will issue an amended birth certificate upon court order. Changing your name will require an original or certified copy of the court order for your name change.
Arizona will issue a new birth certificate.
You will need a written statement by a physician verifying either that 1) GRS has occurred or 2) a record should be changed based on the results of genetic testing. An original or certified copy of the court order for your name change may be required. 
Arkansas will issue an amended birth certificate upon court order. Whether the old information or the fact that an amendment has taken place is readily apparent from the new certificate is a matter of judicial discretion. An original or certified copy of the court order for your name change is also required. 
California will issue a new birth certificate upon affidavit of a physician.
Starting January 1, 2014, trans people seeking gender marker change on their birth certificate will be able to apply directly to the Office of Vital Records to amend a birth certificate. This will require an affidavit of a physician attesting that the person has undergone "clinically appropriate treatment" which likely means a minimum of a monitored hormone therapy regimen.
Later in the same year on July 1, 2014, one will be able to bypass the expensive civil filing fee and the publication of legal notice in order to changes ones legal name. It will still require a court hearing but the process and cost will be significantly simplified.
1278. (a) (1) Except as provided in subdivisions (c) and (d), the petition or application shall be heard at the time designated by the court, only if objections are filed by a person who can, in those objections, show to the court good reason against the change of name. At the hearing, the court may examine on oath any of the petitioners, remonstrants, or other persons touching the petition or application, and may make an order changing the name, or dismissing the petition or application, as the court may seem right and proper.
(d) If the petition for a change of name is filed by a guardian on behalf of a minor ward, the court shall first find that the ward is likely to remain in the guardian’s care until the age of majority and that the ward is not likely to be returned to the custody of his or her parents. Upon making those findings, the court shall consider the petition and may grant the petition only if it finds that the proposed name change is in the best interest of the child.
Colorado will issue a new birth certificate upon court order. An original or certified copy of the court order for your name change is also required. 
Connecticut will issue an amended certificate with no reference to the old information. You must provide a notarized affidavit affirming that the existing vital record is incorrect or incomplete, and that the newly provided information is accurate. You must submit documentation to the Vital Records office in the town where the vital event occurred proving that the information to be entered onto the record is accurate. There is no processing fee for amendments or corrections. Cost of a replacement certificate varies.
Only the commissioner shall amend a birth certificate to reflect a gender change. In order to request a gender change amendment the following documents shall be submitted to the commissioner:
- Affidavit from a licensed psychiatrist, psychologist or clinical social worker performing a psycho-social evaluation, attesting to the fact that the registrant is socially, psychologically and mentally the designated sex;
- Affidavit from the surgeon performing the sex change operation, attesting to the fact that the surgery was performed;
- Court order for legal name change if applicable.
Delaware will issue an amended certificate with no reference to the old information, upon court order. Your petition to the court may require an affidavit of a physician documenting the gender reassignment. You may need an original or certified copy of the court order for your name change.
District of Columbia
Washington will grant new birth certificates to transgender people who provide a statement from a licensed healthcare provider that they have undergone "appropriate treatment" for a gender transition.
Florida will issue an amended certificate with no reference to the old information. Changing it requires:
- A completed "Application for Amended Birth Certificate"
- A notarized "Affidavit of Amendment to Certificate of Live Birth"
- A certified copy of a court order of name change
- A sworn affidavit from the physician who performed GRS containing his/her medical license number as well as stating that you have completed sex reassignment in accordance with appropriate medical procedures and that you are now considered to be a member of the reassigned gender. It also requires a small fee.
This state will issue a new birth certificate, based in part on the old record, upon court order. An original or certified copy of the court order for your name change is also required.
2600 Skyland Drive, NE
Atlanta, GA 30319-3640
For more direct means of obtaining instructions for correcting a vital record, contact the Legal Section of the Vital Records office (404-656-4901)
Hawaii will issue a new birth certificate. You will need a affidavit written by a physician that verifying that GRS has occurred. A court order is not required.
Idaho will NOT change sex on the birth certificate at this time. A bill to permit the changes was rejected by the Idaho legislature. Idaho will, however, change the name on the birth certificate upon court order. 
Illinois will issue a new birth certificate and also seal the old record to the public. While the language "...after undergoing an operation(s) having the effect of reflecting, enhancing, changing, reassigning or otherwise affecting gender." implies genital surgery, it is not required to have had genital surgery for gender marker change. However, it also does not state exactly what criteria is considered acceptable evidence. Therefore you must contact DPH to obtain an up to date form for gender change on your birth certificate.
If you want your name changed at this time, a certified copy of the Court Order of Legal Name Change must be submitted as well. The fee to create a new birth record is $15 and includes one certified copy, additional copies of the same record requested at the same time are $2 each.
This state will issue an amended birth certificate upon court order. The old record is sealed and the new record/certificate does not reveal the fact that amendments have taken place. The order must specifically order the Indiana State Department of Health (ISDH) to change the sex on your birth certificate. You will need to produce a surgeon's letter to the court as evidence of (genital) surgery.
The fee to create a new birth record is $18 with checks or money orders made out to "ISDH."
Iowa will issue a new birth certificate but it must be accompanied by a notarized affidavit from a licensed physician/surgeon or osteopathic physician/surgeon stating that by reason of surgery or other treatment by the licensee, the sex designation of the person has been changed. A name change requires an original or certified copy of the court order.
Kansas will issue an amended birth certificate. The new certificate will state that it has been amended but will not reveal which items were changed. Changing the gender marker requires a doctor's letter verifying that GRS has taken place. 
Kentucky will issue an amended certificate after submitting a "sworn statement" by a licensed physician stating that the applicant has had GRS. Also required is an original or certified copy of the court order for your name change. Please note that current interpretation of Kentucky law may require a notarized letter from your GRS surgeon, which can be difficult if your surgery was performed in the past or in another country.
Louisiana will issue a new birth certificate upon court order. Evidence needed includes an original letter from your GRS surgeon and an original or certified copy of the court order for your name change. If you are married, your spouse must give written consent for the changes. 
The Office of Vital Records will issue an amended birth certificate upon the order of the local probate court and the payment of a fee. Applicants must submit to the court an Application for Correction (Form VS-7: "Correcting a Vital Record in Maine") and a letter from the treating physician verifying that the surgery/treatment has been "completed." Both Form VS-7 and the letter attesting surgery must be notarized before submitted to the court.
The certificate will be marked "amended," a date stamp will be placed on the document, and a summary description of the evidence submitted in support of the correction will be permanently attached to it. The Office of Vital Records may issue a new certificate with no indication of the changes made on request.
Maine Department of Human Services
244 Water Street
Augusta, ME 04333-0011
Maryland will issue an amended birth certificate upon court order. Current policy is to mark the new certificate as having been amended unless the court order specifies that the original record is to be sealed. It is possible to obtain a Court Order to indicate the correct sex along with your new name should you desire to change them simultaneously. An original or certified copy of the court order for your name change may be required.
Massachusetts will issue an amended birth certificate. You will need an original letter from your GRS surgeon and an original or certified copy of the court order for your name change. The letter from the surgeon must use the word "completed," not just "performed."
Michigan will issue a new birth certificate. You will need an affidavit from a physician certifying that GRS has been performed and, if your name is being changed also, an original or certified copy of the court order for your name change. The fee is $26.00. 
Minnesota will issue an amended birth certificate upon court order by default. In theory the department of health allows for gender marker change with a surgeons letter and a separate statement from a physician. The language in the letters must include a "link to the original birth record by showing on the document and on the birth record information that is not to be changed. The link must be a combination of at least two of the following items: last name, date of birth, place of birth, and the names or partial names of the parent(s)."
The court order must state:
- The EXACT name of the person on the existing birth certificate to be amended
- The birth record be changed in the "It is ordered that" section of the court order
- Whether the original certificate is to be amended or a new certificate is to be issued
A certified copy of the court order along with a notarized Application to Amend a Birth Record is then sent to:
Central Cashiering - Vital Records
P.O. Box 64499
St. Paul, Minnesota 55164-0499
Your documents will be returned after processing. There is a $40 fee to amended a birth record. There is a separate fee for a copy of a new birth certificate, for a new copy, the fee is $16. If you return a copy that has been issued less then a year ago, there is no charge, otherwise the charge for an exchange is $7. If you exchange your current birth certificate, it will be amended.
Mississippi may issue an amended birth certificate upon affidavit of at least two reputable persons having personal knowledge of the facts in relation thereto. Changes are at the discretion of the state registrar of vital records. The amended birth certificate will have the new name and gender typed in the margin but the original name and gender fields will remain unchanged.
Missouri will issue an amended birth certificate upon court order. You will need an original or certified copy of the court order for the name change. The birth certificate will be marked Amended.
Contact Information: The best way to contact the Bureau of Vital Records is at a local Health Department Or by phone anywhere in the state (601) 576-7981 The Website is: http://www.dhss.mo.gov/BirthAndDeathRecords/index.html
Montana will issue an amended birth certificate upon statement from a surgeon that the applicant's sexual characteristics have been surgically changed. While the state regulations imply need for genital surgery, they do not explicitly state so and as such, a number of other procedures like orchiectomy, or top surgery can be done in place of GRS.
The order must contain sufficient information for the department to locate the record. If the registrant's name is also to be changed, the court order must indicate the full name of the registrant as it appears on the birth certificate and the full name to which it is to be altered. Any certified copy issued after the amendment will indicate it was altered.
Nebraska will issue a new birth certificate, upon receipt of a notarized affidavit from the physician that performed GRS, and a certified copy of an order of name change. The evidence from which the new certificate is prepared and the original certificate of birth shall be available for inspection only upon the order of a court of competent jurisdiction. The affidavit must be notarized in presence of the GRS surgeon, and since notaries do not exist in Thailand, it is difficult to get proper paperwork certifying that GRS was actually performed. You can only get a notarized affidavit at the US embassy unless you get the doctor to go there with you. 
Nevada will issue a new birth certificate upon court order. The court order must specify those facts to be changed on the new certificate. All other items must remain as they originally appeared on the original certificate.
New Hampshire will issue a new birth certificate upon court order. This is obtained by submitting evidence of genital reassignment surgery. The new birth certificate will reflect the specific amendments that have been made, will bear the phrase “gender changed per court order” and will also add “AKA” to the text between the old and new names. It is theoretically possible to have the court order specify that these changes not be noted on the document itself. You will also need an original or certified copy of the court order for your name change. 
The courts of the state of New Hampshire find that said request of relief is proper and that such change will not be detrimental to the interest of any persons, nor be against the interest of the state or of any given establishment. Wherefore, the courts of the state of New Hampshire understand that select circumstances, such as this case, require judicial intervention in order to prevent discrimination, especially inequality in medical care and public accommodation.
Thereto, the explicit requirement of surgical procedures or medications that may be deemed unsuitable, dangerous, unnecessary, or currently irrelevant to the Petitioner by medical assertion shall be given relief notwithstanding N.H. Code Admin. R. He-P 7007.03(e). Upon such relief as given by the courts the vital record(s) of the said Petitioner shall be amended in such a way as to cause a new birth certificate to be issued without showing any changes or amendments to such record, including the corresponding certificate.
New Jersey will issue an amended birth certificate.
Changing the gender marker requires a statement from a licensed physician stating that the applicant has had "clinically appropriate treatment for the purpose of gender transition, based on contemporary medical standards, or that the person has an intersex condition."  Surgery is no longer a requirement for gender marker change. 
New Mexico will issue a new birth certificate. The old information will be ‘sealed’ and cannot be opened without a court order. The change will be granted upon receipt of a duly-notarized statement from the person in charge of an institution or from the attending physician indicating that the sex of an individual born in this state has been changed by surgical procedure, together with a certified copy of an order changing the name of the person.
1105 St. Francis Drive
Santa Fe, New Mexico 87503
This process is used if you were born in New York State outside of New York City. The New York State Department of Health website has no information on how to make changes. The department needs to be contacted directly.
New York City natives can go to the New York City Department of Vital Records website for contact information. The downloadable forms make no provisions for birth certificate changes resulting from sex reassignment surgery.
In order to change the name on a birth certificate filed in New York State (outside of New York City) a court order is required. The order must have the court seal and be certified by the clerk of the court. Certified proof of publication must be included if it was required when you changed your name. Please make certain the court order includes the following information needed to identify the person named on the certificate: original name, date and place of birth.
In order to change the sex on the birth certificate you must submit:
- Written statements signed by the surgeon or surgeons who performed the GRS. They should specify the date, place and type of procedure. Note that in cases of FtM gender reassignment, the statements must demonstrate proof of bilateral mastectomy and total hysterectomy.
- Surgical reports made in the operating room describing, in detail, all of the procedures performed on the applicant. Again, in cases of FtM GRS, the statements must demonstrate proof of bilateral mastectomy and total hysterectomy.
- A psychological report documenting your history of "gender dysphoria", and/or that you have satisfied the WPATH Standards of Care for gender reassignment. (The GRS recommendation letters from your therapists) Other medical reports concerning hormonal, chromosomal or endocrinological information, provided by your physician, should also be included.
- A completed correction application signed by the person named on the birth certificate.
The application form will be mailed to you along with the instruction letter from the NYS DOH.
As soon as all of the correct documentation is received, it is submitted for legal and medical review. Processing time, approximately three months. One certified copy of the birth certificate will be provided after the changes are made. Additional copies are $30 each.
North Carolina will issue a new birth certificate. The request must be accompanied by a notarized statement from the physician who performed the GRS or from a physician licensed to practice medicine who has examined the individual and can certify that the person has undergone GRS.
North Dakota will issue an amended birth certificate. The new certificate will be clearly marked in the upper margin with the word "amended." The original certificate shall then be placed in a special file and shall not be open to inspection except by order of a court of competent jurisdiction or by the state registrar for purpose of carrying out the provisions of North Dakota Century Code chapter 23-02.1 and properly administering the vital records registration program.
The evidence and documents required include:
- A written request of the person who has undergone the operation
- An affidavit by a physician that the physician has performed an operation on the person, and that by reason of the operation, the sex designation of such person's birth certificate should be changed
- And a certified copy of your court order decreeing a legal change in name
See http://www.ndhealth.gov/vital for more up to date information.
Ohio will NOT change sex on the birth certificate at this time. The state will, however, change the name on the birth certificate upon court order.
Oklahoma will, by default, issue a new birth certificate. The amended information may be noted on the birth certificate. In order to change it, both a court order and a doctor’s letter may be required.
Oregon will issue an amended birth certificate upon a certified copy of a judgment (court order) that 'an individual born in this state has completed sexual reassignment and that the sex on the record of live birth must be changed.' Surgery is not a prerequisite for document changes. The court order of name and/or gender marker change is kept by the Center for Health Statistics for record keeping purpose.
The new certificate will state that it has been amended but will not reveal which items were changed. In order to obtain a court order to change the sex marker, a Name Change form must be filled out and modified by crossing out the word "name" and inserting "gender" on the form. You may need a certified copy of the court order for your name change. 
Pennsylvania will issue an amended birth certificate upon court order. There is no mention that any information was amended on the new certificate. Documents to be included with the application include:
- The original letter from your SRS surgeon, stating that surgery has been performed
- An original or certified copy of the court order for your name change
See the following link for an application and contact information: http://www.dsf.health.state.pa.us/health/cwp/view.asp?a=168&Q=202212
Rhode Island will issue an amended birth certificate. The certificate will be marked “amended” when changed; the date of modification and a summary of evidence supporting the change will accompany the certificate. It will not disclose the former name.
For changes to the sex designation on birth certificates, the Office of Vital Records has a policy requiring a notarized statement from the hospital or clinic where surgery was performed and must be signed by the physician in charge of the surgery.
South Carolina will NOT issue a new birth certificate or amend the old the one. They will send a "card" that can be attached to the old birth certificate indicating change of name and sex. The Bureau of Vital Statistics requires an original court order for the name change and a letter from the GRS surgeon. The fee is $39.00.
Bureau of Vital Statistics
2600 Bull Street
Columbia, SC 29201
This state requires a court order to amend a birth certificate. To change the gender marker you'll need to submit evidence of GRS surgery to the court. Although the Registrar will follow any specific instructions in a court order, their general policy is to issue a new certificate with no indication of amendment. 
This state will only change the name on a birth certificate. The sex of an individual will not be changed on the original certificate of birth as a result of GRS. 
This state may amend the existing birth certificate. Prior to Littleton v. Prange, Texas issued new birth certificates. To change the gender marker requires:
- The original court order of name change
- A notarized copy of the Surgeon's Letter
- And a copy of your Driver's License or state issued ID card.
Depending on the county you live in, it may be difficult to correct information on your birth certificate without the use of a court order. 
Utah will issue an amended certificate. The new certificate will state that it has been amended but will not reveal which items were changed.
You will need a certified copy of the court order for your name change and/or change of sex designation. In order to obtain a court order, it is likely one needs a letter certifying that reassignment surgery has been performed. There is a $25 fee. 
Vermont will issue a replacement certificate upon court order.
Surgery is not a requirement in supporting evidence. There is a fee of $15 for the replaced certificate.
(a) Upon receiving from the probate division of the superior court a court order that an individual’s sexual reassignment has been completed, the state registrar shall issue a new birth certificate to show that the sex of the individual born in this state has been changed.
(b) An affidavit by a licensed physician who has treated or evaluated the individual stating that the individual has undergone surgical, hormonal, or other treatment appropriate for that individual for the purpose of gender transition shall constitute sufficient evidence for the court to issue an order that sexual reassignment has been completed. The affidavit shall include the medical license number and signature of the physician.
(c) A new certificate issued pursuant to subsection (a) of this section shall be substituted for the original birth certificate in official records. The new certificate shall not show that a change in name or sex, or both, has been made. The original birth certificate, the probate court order, and any other records relating to the issuance of the new birth certificate shall be confidential and shall not be subject to public inspection pursuant to 1 V.S.A. § 317(c); however an individual may have access to his or her own records and may authorize the state registrar to confirm that, pursuant to court order, it has issued a new birth certificate to the individual that reflects a change in name or sex, or both.
(d) If an individual born in this state has an amended birth certificate showing that the sex of the individual has been changed, and the birth certificate is marked “Court Amended” or otherwise clearly shows that it has been amended, the individual may receive a new birth certificate from the state registrar upon application.
Virginia will issue an amended certificate upon court order. The State Registrar may issue a new birth certificate if presented with a notarized affidavit from the physician performing the surgery.
A certified copy of your name change (court order) as well as a copy of the order to change the legal sex (marker) must be in the possession of the State Registrar along with a request for a new (birth) certificate.
Washington State will issue a new birth certificate. The old record is deleted. Washington’s statutes and administrative code are silent about amending vital records. The Department of Health’s policy is to issue an amended certificate upon submission of either a court order or a letter from the treating surgeon attesting to the change of sex.
West Virginia will issue an amended birth certificate upon submission of either a court order or a notarized statement from the surgeon whom preformed GRS. If you change your sex first and then apply for a name change, the old name will show on the birth certificate; it will be stricken through but still visible and the new name will be typed above or beside it. However, if you change your name first and then your sex, or change them both concurrently, they will retype the birth certificate entirely without any reference to the old information. Hence, a legal name change first or simultaneously with the request for gender change is recommended.
350 Capitol Street
Charleston, WV 25301-3701
Office Hours: Monday - Friday 8:30 am - 5:00 pm Eastern Time
Wisconsin will issue an amended birth certificate upon court order. Whether the new document reflects the changes made is a matter of judicial discretion. To obtain a court order, you will need a signed, dated, notarized letter from your surgeon confirming the date of the procedure. The surgeon should include your name, date of birth, date of surgery, information on what surgery was performed, and where it was performed. The form that needs to be filled out for the birth certificate change is DOH 5035. You will need to include your original birth certificate or a certified copy.
1 West Wilson Street, Room 158
Madison WI 53702
Wyoming will issue an amended birth certificate upon court order. Whether the new document reflects the changes made is a matter of judicial discretion.
2300 Capitol Avenue
Cheyenne, WY 82002
- Centers for Disease Control: Where to Write for Vital Records
- Documenting Gender: Incoherence and Rulemaking by Dean Spade, Seattle University School of Law, Hastings Law Journal, Vol. 59, No. 1, 2008
- Instructions for changing name and sex on birth certificate - State-by-state instructions for US and Canada
- Readers may use this email link to report errors and/or omissions they have discovered, or to add additional material or comments regarding this article "Changing sex on birth certificates in the US"
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