In the U.S., an accurate birth certificate is indispensable for accessing essential services like banking, healthcare, and education.
That’s why it’s essential to update identity documents, to reflect your true gender identity.
Today, there are around 1.6 million transgender people living in the U.S. according to a study by UCLA. As attitudes of gender expression evolve, so do policies on updating birth certificates to represent affirmed gender.
Most identity documents are issued by your state of residence, and the rules for any and all alterations vary state-by-state. In this post, we’ll explain current policies on birth certificate gender changes across the United States for transgender citizens.
Latest Policy Changes for Transgender People Updating Birth Certificates
Laws on changing gender markers on key vital records are changing across the United States. Here are the latest updates on rules for amending your birth certificate to reflect your gender identity:
- 20 January, 2025: President Trump signs an executive order mandating that federal agencies recognize only male and female sexes, as determined by biological characteristics at birth. Despite this, state-wide policies on amending gender markers still stand.
- Oklahoma (16 December, 2024): A federal judge rules that Governor Stitt’s prohibition law on altering gender markers on birth certificates is unconstitutional. The state has not yet fully implemented this ruling.
- Texas (30 August, 2024): The Department of State Health Services announces that court orders can no longer be used to change the sex listed on birth certificates, effectively halting gender marker amendments.
- Oklahoma (8 November, 2021): Governor Kevin Stitt issues Executive Order 2021-24, prohibiting the Oklahoma State Department of Health from amending gender markers on birth certificates.
Do federal rulings affect birth certificate amendments?
Following President Trump's return to office in 2025, new federal executive orders reportedly aim to standardize gender definitions nationwide.
It’s possible that these initiatives could influence state-level rulings. However, policies on amending gender markers on birth certificates ultimately remain at the disclosure of state authorities.
Can I Change the Gender Marker on My Birth Certificate?
In most states, it’s possible to change your birth certificate gender if you are transitioning. At present, only 6 states prohibit gender marker amendments entirely: Florida, Kansas, Montana, Oklahoma, Tennessee, and Texas.
The process of updating the gender marker on your birth certificate differs from state to state. Certain states mandate evidence of gender-affirming surgery, while others have more lenient criteria. Once your request is approved, you’ll receive either:
- New birth certificate with an updated gender marker, or
- Amended birth certificate which shows a changed gender marker
The type of updated birth certificate you receive depends on state policy. Applicants in Mississippi State can select either type of certificate they receive, but different supporting evidence is required in each case.
Much like recognition of the gender ‘X’ marker on birth certificates for intersex and non-binary people, rules on updating vital records for transgender U.S. citizens are constantly being updated state by state.
In states where sex designation modifications on birth certificates are permited, the rules on what supporting evidence is required vary.
In some states, you will need to have undergone gender-affirming surgery, whereas, in others, the decision to consider you eligible for a change of gender on your birth certificate is based on other criteria.
In around half of the U.S. States, you will need evidence of SRS surgery before your birth certificate can be changed. In these states, you will usually be required to present a court order showing proof of your new sex designation after gender-affirming surgery.
In other states, the rules are more flexible, and you won’t need to prove that you’ve completed surgical treatment. This means you will be able to change your birth certificate much earlier in your transition.
When it comes to making a change to your vital records and identification documents, eligibility rules vary state by state. In the case of people going through a gender transition, you will often be required to submit supporting documents or medical certification to show you are undergoing gener-affirming medical treatment.
Changing Birth Certificate Sex Designation
If you are unsure what you need to do to adjust your birth certificate gender markers, read our quick guide to get the details on requirements in your state of birth.
Can I use my new name on a transgender birth certificate?
In most cases, yes. The majority of US states allow you to change your name and gender, subject to a few conditions. These are mostly background checks to prevent fraud and criminal intent, and, in some cases, a court order may be required to change a name on a birth certificate.
Read More: Transgender Name Change
Transgender birth certificates, ID laws and policies per state
The following table details which states allow you to change your gender marker on a U.S. birth certificate and presents the related laws, statutes and requirements.
In any case, you will need to order a certified copy of your birth certificate to present alongside your birth certificate amendment form to request any modifications.
If you are looking to reflect a change of gender on your birth certificate, make sure you follow the correct rules for the state in which your birth was first registered:
| State | Gender Marker Changes Accepted | Type of Certificate Issued | Requirements To Change Your Gender Marker |
| Alabama | Yes | Amended birth certificate | Certification of gender reassignment surgery |
| Alaska | Yes | Amended birth certificate | Certification of clinical treatment for gender transition |
| Arizona | Yes | Amended birth certificate Arizona Legislature: § 36-337 (A)(3) (2006) |
Certification of gender reassignment surgery Or, medical evidence showing that your chromosomal count differs from your assigned gender |
| Arkansas | Yes | Amended birth certificate | Certification of gender reassignment surgery |
| California | Yes | New birth certificate California Health & Safety Code: § 103426 (2018) |
Personal attestation of your wish to change your gender marker |
| Colorado | Yes | Amended birth certificate | Personal attestation of your wish to change your gender marker |
| Connecticut | Yes | Amended birth certificate | Certification of clinical treatment for gender transition |
| Delaware | Yes | Amended birth certificate | Certification of clinical treatment for gender transition |
| D.C. | Yes | Amended birth certificate | Certification of clinical treatment for gender transition |
| Florida | No | Not available | |
| Georgia | Yes | Amended birth certificate | Certification of gender reassignment surgery |
| Hawaii | Yes | Amended birth certificate Hawaii State Legislature: § 338-17.7(a)(4)(B) |
Certification of clinical treatment for gender transition |
| Idaho | Yes | Amended birth certificate | Certification of clinical treatment for gender transition |
| Illinois | Yes | Amended birth certificate | Personal attestation of your wish to change your gender marker |
| Indiana | Yes | New birth certificate | Court order to change your gender marker |
| Iowa | Yes | Amended birth certificate Iowa Code: Ann. § 144.23(3) (2004) |
Certification of clinical treatment for gender transition |
| Kansas | No | Not available | |
| Kentucky | Yes | Amended birth certificate | Certification of gender reassignment surgery |
| Louisiana | Yes | Amended birth certificate | Court order to change your gender marker Certification of gender reassignment surgery |
| Maine | Yes | Amended birth certificate | Certification of clinical treatment for gender transition |
| Maryland | Yes | Amended birth certificate | Certification of clinical treatment for gender transition |
| Massachusetts | Yes | Amended birth certificate General Law of the Court of Massachusetts: Ann. ch. 46, § 13(e) (2015) |
Certification of clinical treatment for gender transition |
| Michigan | Yes | New birth certificate Michigan Legislature: Ann. § 333.2831(c) (2006) |
Personal attestation of your wish to change your gender marker |
| Minnesota | Yes | Amended birth certificate | Certification of clinical treatment for gender transition Or, a court order to change your gender marker |
| Mississippi | Yes | Amended birth certificate | Personal attestation of your wish to change your gender marker |
| New birth certificate | Court order to change your gender marker Certification of clinical treatment for gender transition |
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| Missouri | Yes | Amended birth certificate Revised Statues of Missouri: Ann. Stat. § 193.215(9) (2006) |
Court order to change your gender marker Certification of gender reassignment surgery |
| Montana | No | Not available | |
| Nebraska | Yes | New birth certificate | Court order to change your name Certification of gender reassignment surgery |
| Nevada | Yes | New birth certificate | Affidavit from a family member, friend, colleague, or medical professional attesting to your gender transition |
| New Hampshire | Yes | New birth certificate | Certification of clinical treatment for gender transition |
| New Jersey | Yes | New birth certificate | Personal attestation of your wish to change your gender marker |
| New Mexico | Yes | Amended birth certificate | Personal attestation of your wish to change your gender marker |
| New York | Yes | Amended birth certificate New York City Health Code: § 207.05(a)(5) (2014), as amended by the Birth Certificate Modernization Bill, Int. No. 491-A |
Personal attestation of your wish to change your gender marker |
| North Carolina | Yes | New birth certificate | Certification of gender reassignment surgery |
| North Dakota | Yes | Amended birth certificate North Dakota Enrolled House Bill: HB 1297 |
Certification of "permanent and complete" clinical treatment for gender transition |
| Ohio | Yes | Amended birth certificate available in some counties | Court order to change your gender marker |
| Oklahoma | No* | Not available | *A federal court has ruled that Oklahoma's ban on gender marker changes for birth certificates is unconstitutional, but the state has yet to fully implement the ruling. |
| Oregon | Yes | Amended birth certificate | Court order or notarized application to change your gender marker |
| Pennsylvania | Yes | Amended birth certificate | Certification of clinical treatment for gender transition |
| Puerto Rico | Yes | Amended birth certificate | Signature from a healthcare professional on your application |
| Rhode Island | Yes | Amended birth certificate | Affidavit of requested gender change from the Office of Vital Records Certification of clinical treatment is no longer required |
| South Carolina | Yes | Amended birth certificate | Court order to change your gender marker Certification of "permanent and complete" clinical treatment for gender transition Evidence of gender reassignment surgery is not required |
| South Dakota | Yes | Amended birth certificate | Court order to change your gender marker |
| Tennessee | No | Not available | |
| Texas | No | Not available | |
| Utah | Yes | Amended birth certificate | Court order to change your gender marker |
| Vermont | Yes | New birth certificate | Certification of clinical treatment for gender transition |
| Virginia | Yes | Amended birth certificate Virginia Law: 12 Va. Admin. Code § 5-550-320 (2006) |
Certification of clinical treatment for gender transition |
| Washington | Yes | Amended birth certificate Washington State Legislature: WAC 246-490-075 (2018) |
Personal attestation of your wish to change your gender marker |
| West Virginia** | Yes | Amended birth certificate | Court order to change your gender marker |
| Wisconsin | Yes | Amended birth certificate | Certification of gender reassignment surgery |
| Wyoming | Yes | Amended birth certificate | Court order to change your gender marker Certification of gender reassignment surgery |
Required Documents for Gender Change on a Birth Certificate
Changing your documents as part of a gender transition is often an important and highly symbolic step.
The required document common to all states that allow sex designation changes on a birth certificate is a certified copy of the birth certificate to be amended. Some states will require you to present other documents alongside your current birth certificate.
More information is detailed on the National Center for Transgender Equality website — choose your birth state from the dropdown menu.
Once the updates have been made, you will need to obtain a certified copy of your new birth certificate. Make sure to order a long-form birth certificate so that it reflects the changes to your name and updated gender.
An official (long-form) copy of a birth certificate bears legal validity, so it will be accepted when you apply to update other forms of government-issued identification documents, such as a driver’s license.
If you are looking to apply for a driver’s license or a Social Security card and need proof of identity, you can order your birth certificate online. This will save you time, as you will be able to skip visiting and waiting in line at your local government office or vital record office.
Read more: Same Sex Parents on a Birth Certificate
