Updated April 2020
Process: Does the state require a court order or can you go directly to the vital records
agency to update the gender marker?
31 states + 2 territories + DC +NYC have administrative process:
Alaska, Arizona, California, Connecticut, Delaware, District of Columbia, Florida, Guam, Hawaii,
Idaho,** Illinois, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Maine, Michigan, Minnesota,
Montana, Nebraska, Nevada, New Jersey, New Mexico, New York, New York City, North Carolina,
North Dakota, Oregon, Pennsylvania, Puerto Rico, Rhode Island, Washington, West Virginia, Virginia.
17 states and one territory require a court order:
Alabama, Arkansas, Colorado, Georgia, Indiana, Louisiana, Missouri, Mississippi, New Hampshire,
Northern Mariana Islands, Oklahoma, South Carolina, South Dakota, Texas, Utah, Vermont, Wisconsin,
and Wyoming.
2 territories have no clear process:
American Samoa, US Virgin Islands.
2 states do not allow amendments of the gender marker on a birth certificate:
Tennessee by statute, Ohio by agency policy.
Standard: Does the state require medical evidence to update the gender marker?
10 states + NYC do not require provider signature:
California,* Colorado,* Idaho,** Montana, Nevada,* New Jersey,* New Mexico,* New York, Oregon,*
and Washington,* and New York City.*
13 states + DC + Puerto Rico require “appropriate” treatment for the individual (no surgery):
Alaska, Connecticut,* Delaware, District of Columbia, Florida, Hawaii, Illinois, Kansas, Maryland,
Massachusetts, Minnesota, Pennsylvania, Puerto Rico, Rhode Island,* Vermont, and Virginia.
11 states + 1 territory require proof of surgery in the statute:
Alabama, Arizona, Arkansas, Georgia, Guam, Kentucky, Louisiana, Michigan, Missouri, Nebraska,
North Carolina, and Wisconsin.
4 states require proof of surgery by written policy or actual practice by the agency:
Iowa, Maine, North Dakota, and West Virginia.
9 states + 3 territories have no specific policy or practice and the judge or policy official determines:
American Samoa, Indiana, Northern Mariana Islands, Mississippi, New Hampshire, Oklahoma, South
Carolina, South Dakota, Texas, Utah,* US Virgin Islands and Wyoming.
2 states do not allow amendments of the gender marker on a birth certificate:
Tennessee by statute, Ohio by agency policy.
* - 10 states and NYC allow for a gender neutral designation, typically “X,” on the certificate.
** - Idaho SB509 was signed into law with an effective date of July 1, 2020 and would prohibit birth
certificate gender changes. However, implementation of this new law barred by a 2018 court order.
For more information please contact: Harper Jean Tobin, Policy Director, National Center for Transgender Equality
(202) 804-6047 ▪ hjtobin@transequality.org ▪ www.TransEquality.org
SUMMARY OF STATE
BIRTH CERTIFICATE
GENDER CHANGE LAWS
