Policy Brief: Birth Certificate Gender Markers

A birth certificate is an important document used to prove one’s identity and citizenship. For those who can afford one, a passport can serve the same purposes. However, the ability to change one’s sex designation on birth certificates remains an important issue for many transgender people. As lawyers at Lambda Legal point out, states have varying procedures for updating these documents, and a few actually prohibit changing the gender marker on birth certificates.

Many states model their policies for amending birth certificates on the Model Vital Statistics Act and Regulations (or Model Law). Currently being revised, the Model Law is developed by consultation between the state and federal governments and was last updated in 1992. The Model Law is intended to be a guide for states, so that states can model their own vital statistics laws and regulations after its suggestions.

What’s wrong with these laws?

The 1992 Model Law says that a person wanting to change their sex on their birth certificate should present a court order certifying that their sex “has been changed by surgical procedure.” There are three problems with this approach, which many states still use.

First, the requirement of a court order can create a barrier to those transgender people who don’t have enough money to hire a lawyer or who don’t have enough knowledge to navigate the legal system on their own. Also, some courts are hesitant to issue orders amending birth certificates that were issued by another state, creating problems for transgender people who want to change their birth certificate after they move away from the state where they were born.

Second, the Model Law’s requirement of “a surgical procedure” in every case is at odds with the medical community. The World Professional Association for Transgender Health (WPATH) recognizes that different patients will have different medical needs. Surgical treatments may be necessary and appropriate for some transgender individuals, but not for others. The Model Law’ ignores the differing needs of transgender communities.

Third, the Model Law does not say what the new birth certificate should look like after the proper documentation is submitted. Ideally, the state would create a new birth certificate that reflects the amended gender, and some states do this. However, other states simply change the existing birth certificate, issuing one that shows the previous gender, while others designate on the new birth certificate that the gender has been changed. These approaches out transgender people whenever birth certificates are used to verify their identity.

NCTE’s Proposal:

An updated version of the Model Law is currently being developed by a group of state officials coordinated by the National Center for Health Statistics (a part of the CDC). NCTE and allies have been advocating with NCHS to change this outdated and restrictive policy about amending birth certificate sex designation. Specifically, NCTE has suggested that NCHS make three changes in its revisions of the Model Law based on approaches developed by some states and federal agencies.

  • The revised Model Law should allow people to change the sex designation on their birth certificate by submitting the required documentation directly to the vital statistics agency, rather than requiring a court proceeding. This will eliminate the unnecessary costs and other obstacles sometimes associated with going through the state court systems.
  • The revised Model Law should not require proof of specific medical procedures in order to amend birth certificates. Instead, the Model Law should reflect contemporary standards of care, and require only that an individual’s physician certify that the individual has completed the treatment the physician deems necessary to achieve gender transition. This change would recognize that different people have different medical needs, and avoid disclosure of any confidential medical information.
  • The revised Model Law should make clear that a new birth certificate should be issued after an individual presents the proper documentation, rather than a birth certificate that shows the original gender designation or states that the gender has been changed.

These recommendations reflect a growing trend in state and federal policies. The Department of State modernized its policy on passports in 2009, and the policy for “Consular Reports of Birth Abroad,” which are federal birth certificates for U.S. citizens born outside of the U.S., also no longer requires proof of surgery. Recent legislation in Vermont adopted the same approach for that state’s birth certificates, and a similar bill is being considered in California.

NCTE will continue to advocate for these changes in the new Model Law, and support the work of activists at the state level. Ensuring that transgender people are able to change their identity documents to reflect their gender identity is a major priority for NCTE.

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10 Responses to Policy Brief: Birth Certificate Gender Markers

  1. Ant says:

    Ive been waiting for this to happen. i knew there was a reason Ive been waiting to change mine after surgery. I just do not feel like Vitals front line staff should be able to violate all of my HIPPA rights. If the passport agency has changed their laws then I think respectively all other agencies should get the drift and follow suit

  2. Karla says:

    This is just WRONG! I strongly feel that the way you were brought into this world is WHAT IT IS! You can’t go back in the past and change things, so why is it okay to do it now? Transgender or not…you ARE what you were made! Not what you want to be!

    • Leslie Gray says:

      With all due respect, you are of course entitled to your opinion, just like everyone else, you are also free to voice that opinion. That means that you also have to listen to the replies of others when they exercise their right to free speech. That being said….I’d really like for you to try to live for one month, no make that one week, you wouldn’t last a month, being in the wrong gender.

      Try waking up every single morning for your entire life knoning that your friends went on to be the gender they felt like they belonged in when they hit puberty, but somehow your body took a wrong turn. You grew breasts when you felt like you should not have. Or,in my case, you didn’t when you really knew you should.

      Since you were big enough to know that there was a part of the anatomy that made you different from your brother or sister. You just knew you were going to grow up to look like Mom or Dad, only when the time came for that part of your growth to begin your body betrayed you. You went the wrong way.

      It’s like being forced to eat meat, when you know you should be a vegetarian. Everytime you look in a mirror, that revolting thing looks back at you. Oh, you sort of get used to it after a while, almost. Then, you start getting these urges, desires.

      The internal image of your body has always been at odds with the outward reality and you ignored it. Now, your body wants to reproduce. Your biological mechanisms are running full tilt and you want a…hey wait a minute. I’m a man / woman, why do I want this partner when I should have that partner? What’s wrong with me?

      Many of us don’t survive that experience. Suicide among trans kids runs painfully high in this country. I barely survived my own experience. As it is, I was beaten severely and went into hiding, into the closet for the years when I needed to get medical treatment and help. Now, I’m facing those early days in my 50′s.

      You’re afraid of what you don’t understand. You want to hate us because you don’t understand us. That’s OK, we understand. Most of us are afraid of you too. The difference here is that we’re not trying to throw stones at you for being heterosexual.

      So, answer one question if you would. If you hate us and think that we should be forced to stay the way we are, then why are you reading and posting on this site?

      • . . . Suicide among trans kids runs painfully high in this country. I barely survived my own experience . . .

        Just sharing what someone I know has experienced. Suicide is intentionally induced via ‘Soul Loss’ or an electronically caused effect to simulate the same. Many are aware of the loss, but attribute it to ‘differences’ induced by hormones or the SRS itself. There is no need to spiritually/psychologically punish simply because they are different. This is an abuse of nature’s expressions. No being is truly male or female, especially on the energic and soul level. The physical attempt to match results in the so called TG or shemales revoled by the fundos of any faith or the fundos aming the psychiatric establishment who butcher with pills.

    • Melissa says:

      Frankly I don’t see what it is to you. If it makes a person happier with their life and Big Brother has an updated recording of their present gender, what do you care? You’re not God and you don’t run the planet! My experience with people is when people like you are obsessed with trying to run someone else’s life, it’s usually a sign you don’t have much of a handle on you’re own!

  3. Christian Poulsen says:

    As one who has lived a life of miracles and identified as transgender about 1957 I am thankful for and applaud all the efforts that are being made in our behalf.
    When I was originally diagnosed about 1957 (I nearly died from kidney failure- University of California San Francisco brought me back) the philosopy was that as a child is raised so that child will become. When I came to in the hospital the doctors were already discussing a transition program for me. But my father turned his back, said “You want to be a woman?” and left the room! I was then placed in a boy’s school under what is now known as full standards of care (Psychiatric, medical, and counseling) for three years.
    Thank God for the church, the psychiatrist, female teachers, and others who pulled in around me to keep me alive! I determined to fight. I started researching medicine, nutrition, psychology, etc. to stay alive!
    I nearly died two other times and was the subject of four major medical studies before I finally started transition. I have GID and a hormone imbalance. My health has come back incredibly well. Transgender is defintely a medical condition and is fraught with many difficulties and tremendous medical expenses (most of my medical care has been considered “experimental”- not covered by any insurance)
    I am now under the capable care of Dr Jennifer Ann Burnett (Dr.Jen’s Page) and Dr. Sallie Hunt- Thank God for them! I now working through the process of transition with my wife and family. Prayers are appreciated!

  4. katkat says:

    Does anyone know which states now have Birth Certificate Gender Marker Change policies that align with NCTE/WPATH standards, and links to those policies? Thank you in advance for your information!!!

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