Will They Strike Surgery Out Of The Requirements?

Those of us who live in New York City often decry our state's lawmakers, who tend to be more socially and politically conservative than their counterparts here in the Big Apple. "Those upstate Republicans" in the state Senate are, in our view, responsible for everything retrograde that burdens our city and state.

For example, they spent decades blocking the inclusion of language that would extend the provisions of the state's non-discrimination laws to transgender people.  The same year they first rejected such a proposal--1971--they also passed the Urstadt Law, which took away the City's power to pass local rent regulations more stringent than those of the State.

But there's one city-state discrepancy that can't be blamed on the "upstate Republicans":  If you were born anywhere in New York State except for the five boroughs of New York City, you can change the gender on your birth certificate on a recommendation from your doctor, psychotherapist  or, in some cases, other health-care professionals whose services you used.  On the other hand, if you were born in the Bronx, Brooklyn, New York (Manhattan), Queens or Richmond (Staten Island) counties, you have to undergo gender-reassignment surgery.

The five boroughs of New York City constitute one of the 57 jurisdictions in the US that has responsibility for its own birth registration.  Most of those jurisdictions are states, and someone applying for a change in his or her birth certificate (or, in some states, a new one)  would write to the state's commission of health or its equivalent. Most states require proof of GRS or an equivalent procedure (as Georgia, where I was born, does); a few (including California, Oregon, Rhode Island, Vermont and Washington DC) do not and a few other states (Idaho, Kansas, Ohio and Tennessee) will not change the gender on a birth certificate for any reason.

So, interestingly, I had about the same experience in getting my new birth certificate from Georgia that I would have had if I'd been born in New York City.  To be fair, the folks in the Peachtree State processed my application quickly and I had my new birth certificate within days. 

I don't know how quickly or slowly the  process works here in the Big Apple. But it would almost certainly go more smoothly--and be easier on the applicant--if transgender advocates' testimony at a City Council Health Committee hearing the other day have any effect.  They are calling for passage of a proposal that would eliminate the requirement for surgery, and Gretchen Van Wye, Assistant Commissioner of the Bureau of Vital Statistics spoke in favor of such a legislative move.

The City Council could vote on the proposal by the end of this year.

Dignity In Death

Too many trans people face the dilemma of being defined by a document issued when they were born while they are living their lives their true selves.

I was in such a dilemma for several years:  I was living as Justine, a woman, but my birth certificate still said I was a boy named Nicholas.  That could have been problematic had I had a medical emergency or worse.  After all, I could have been buried as a man. (On top of that, I don't think I want to be buried.  But that's another story altogether.)

For too many trans people, the obstacles involved in changing their birth certificates are prohibitive.  In some states and countries, the procedure is endless and expensive.  And, in many jurisdictions, changing birth certificates for any reason is simply not allowed.

That is why I was gratified to read about this latest development from California:

Sacramento, CA – The Respect After Death Act (AB 1577), authored by Assembly Speaker-elect Toni Atkins and sponsored by Transgender Law Center and Equality California, passed the Assembly Health Committee today by a bipartisan provisional vote of 17-1. The bill is designed to help ensure transgender people have their authentic gender identity reflected on their death certificates.




The Respect After Death Act will mean that death certificates reflect the authentic lived gender of the deceased, with various forms of proof accepted under the law, including written confirmation of the deceased’s wishes, updated birth certificates and driver’s licenses, or medical records of gender transition.



“Transgender people deserve the same dignity and respect in death as everyone else,” said John O’Connor, executive director of EQCA. “This bill provides much needed legal guidance that



“Every person deserves to be treated with dignity after their death, including having their death certificate accurately reflect who they are,” said Speaker-elect Atkins. “AB 1577 will provide direction to officials for determining the wishes of the deceased with respect to their gender identification. I am grateful for the strong bipartisan support of my colleagues on the Assembly Health Committee.” will make it easier for authorities to do their jobs. It also ensures that when California remembers transgender people who have passed, it remembers their authentic selves.”



Current law requires death certificates to list personal data such as name, sex, and race, and there is no legal guidance about how the official filling out the death certificate should determine a transgender person’s sex. The lack of guidance sometimes results in cases where the information on the death certificate is not consistent with the deceased’s lived gender. This can put funeral directors and coroners at risk of liability if the friends and family of the deceased believe that they listed the incorrect sex.



“Too often, the identities of transgender people are disrespected, especially when we are unable to speak for ourselves. Gender identity represents a core part of who we are as people and this identity should be recognized even upon our deaths,” said Masen Davis, executive director of Transgender Law Center. “When a loved one is not honored as their authentic self upon their passing it is extremely painful for the family, friends, and community.”

The Netherlands Regains Its Edge

As of this writing, Argentina remains the nation with the most enlightened laws regarding gender identity.  Essentially, any Argentinian 18 years or older can live in whatever gender he or she chooses.  There are no prerequisites: no hormones, no surgery, not even a third-party recommendation or consent.

A year and eight months have passed since Argentina's ruling.  Since then, the United Kingdom, Austria and Portugal have done away with the requirements for hormones, surgeries or other medical or psychiatric interventions in order to change the gender marker on a person's identification documents.  A German court has ruled in favor of a similar policy.

Perhaps not surprisingly, the Netherlands is about to join them.  Like their European counterparts--and unlike Argentina--the Netherlands will require expert testimony attesting to the applicant's long-held conviction that he or she is of a gender different from the one to which he or she was assigned at birth.  The Dutch will, like the other nations mentined, not require any medical, pharmacological or psychiatric procedures or treatments.  One way in which the Dutch have parted company with those nations, though, is that a person has to be only 16 years old in order to make the changes.

I began my previous paragraph with "Perhaps not surprisingly" because, for one thing, the Netherlands was the first nation to legalize same-sex marriage.  Perhaps even more relevant is the fact that in 1985, it was one of the first nations to pass legislation enabling transgender people to change their registered gender.  In the ensuing quarter-century, the laws have lost some of their edge as understanding of what it means to be transgendered has advanced in the medical, legal and academic communities as well as among the general public.  So, apparently, the Dutch figured it was time to make the changes to reflect that knowledge as well as their changing understanding of human rights laws.

Documenting Us

Nearly all of us who are gender-variant have faced, at one time or another, this dilemma.

We apply for a job, to school or for benefits.  We have been taking hormones, living by the gender of our minds and spirits and have, in various ways, changed our appearance, style of dress and demeanor to reflect that gender.  And we've changed our names.

So we have driver's licences, passports and other IDs with our new names and photos of ourselves.  But there's one problem:  the "M" or "F" box still reflects what we presented to the world before our changes.

If we're lucky, the person who asked for our documents is confused.  If we're not, we face ridicule, discrimination and even violence. Either way, we've been "outed" and are forced to explain our stories to audiences that can be none-too-sympathetic.

A cisgender person does not have to so explain him or herself to go to school, get a job or benefits or even to rent or test-drive a car.  So why should we be expected to do that?

At least the author of this article seemed to understand, to some degree, our dilemma.  But the comments were full of people trying to sound snarky but who ended up looking stupid and/or hateful. I mean, who changes his or her gender to commit identity fraud, hijack planes or commit other crimes.  Because there is a "paper trail" (or, perhaps, digital footprint) of our transition, we would be easier to track than most other people.

Some states and municipalities--including, thankfully, the ones in which I live--have come to understand what I've just said, and have changed policies accordingly.  But there are still three states--Idaho, Tennessee and Ohio--that won't change the gender on a birth certificate, even after a person has had gender reassignment surgery. 

I can see that progress has been made even during the time of my own transition.  But, as I can also see, there is still much to be done.    

Surgery Not Required In Ontario

In the Canadian province of Ontario, it is now possible for a person to change the gender as well as the name on his or her birth certificate, even if he or she hasn't had gender reassignment surgery.

This change in policy stems from an April ruling from the province's Human Rights Tribunal in the case of a born-male woman known as "XY" .  The Tribunal declared the surgery requirement to be discriminatory. Furthermore, the Tribunal's ruling said that the requirement added to the stigma felt by members of the transgender community, and reinforced stereotypes about how they experience gender.

I am of two minds about this ruling.  On one hand, I am glad that the requirement for surgery has been eliminated, and would like to see American states similarly change their policies.  The surgical requirement discriminates against those who can't afford surgery or can't have it for medical reasons. It also, as the Ontario tribunal's ruling notes, reinforces the gender binary.  We are now learning that gender identity is not merely "performative," genital or chromosomal; it is far more complex, and complicated than almost anyone realizes.  That means, of course, that there are far more than two ways to experience, much less express, gender.

Dropping the surgical requirement will also make it easier for many people, especially young trans folk, to gain admissions to schools, jobs, housing and many other actual and de facto necessities of life.  Someone who does not have those things, and can find no other option but a homeless shelter and other public assistance, will be assigned to a shelter and given benefits according to whether the "male" or "female" is indicated on the birth certificate.

On the other hand, as a friend of mine says, a birth certificate is part of an accurate record of a person's history. This friend, who is transitioning, does not want to change the gender, or even the name, on the birth certificate. The birth certificate records the gender of the body into which a person is born and the name given at the time of birth.  My friend believes that these are a vital part of a life history.

I can sympathise with this friend's feelings, and feel that if anyone who doesn't want to change his or her birth certificate, even after surgery, should have that right.   At the same time, I realize this friend is unlikely to change jobs and probably won't move until retirement from said job.  My friend will not therefore have to face the dilemma of having to start life with documents that don't match gender identity or presentation.

So, as I said, I am glad for the Ontario ruling and hope other Canadian provinces and American states--as well as other nations--follow suit.  But I also hope that no one is forced to alter his or her records after a transition and surgery.

Putting the "Lone" in "The Lone Star State"

Most states allow a transgendered person to get a court order to change his or her legal gender.  That court order can, in turn, be used to get a driver's license and other documentation with the person's "new" gender. It can also be used to get a marriage license.


Some states require that a person undergo Genital Reconstructive Surgery (GRS).  Others merely require certification from a doctor that the person suffers from Gender Identity Disorder (GID) or a related condition.  Here in New York, I was able to get such an order after obtaining letters from my doctor and therapist saying that I was receiving treatment, which included my therapy sessions and hormones.  That allowed me to get a non-driver's ID with an "F" in the space for "sex" before I had my surgery.


Texas was one of the last states in this country to provide such an avenue for transgendered people, having done so only two years ago.  Now some of that state's legislators are, in effect, trying to nullify it, at least in part, with a new piece of legislation.  


State Senator Tommy Williams and Representative Lois Kolkhorst have introduced a bill that would prohibit county and district clerks from allowing court orders recognizing sex changes to be used as part of the necessary documentation for obtaining a marriage license.  


If the legislation is passed, Texas would be saying, in effect, that a person's gender is assigned at birth and can never be changed, even if that person's mind and spirit are incongruent with it.   At least, that's what the state would be saying for the purposes of marriage.  And, because the Texas constitution defines marriage as being between one man and one woman, it would mean that, as an example, if I were living in Texas, I could marry only as a man, and that I couldn't marry anyone who is not a woman.  


Now, that may seem like an academic question for me, as I don't plan on getting married or living in Texas any time soon.  But, of course, that is a not-so-academic question for any number of transgender people living in the Lone Star state.  


But this development is most worrisome for an admittedly small (at least relatively speaking) group of transgendered Texans.  They are the ones who were married during the past two years.  If the bill is passed, what will happen to them?  Will their marriages be nullified?  


Ironically, Representative Kolkhorst authored the 2009 law that allows sex change documentation to be used in obtaining marriage licenses.  So far, she hasn't said why she wants to, in essence, reverse her own legislation.

It's A Girl Again!

Another "girl" was "born" today.


Or, more precisely, a girl who was born on 7 July 2009 became who she is, again.


Actually, the event happened a couple of days ago.  But I just got the official documentation of it today.


I'm talking about my birth certificate.  I know I should've had it changed a while ago.  But somehow it didn't seem as urgent as changing my passport or Social Security cared, or my state ID.  Those last three documents are the ones used in nearly all situations requiring personal identification.  However, I can't remember the last time I had to show my birth certificate.


On the other hand, I didn't know I would feel as good as I did about getting that new birth certificate.  When I said getting it didn't seem urgent, I was telling just part of the truth.  Something about changing my birth certificate seemed even more monumental (at least in my life) than changing those other documents.  After all, most people get new passports, driver's licenses or other government IDs every ten years.  Some people even get new Social Security cards.  However, most people get only one birth certificate in their lives.


Getting the new birth certificate was easier than I expected.  It turns out that Georgia, where I was born, actually has an easier process than many other states--including New York!  I had to send the following items to the Georgia Bureau of Vital Statistics in Atlanta:

• My old birth certificate
• A certified copy of Marci Bowers' letter certifying that she performed my surgery
• The court order for my name change
• A photocopy of my New York State ID and US Passport*, and
• A money order for $35.

I sent these items via Express Mail, and included a pre-paid Express Mail return envelope.  Today, ten days later, I received my new birth certificate.

It is a brand-new certificate.  I found out that many other states issue amended copies--in some cases, with the former name and gender visibly typed over.  And some other states won't change a person's name or gender at all.

Now I have an official Georgia birth certificate that records my sex as "female."  Does that mean I'm now officially a Southern Belle?  Well, maybe if I were a little bit more belle, I guess I could be one.