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Requirements for trans people to alter the sex on their birth certificate in the United States and its colonies as of March 2016.

Legend:

  • Purple: SRS not required. (California, Utah, Wyoming, Guam, US Virgin Islands, Northern Mariana Islands, Mississippi, Indiana, Missouri, New York, Vermont, New Hampshire, Washington DC, Michigan, Washington, Oregon, South Dakota, Minnesota, Iowa, New Jersey, Connecticut, Maryland)
  • Purple with black bars: Although the law requires “an operation” to have occurred, this does not have to be SRS. (Illinois)
  • Pink: SRS required for sex marker change. (Alaska, Hawai’i, Montana, North Dakota, Wisconsin, Maine, Massachusets, Rhode Island, Pennsylvania, Delaware, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Alabama, Louisiana, New Mexico, Arizona, Nevada, Colorado, Nebraska, Kentucky, Arkansas. Oklahoma)
  • Pink with black bars: Some officials have refused to amend the sex on birth certificates to reflect a sex change after the ruling Littleton v. Prange; however, a judge can order an amendment. (Texas)
  • Red: Can not change sex on birth certificate. (Idaho, Ohio, Kansas, Tennessee, Puerto Rico, American Samoa)