44 states in Washington DC allow gender change on birth certificates. Six states don’t allow change.

As of 20 2644 US states in Washington DC allow individuals to change the gender marker on their birth certificates. They require requirements and processes very heavily by jurisdiction. Only six states Florida, Indiana, Kansas, Oklahoma, Tennessee, and Texas prohibit gender marker updates entirely. The legal requirements for the 44 states that permit updates generally fall into three categories. They can self change it with no medical proof needed.. The second one is medical provider certified required, which is a doctor therapist or counselor no surgery required.. the third is court order and or proof of surgery required.