Massachusetts ends surgery requirement for legally changing gender on birth certificates

Last modified: Monday, August 24, 2015

At one time, whenever trans-individuals applied to change their gender on their birth certificates, they were required to hand over a document containing proof that they underwent surgery.

That document can now be tossed out in Massachusetts, according to the Gay and Lesbian Advocates and Defenders of New England.

As of Aug. 1, the Commonwealth of Massachusetts enacted a decisive change in the law concerning legal amendments to birth certificates as a result of permanent sex reassignment. Whereas proof of surgery was once required for the purpose of successfully changing one’s gender on birth certificates issued in Massachusetts, GLAD representative Carisa Cunningham confirmed Thursday that surgery is no longer a prerequisite.

Massachusetts now joins Connecticut, Rhode Island, Vermont and Washington, D.C., as well as five other states in updating the application process by which trans-individuals can obtain a birth certificate that properly states their gender identity.

GLAD, based in Boston, worked with advocates and policymakers in Massachusetts and the rest of New England to ensure that the policy change was carried out, Cunningham said.

Jennifer Levi, director of GLAD’s Transgender Rights Project, pointed out that the policy change is positive for those who identify as transgender, particularly because the initial requirement denied recognition to those who did not have medical need or otherwise could not afford the procedure.

“This is a critical advance for the Commonwealth’s transgender citizens,” Levi said. “When transgender people cannot get identity documents that accurately reflect a person’s gender identity, we are vulnerable to discrimination, harassment, and violence.”

Genny Beemyn, director of the Stonewall Center at the University of Massachusetts Amherst, expressed a similar reaction when reached Friday afternoon.

“It is a long overdue step and will help many trans-people who cannot afford or who are not interested in surgery be able to have their birth certificate and other documents that rely on a birth certificate match how they identify themselves,” Beemyn said. Beemyn is also the coordinator for Campus Pride Trans Policy Clearinghouse, an online resource for transgender policies at colleges and universities nationwide.

Mount Holyoke College President Lynn Pasquerella said that, as a “medical ethicist,” she was pleased to hear about the recent policy change. She noted that the American Medical Association, which has offices spread along the east coast, adopted a new policy last summer that favored the elimination of any government standard that an individual must have undergone surgery in order to change the sex as displayed on a birth certificate.

“Their recommendation was based on the principles that such a requirement is inconsistent with current medical standards and imposed burdens for already marginalized individuals,” Pasquerella said. “The requirement also carried the potential for creating burdens around disallowing access to treatments and screening procedures for those whose legal identity does not conform to their gender identity.”

She added that the World Health Organization also endorsed the changes as exemplified in the Massachusetts policy change. By taking out the surgery requirement, Pasquerella said, the decision by the state of Massachusetts is now “consistent with recommendations by both the American Medical Association and the World Health Organization.”

Cunningham said that the forms and instructions for requesting a gender marker change were updated Aug. 19 on the Commonwealth’s website. She added that while proof of surgery is now exempt as a requirement from the application, applicants must still provide a notarized physician statement indicating that they completed medical intervention to permanently reassign their gender.

Cunningham clarified that any treatment appropriate for gender transition — surgical or hormonal, for instance — qualified as medical intervention.

In addition to the notarized statement, the updated forms state that applicants must fill out an affidavit and provide a court-certified copy of the legal name change decree, as well as some form of payment to cover the amendment fee.

GLAD plans to issue an updated “tool kit” — a clear step-by-step list of instructions — on their website to further aid Massachusetts-born citizens who wish to amend their birth certificate on account of permanent sex reassignment. Cunningham added that interested applicants seeking further information about the policy change should reach GLAD Answers at either 800-455-GLAD or


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