Recognition (USA)

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It is estimated that there are over 450,000 nonbinary individuals in the United States of America, although totally accurate numbers are difficult to ascertain. This article gives information on recognition of nonbinary gender identities in law, government, services, and businesses in the USA. This also deals with policies about transgender people in general, and related policies about intersex people. Recognition here means whether an organization acknowledges that such people exist and have valid identities, and the organization does this by routinely giving them a place where they aren't forced into being wrongly categorized as a gender that doesn't match their gender identity. In the case of recognition of nonbinary people, this means the system doesn't force them to wrongly say they are one of the binary genders (female or male).

How to use

When adding to the tables, please note all sections are in alphabetical order, as are the entries within them. Here is an explanation of the columns and the color code in most of the tables on this page.

Color code for each cell in the below tables:

• green (#9f9) means it doesn't ask for this information at all. This is ideal because it doesn't need to be changed, won't make a mismatch with other paperwork, and is no trouble.
• blue (#9ff) means it offers a write-in field. This is good because it acknowledges the existence of nonbinary people, but it can make a mismatch with other paperwork.
• yellow (#ffb) means it asks but answering it is optional. For a title, this means it lets you leave it blank. For a gender, this means it lets you leave it blank, or select an option called "none", "prefer not to state", or "unspecified". This doesn't acknowledge the existence of nonbinary people and can make mismatches with other paperwork, but it's better than otherwise.
• purple (#f9d) means it has a mandatory selection but gives some gender-neutral options, which may even acknowledge the existence of people who are nonbinary or intersex. For a title, this means the available options include not only Dr but Mx. For gender, it acknowledges that there could be other genders than female or male, giving options such as "other" or "intersex". This acknowledges the existence of nonbinary people, which is good, but requires you to be either out or closeted, and can create mismatches with other paperwork, which is trouble.
• red (#f99) is mandatory selection, without gender-neutral options. For a title, the only remotely gender-neutral titles it offers are things such as "Dr". For a gender, it only allows only female or male. This is the worst because it is nonbinary erasure. Activists need to let the organization know it can be more inclusive.
• white background means we don't have information about this yet, or some other situation (describe)

Columns in the table:

• Title is for title selection. Does the organization's paperwork require you to give a title such as Dr., does it let you leave it blank, or does it let you write in gender neutral titles such as Mx?
• Gender is for explicit gender (or "sex") selection. Does the organization's paperwork require you to say what gender you are, or doesn't ask? If it does, are you limited only to female and male options, or does it offer more options, or can you write in something else?

Ideally, please include a link to evidence, such as a screenshot or scan of the paperwork, with personal details blacked out, or cite a source.

Businesses

This section is for kinds of businesses other than listed elsewhere on this page. Please add to this section.

Planet Fitness in Richmond, CA is willing to let individuals "choose" which of the two binary locker rooms they would like to use.

As of 2019, United Airlines passengers "now have the ability to identify themselves as M(male), F(female), U(undisclosed) or X(unspecified), corresponding with what is indicated on their passports or identification."

Charities

Charitable organizations. Please add to this section.

Education

See Educational bodies (USA).

Finance

Banks, credit unions, and other financial institutions.

Organization	Title	Gender	Notes
BECU (credit union)			Doesn't print title on debit or credit card.
BMO Harris (bank)			"True Name" initiative enables customers to have their chosen name on the their cards
Capitol One (bank)			Doesn't print title on debit or credit card.
Chase (bank)			Doesn't print title on debit or credit card.
Mastercard			"True Name" initiative enables customers to have their chosen name on their cards
SunTrust (bank)			Doesn't print title on debit or credit card.
Wells Fargo (bank)			Doesn't print title on debit or credit card.

Employment

See also our page on Employment.

In general, employment discrimination laws regarding gender identity and LGBT identity vary by state. See Wikipedia: Legal aspects of transsexualism in the United States - Employment discrimination.

Private employment agencies

Public employment agencies (the Department of Labor, the "unemployment agency") would be not in this section, but the section for state government and the federal government.

Organization	Title	Gender	Notes
RobertHalf OfficeTeam (office temping agency)	Doesn't ask	Doesn't ask

Government

Federal and state governments

Official documents of identity

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Legal requirements each state has for altering the sex on one's birth certificate. Lavender: State does not require SRS to alter sex on the birth certificate Green: Altering sex on birth certificate requires SRS Red: State does not alter sex on birth certificates for transsexuals

The procedure each state uses to alter the sex on one's birth certificate. Blue: New birth certificate is issued with the correct sex designation Lavender: Old birth certificate is amended to correct sex designation Red: State does not alter sex on birth certificates for transsexual people

In the USA, official documentation such as driver's licenses, passports, and birth certificates all show an M or an F only. Only one person in the USA has managed to get a different gender marker than M or F, who was an adult intersex person who asked for theirs to say "hermaphrodite." Currently, even changing one's gender marker from M to F or vice versa is difficult. Some states require proof of surgery (meaning a letter from the surgeon, or from a doctor who has examined the person) to change the gender marker on the identification, some states don't, and some states don't allow the gender marker to be changed at all.

Activism for nonbinary and intersex people-- and transgender people of all kinds-- should ask for these forms of identification to allow another gender marker, such as X, and to be able to change one's gender marker more easily, without proof of surgery or other paperwork. Or better yet, activism should ask for these forms of identification to stop recording sex or gender entirely, because there are better ways to identify people now. That would make life and paperwork safer and easier for transgender people of all kinds.

In the tables below, this section uses a slightly different color code and column labels than the rest of this page, though still loosely based on traffic lights:

• blue (#9ff) means it's routinely friendly to transgender, intersex, and nonbinary people. In the column labeled "gender" (or "sex," if that is the term used on that document), this would mean it doesn't ask for gender information at all, or gives an option not to give the information, or gives an option other than M or F. In the column labeled "change," it lets you change your gender marker without proof of surgery.
• yellow (#ffb) means it has only rarely or with great difficulty been friendly to transgender, intersex, and nonbinary people. In the column labeled "gender," there have been rare cases where someone managed to get a gender marker other than M or F. In the column labeled "change," changing one's gender markers requires proof of surgery.
• red (#f99) means it's not friendly at all to transgender, intersex, and nonbinary people. In "gender," this means it requires everyone to choose M or F. In "change," this means it doesn't let anyone change their gender markers.
• white background means we don't have information about this yet, or some other situation (describe)

Birth certificate

In the USA, most states issue birth certificates with an M or F only, with the limitations described above. Birth certificates call their gender markers "sex" rather than "gender," and the legal definition they use for this is defined by the past or current condition of the genitals, as determined by an examination from a doctor. With this term, defined in this way, it will be difficult to get officials to recognize gender identity with no relation to genitals, or nonbinary gender identity in people who aren't intersex, or even in people who are.

State	Sex	Change	Notes
Alabama	M or F only	Requires proof of surgery to change sex designation.
Alaska	M or F only
Arizona	M or F only	Requires proof of surgery to change sex designation.
Arkansas	M, F, or X	No documentation needed
California	The first state to allow a third option, "nonbinary," on birth certificates, starting when SB 179, or the Gender Recognition Act, was signed into law on October 15, 2017.	Allows change without a hearing upon request.
Colorado	M or F only	Requires proof of surgery to change sex designation.
Connecticut	M or F only	Allows people to change sex designation, no proof of surgery required.
Delaware	M or F only	Requires proof of surgery to change sex designation.
District of Columbia	M or F only	Allows people to change sex designation, requiring only a letter from a doctor, not surgery.
Florida	M or F only	Requires proof of surgery to change sex designation.
Georgia	M or F only	Requires proof of surgery to change sex designation.
Hawaii	M or F only	Requires proof of surgery to change sex designation.
Idaho	M or F only	Doesn't allow anyone to change sex designation.
Illinois	M or F only	Requires proof of surgery to change sex designation.
Indiana	M or F only	Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.
Iowa	M or F only	Requires a doctor's proof of "surgery or other treatment [so that] a sex change has occurred" to change sex designation.
Kansas	M or F only	Doesn't allow anyone to change sex designation.
Kentucky	M or F only	Requires proof of surgery to change sex designation.
Louisiana	M or F only	Requires proof of surgery to change sex designation.
Maine	M, F, or X	Requires an "individual notarized affirmation that the change is made to align the record with their gender identity." Name on birth certificate can only be changed at the same time as the gender marker change.	"At the time of birth, parents may opt to have a nonbinary designation on the [baby's] birth certificate."
Maryland	M or F only	Requires proof of surgery to change sex designation.
Massachusetts	M or F only	Requires proof of surgery to change sex designation.
Michigan	M or F only	Requires proof of surgery to change sex designation.
Minnesota	M or F only	Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.
Mississippi	M or F only	Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.
Missouri	M or F only	Requires proof of surgery to change sex designation.
Montana	M or F only	Requires proof of surgery to change sex designation.
Nebraska	M or F only	Requires proof of surgery to change sex designation.
Nevada	M or F only	Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.
New Hampshire	M or F only	Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.
New Jersey	M, F, or undesignated/nonbinary. The latter became available on February 1, 2019, making this the 6th state to offer nonbinary birth certificates.	In 2019, proof of medical transition or surgery is no longer required to change your birth certificate in this state.
New Mexico	M or F only	Requires proof of surgery to change sex designation.
New York	"X" available on birth certificates since 2019.	Allows people to change sex designation, requiring only a letter from a doctor, not surgery.
North Carolina	M or F only	Requires proof of surgery to change sex designation.
North Dakota	M or F only	Requires proof of surgery to change sex designation.
Ohio	M or F only, with only one case to the exception: an adult intersex person won a lawsuit to change their birth certificate to say "hermaphrodite."	Doesn't allow anyone to change sex designation.
Oklahoma	M or F only	Requires proof of surgery to change sex designation.
Oregon	M or F, with one exception where a birth certificate was changed to say "Nonbinary"	Allows people to change sex designation. Applicant must have undergone surgical, hormonal, or other treatment appropriate for that individual for the purpose of gender transition and that sexual reassignment has been completed. Surgery not required. Doctor letter may be required by a specific judge, though this is uncommon.
Pennsylvania	M or F only	Requires proof of surgery to change sex designation.
Rhode Island	M or F only	Requires proof of surgery to change sex designation.
South Carolina	M or F only	Allows people to change sex designation.
Tennessee	M or F only	Doesn't allow anyone to change sex designation. Furthermore, "this is the only state that has a statute specifically forbidding the correction of sex designations on birth certificates for transgender people."
Texas	M or F only	Allows people to change sex designation.
Utah	M or F only	Allows people to change sex designation.
Vermont	M or F only	Allows people to change sex designation, requiring only a letter from a doctor saying they've had a transition, not strictly surgery.
Virginia	M or F or X since July 1, 2020.	Allows people to change sex designation, requiring only a letter from a Gender Designation Change Request signed by a physician, psychiatrist, nurse practitioner, clinical social worker, psychologist, or professional counselor, certifying the applicant's gender identity.
Washington	M, F, or X, since January 27, 2018, per rule WAC 246-490-075.	Allows people to change sex designation on birth certificate. Since January 27, 2018, per rule WAC 246-490-075 requires only "the appropriate Sex Designation Change request form. A court order or a letter from your physician will not be accepted."
Wisconsin	M or F only	Allows people to change sex designation.
Wyoming	M or F only	Allows people to change sex designation.

Driver's license

In the USA, driver's licenses in most states can show an M or F only, with the limitations described above that apply to all official documents. As with birth certificates, the gender marker on driver's licenses is called "sex" instead of "gender." All U.S. states allow the gender marker to be changed on a driver's license, although the requirements for doing so vary by state. Often, the requirements for changing one's driver's license are less stringent than those for changing the marker on the birth certificate. This can create conflicts between documents, because sometimes a person is allowed to change their marker on one document, but not the other.

State	Sex	Change process	Notes
California	M, F, or "nonbinary," which became available on driver's licenses in October 15, 2017.
Colorado	Starting November 30 2018, drivers licences and ID cards can have an M, F, or X marker.	Must have a DR2083 Change of Sex Designation form with a signature from their medical or behavioral healthcare provider. No specific surgery or other treatment is required.
Hawaii	"Starting July 1, 2020, Hawaii will update the gender marker on a Hawai’i ID to male, female, or X upon self-attestation by the applicant of their gender, no medical documentation required."
Massachusetts	M, F, or X options since November 2019
New Hampshire	M, F, or X options since January 1, 2020
Oregon	M, F, or X. The X became available on driver's license forms on 2017-07-01.
Pennsylvania	"X" gender designation available starting July 2020.	Fill out a form and bring it to DMV in person. No medical or social service documentation is needed.
Washington DC	M, F, or X (X available since June 2017)
Washington state	M or F only.

Passports

In the USA, passports show an M or F only, with the limitations described above that apply to all official documents. The State Department determines what identifying biographical information is placed on passports. In 2010, they began to allow permanent gender marker changes to be made with a letter from a doctor saying that "the applicant has had appropriate clinical treatment for gender transition to the new gender," and no longer requires proof of surgery.

Military ID

Military retiree ID cards provide an option for photo ID for some transgender people, as they don't display gender on them. However, these cards are only available to those who served in the military, and not accessible to all transgender people.

Social Security card

Social Security cards are one of the few government-issued IDs that do not list gender on them. However, the Social Security Administration keeps a record of gender. Current policy holds that surgery is not required to change that gender record. Instead, the Administration will accept a full-validity U.S. passport, a state birth certificate showing the new gender, a court order ordering legal recognition of the new gender, or a doctor's letter saying that the person "has had appropriate clinical treatment for gender transition to the new gender."

Marriage certificates

Massachusetts

Marriage certificates at the City of Cambridge in Massachusetts ask for binary sex, but by special permission, this can be left blank, so the marriage certificate has no gender on it.

Voting

Transgender disenfranchisement is the practice of creating or upholding barriers that keep transgender people from voting. One way this happens is by requiring that people need to show ID to vote. That makes problems for transgender people who have mismatches on the gender markers on their ID. For nonbinary people, in particular, they may be limited to forms of ID that don't show a gender marker, such as Social Security cards (which some states don't accept as ID) or military retiree ID cards (which some people don't have and perhaps can't get). Some states let people prove their identity by showing a utility bill, which doesn't show gender, assuming the bill doesn't address the customer by a gendered title. See Wikipedia:Transgender disenfranchisement in the United States for more about this transgender rights issue.

Housing

In general, laws regarding housing discrimination for gender identity and LGBT people vary by state. See Transgender rights in the United States on Wikipedia.

Medical

Clinics, hospitals, health insurance. Please add to this section.

Health insurance

See the article Health insurance for more on this topic.

Many kinds of health insurance don't cover transgender-related healthcare (meaning hormone therapy and surgery). However, in some states, insurance is required by law to cover it:

• California (April 2013)
• Colorado (March 2013)
• Connecticut (December 2013)
• Illinois (July 2014)
• Massachusetts (June 2014)
• New York (December 2014)
• Oregon (January 2013)
• Vermont (April 2013)
• Washington state (June 2014)
• Washington D.C. (February 2014)

The Human Rights Campaign (HRC) maintains a list of health insurance companies and their relevant policies: "Finding Insurance For Transgender Related Health Care."

However, even with coverage, many insurance companies will misgender clients on ID cards, websites, and promotional mailings (such as those offering a discount for getting a certain medical procedure).

Many medical records use M or F markers and contain all aliases, and even in trans-centric places like the Lyon-Martin Clinic, paperwork is labeled by legal gender marker and a (T) for transgender when applicable. These markers and names often print on medical ID bracelets, including emergency rooms, hospitals, and in-patient psychiatric wards. At least one hospital, Sutter General in West Oakland, is willing to prevent deadnames from printing to ID bracelets upon formal request through the patient complaint customer service phone line; however, it was not willing to remove the gender marker.

Additionally, even without medical records, ambulances and hospitals tend to pick a gender marker based on how they interpret a person to look, without asking. And even in emergency rooms with a fill-in-the-blank option for gender, staff and records tend to completely ignore this altogether.

Blood donation

The American Red Cross Blood Services does not ban transgender or nonbinary people from donating blood/platelets/etc, and they recognize the existence of various nonbinary genders. However, donors must self-identify themselves as either male or female; this is required by the FDA.

Shopping

Supermarkets, stores, and other kinds of shopping in the USA. Please add to this section.

Utilities

Utilities such as power, gas, electricity, water, and communications. Please add to this section.

Veterinary

Animal and pet clinics and hospitals. Please add to this section.

Websites

Websites and online services specific to the USA, other than those listed elsewhere on this page. Otherwise, see websites and social networks, which is international. Please add to this section.

See also

• Recognition (Canada)
• Recognition (UK)

External links

• Intersex & Genderqueer Recognition Project "is the only legal organization in the United States addressing the right of non-binary adults to gender-self-identify on legal documents. [...] IGRP's goal is to allow non-binary adults to self-identify as something other than male or female on their driver’s license, passport, and other government-issued identification."
• Movement Advancement Project: Identity Document Laws and Policies
• Lamda Legal: X Gender Markers by State