Recognition (USA)

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    An example driver's license with "Sex: X" issued by the state of New Mexico.

    It is estimated that there are over 450,000 nonbinary individuals in the United States of America[1], although totally accurate numbers are difficult to ascertain.[2] 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."[3]

    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[4][5]
    Capitol One (bank) Doesn't print title on debit or credit card.[6]
    Chase (bank) Doesn't print title on debit or credit card.[6]
    Mastercard "True Name" initiative enables customers to have their chosen name on their cards[4]
    SunTrust (bank) Doesn't print title on debit or credit card.[6]
    Wells Fargo (bank) Doesn't print title on debit or credit card.[6]

    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

    Text lines white icon.svg The contents of this page are outdated. You can help the Nonbinary Wiki by finding up-to-date information and completing it!
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    Legal requirements each state has for altering the sex on one's birth certificate. Dark purple: State does not require SRS to alter sex on the birth certificate
    Lavender: Altering sex on birth certificate requires SRS
    Red: State does not alter sex on birth certificates
    The procedure each state uses to alter the sex on one's birth certificate. Dark purple: 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

    In the USA, official documentation such as driver's licenses, passports, and birth certificates usually show either M or F. Currently, even changing one's gender marker from M to F or vice versa can be 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.[7]
    Alaska M or F only[8]
    Arizona M or F only Requires proof of surgery to change sex designation.[7]
    Arkansas M, F, or X[9] 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.[10] Allows change without a hearing upon request.[11][12]
    Colorado M or F only, with one exception where a birth certificate was changed to say "Intersex"[13] Requires proof of surgery to change sex designation.[7]
    Connecticut M or F only Allows people to change sex designation, no proof of surgery required.[7]
    Delaware M or F only Requires proof of surgery to change sex designation.[7]
    District of Columbia M or F only Allows people to change sex designation, requiring only a letter from a doctor, not surgery.[7]
    Florida M or F only Requires proof of surgery to change sex designation.[7]
    Georgia M or F only Requires proof of surgery to change sex designation.[7]
    Hawaii M or F only Requires proof of surgery to change sex designation.[7]
    Idaho M or F only Doesn't allow anyone to change sex designation.[7]
    Illinois M or F only Requires proof of surgery to change sex designation.[7]
    Indiana M or F only Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.[7]
    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.[7]
    Kansas M or F only Doesn't allow anyone to change sex designation.[7]
    Kentucky M or F only Requires proof of surgery to change sex designation.[7]
    Louisiana M or F only Requires proof of surgery to change sex designation.[7]
    Maine M, F, or X[14] 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.[15]

    		"At the time of birth, parents may opt to have a nonbinary designation on the [baby's] birth certificate."[15]
    Maryland M or F only Requires proof of surgery to change sex designation.[7]
    Massachusetts M or F only Requires proof of surgery to change sex designation.[7]
    Michigan M or F only Requires proof of surgery to change sex designation.[7]
    Minnesota M or F only Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.[7]
    Mississippi M or F only Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.[7]
    Missouri M or F only Requires proof of surgery to change sex designation.[7]
    Montana M or F only Requires proof of surgery to change sex designation.[7]
    Nebraska M or F only Requires proof of surgery to change sex designation.[7]
    Nevada M or F only Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.[7]
    New Hampshire M or F only Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.[7]
    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.[16] In 2019, proof of medical transition or surgery is no longer required to change your birth certificate in this state. [16][7]
    New Mexico M or F only Requires proof of surgery to change sex designation.[7]
    New York "X" available on birth certificates since 2019. Allows people to change sex designation, requiring only a letter from a doctor, not surgery.[7]
    North Carolina M or F only Requires proof of surgery to change sex designation.[7]
    North Dakota M or F only Requires proof of surgery to change sex designation.[7]
    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."[17] Doesn't allow anyone to change sex designation.[7]
    Oklahoma M or F only Requires proof of surgery to change sex designation.[7]
    Oregon M or F, with one exception where a birth certificate was changed to say "Nonbinary"[18] 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. [18]
    Pennsylvania M or F only Requires proof of surgery to change sex designation.[7]
    Rhode Island M or F only Requires proof of surgery to change sex designation.[7]
    South Carolina M or F only Allows people to change sex designation.[7]
    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."[7]
    Texas M or F only Allows people to change sex designation.[7]
    Utah M or F only Allows people to change sex designation.[7]
    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.[7]
    Virginia M or F or X since July 1, 2020.[19] 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. [20]
    Washington M, F, or X, since January 27, 2018, per rule WAC 246-490-075.[21] 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."[21]
    Wisconsin M or F only Allows people to change sex designation.[7]
    Wyoming M or F only Allows people to change sex designation.[7]

    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,[22] 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.[10]
    Colorado Starting November 30 2018, drivers licences and ID cards can have an M, F, or X marker.[23] 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.[23]
    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."[24]
    Indiana "M", "F", or "X" available since 2019.[25] Must visit the Bureau of Motor Vehicles with supporting documentation.[26]
    Maine X marker available since June 2018.[27] Fill out the Gender Designation Form. Standard renewal and duplicate license fees apply.
    Massachusetts M, F, or X options since November 2019 [28]
    Michigan M, F, or X options starting November 10, 2021[29] No medical or legal documentation requirements to change marker[29]
    Minnesota X marker available since late 2018[30]
    New Hampshire M, F, or X options since January 1, 2020[31]
    New Jersey M, F, or X. X became available in April 2021.[32] "To change the gender option, residents can fill out a form on the agency's website, then visit a licensing center as a walk-in customer. They will have to surrender their current license or ID and pay a standard fee of $11.00 to receive a duplicate card."[32]
    Oregon M, F, or X. The X became available on driver's license forms on 2017-07-01.[8]
    Pennsylvania "X" gender designation available starting July 2020.[33] Fill out a form and bring it to DMV in person. No medical or social service documentation is needed.[34]
    Vermont "M", "F", and "Other" available. Fill out this form and pay the applicable fee.
    Washington DC M, F, or X (X available since June 2017)[35]
    Washington state M, F, or X.[36]

    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,"[37] and no longer requires proof of surgery.[38]

    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.[39]

    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."[40]

    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.[41]

    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:[42]

    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.[43]

    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

    External links

    References

    1. ↑ Hendrick; et al. (1 January 2018). ""M," "F," Or "X"? Nonbinary Gender Designations In The Workplace". Fisher Phillips. Retrieved 19 June 2020. Explicit use of et al. in: |author= (help)
    2. ↑ Freeman, Lauren (2018). "Micro Interactions, Macro Harms: Some Thoughts on Improving Health Care for Transgender and Gender Nonbinary Folks". International Journal of Feminist Approaches to Bioethics. doi:10.3138/ijfab.2018.05.29.
    3. ↑ Chen, Tanya (22 March 2019). "United Airlines Announced It Will Be The First Airline To Offer Nonbinary Gender Options For Customers To Book Flights". BuzzFeed News. Retrieved 3 October 2020.
    4. ↑ 4.0 4.1 "Mastercard's 'True Name' supports transgender and non-binary consumers". WARC. 11 June 2020. Retrieved 21 June 2020.
    5. ↑ https://www.bmoharris.com/main/personal/true-name/
    6. ↑ 6.0 6.1 6.2 6.3 Cite error: Invalid <ref> tag; no text was provided for refs named PracticalExamples
    7. ↑ 7.00 7.01 7.02 7.03 7.04 7.05 7.06 7.07 7.08 7.09 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 7.34 7.35 7.36 7.37 7.38 7.39 7.40 7.41 http://www.lambdalegal.org/know-your-rights/transgender/changing-birth-certificate-sex-designations
    8. ↑ 8.0 8.1 "Resources." Intersex and Genderqueer Recognition Project. Updated 2019-06-23. Retrieved 2019-07-08. https://www.intersexrecognition.org/resources
    9. ↑ Kate Sosin and Nico Lang. "Arkansas — Yes, Arkansas — Quietly Begins Issuing Gender-Neutral IDs to Non-Binary People." Into. 2018-10-16. Retrieved 2019-07-08. https://www.intomore.com/impact/arkansas-yes-arkansas-quietly-begins-issuing-gender-neutral-ids-to-non-binary-people
    10. ↑ 10.0 10.1 John Paul Brammer. NBC News. 2017-10-23. Retrieved 2019-07-08. https://www.nbcnews.com/feature/nbc-out/california-paves-way-nonbinary-birth-certificates-n813436
    11. ↑ https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB179
    12. ↑ https://www.buzzfeednews.com/article/jtes/california-just-got-one-step-closer-to-nonbinary-ids
    13. ↑ Mx. Anunnaki Ray Marquez (September 20, 2018). "I am Proudly the First in Colorado to get an Intersex Birth Certificate". Retrieved November 14, 2020.
    14. ↑ Milton, Josh (20 July 2020). "Non-binary people win vital legal recognition as Maine becomes 12th state to issue 'X' gender birth certificates". PinkNews. Retrieved 23 July 2020.
    15. ↑ 15.0 15.1 "Gender Marker Change on Birth Certificates: Frequently Asked Questions" (PDF). maine.gov. Retrieved 23 July 2020.
    16. ↑ 16.0 16.1 https://www.pinknews.co.uk/2019/01/30/new-jersey-gender-neutral-birth-certificates/
    17. ↑ "Litigation." Intersex and Genderqueer Recognition. http://www.intersexrecognition.org/litigation.html
    18. ↑ 18.0 18.1 O'Hara, Mary Emily (10 June 2016). "'Nonbinary' is now a legal gender, Oregon court rules". The Daily Dot. Retrieved 14 November 2020.
    19. ↑ "New Virginia DMV laws now in effect – Gazette Journal". Retrieved 2020-09-09.
    20. ↑ "Virginia". National Center for Transgender Equality. Retrieved 2020-09-09.
    21. ↑ 21.0 21.1 "Sex Designation Change on a Birth Certificate." Washington State Department of Health. Retrieved 2019-07-08. https://www.doh.wa.gov/LicensesPermitsandCertificates/BirthDeathMarriageandDivorce/SexDesignationChangeonaBirthCertificate
    22. ↑ "Driver's License Policies by State." National Center for Transgender Equality. Accessed June 20, 2012. http://transequality.org/Resources/DL/DL_policies.html
    23. ↑ 23.0 23.1 "Colorado to offer non-binary sex identifier on driver licenses and IDs". Department of Revenue - Motor Vehicle. Retrieved 3 August 2020.
    24. ↑ https://transequality.org/documents/state/hawaii
    25. ↑ Hwang, Kelley (March 12, 2019). "Indiana becomes the 6th state to offer a new gender option on driver's licenses". The Indianapolis Star. Retrieved November 11, 2020.
    26. ↑ Licenses, Permits (2020-07-01). "Amending Your Driver's License or Identification Card". Licenses, Permits, & IDs. Retrieved 2020-11-11.
    27. ↑ "Maine BMV to offer non-binary gender designation on driver's licenses, ID cards". maine.gov. June 11, 2018. Retrieved November 11, 2020.
    28. ↑ Vaughn, Alyssa (13 November 2019). "The RMV Officially Recognizes a Non-Binary Gender Option Now". Boston Magazine. Retrieved 5 June 2020.
    29. ↑ 29.0 29.1 Powers, Sara (3 November 2021). "Nonbinary Designation Added For Michigan Driver's Licenses". CBS Detroit. Retrieved 4 November 2021.
    30. ↑ Nelson, Tim (October 2, 2018). "'X' is new gender choice on Minnesota driver's licenses". MPR News. Retrieved November 11, 2020.
    31. ↑ Feely, Paul (July 11, 2019). "Bill allowing 'X' to mark gender on NH licenses becomes law". New Hampshire Union Leader. Retrieved October 30, 2020.
    32. ↑ 32.0 32.1 Sobko, Katie (April 19, 2021). "New Jersey adds 'X' as gender option on MVC driver's licenses". North Jersey Media Group. Retrieved April 19, 2021.
    33. ↑ Limberg, Andrew (23 July 2020). "PA Now Offering Nonbinary Option for Driver License and IDs". 1010 WINS. Retrieved 23 July 2020.
    34. ↑ "Gender-Neutral Designation". PennDOT Driver & Vehicle Services. Retrieved 23 July 2020.
    35. ↑ Norwood, Candice (June 2019). "How Governments Are Transitioning Their Gender Policies to Nonbinary". governing.com. Retrieved 14 April 2020.
    36. ↑ "Change of Gender Designation" (PDF). Washington State Department of Licensing.
    37. ↑ "FAM 1300 APPENDIX M - GENDER CHANGE." United States Department of State. June 10, 2010. Accessed October 14, 2010. http://www.state.gov/documents/organization/143160.pdf
    38. ↑ "FAM 1300 APPENDIX F - PASSPORT AMENDMENTS." United States Department of State. March 18, 2009. Accessed May 7, 2009. http://www.state.gov/documents/organization/86784.pdf
    39. ↑ "Frequently Asked Questions" Transgender American Veterans Association [1]
    40. ↑ See Social Security Administration, Changing Numident Data for Reasons Other Than Name Change, Records Maintenance § 10212.200(B)(2) (as of Mar. 19, 2015). The physician's certificate accepted by the Administration is the same as that accepted by the Department of State for permanently changing one's passport gender. Compare id. with 7 U.S. Dep't of State, Foreign Affairs Manual § 1300 appx. M, at 3-4.
    41. ↑ http://practicalandrogyny.tumblr.com/post/7025100121/gender-free-marriage-certificate-from-cambridge
    42. ↑ http://nonbinary-support.tumblr.com/post/113431196413/states-where-it-is-the-law-for-insurance-to-cover
    43. ↑ "LGBTQ+ Donors". redcrossblood.org. Retrieved 6 June 2020.
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