Editing Recognition (USA)

{{Outdated Information}}
[[File:New Mexico standard horizontal driver identification card obverse - non-PubL109-13 and with neutral gender designator and number and address redaction.png|thumb|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<ref name="Hendrick">{{Cite web |title=“M,” “F,” Or “X”? Nonbinary Gender Designations In The Workplace |author=Hendrick et al. |work=Fisher Phillips |date=1 January 2018 |access-date=19 June 2020 |url= https://www.fisherphillips.com/resources-newsletters-article-m-f-or-x-nonbinary-gender-designations|archive-url=https://web.archive.org/web/20230508034529/https://www.fisherphillips.com/resources-newsletters-article-m-f-or-x-nonbinary-gender-designations |archive-date=17 July 2023 }}</ref>, although totally accurate numbers are difficult to ascertain.<ref>{{cite journal|title=Micro Interactions, Macro Harms: Some Thoughts on Improving Health Care for Transgender and Gender Nonbinary Folks|journal=International Journal of Feminist Approaches to Bioethics|last=Freeman|first=Lauren|year=2018|doi=10.3138/ijfab.2018.05.29}}</ref> 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 gender]]s ([[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."<ref name="Chen2019">{{Cite web |title=United Airlines Announced It Will Be The First Airline To Offer Nonbinary Gender Options For Customers To Book Flights |last=Chen |first=Tanya |work=BuzzFeed News |date=22 March 2019 |access-date=3 October 2020 |url= https://www.buzzfeednews.com/article/tanyachen/united-airlines-transgender-non-binary-gender|archive-url=https://web.archive.org/web/20230529022753/https://www.buzzfeednews.com/article/tanyachen/united-airlines-transgender-non-binary-gender |archive-date=17 July 2023 }}</ref>

==Charities==

Charitable organizations. ''Please add to this section.''

==Education==

Schools of all kinds, as well as other educational resources.

Note that for [[gender nonconforming]] [[children]] and teens, homeschooling or unschooling is an option. This still involves a lot of paperwork, but it's a life-saving option for youth who have difficulty fitting in or feeling safe around peers and faculty at school. Homeschooled or drop-out teens can work to pass the General Education Development (GED) test instead of getting a high school diploma. A GED certificate will satisfy all employers and colleges that ask for a high school diploma.

===Colleges and universities===

In the USA, many colleges use paperwork that makes problems for transgender people, especially nonbinary people. The Common Application and Universal College Application, used by many USA colleges, used to restrict answers to only the binary sex assigned at the birth of the applicant. However, starting in the 2016-2017 academic year, these applications updated the "sex" field to "sex assigned at birth" and added an optional free text field for gender.<ref name="OConnor">{{Cite web |title=College Applications Just Got Way More Gender-Inclusive |last=O'Connor |first=Lydia |work=HuffPost |date=April 28, 2016 |access-date=May 11, 2020 |url= https://www.huffpost.com/entry/common-application-gender_n_57225c03e4b01a5ebde4faf9}}</ref>

The [https://docs.google.com/document/d/1iXcTiWKvTVfIYDx0ciZnZI5Bw5R_hfCdfTZKJPHpeHI/edit?pli=1 Applying to College as a Non Binary Trans Person] article is highly recommended because it goes into more detail about many aspects of college life for a nonbinary person in the USA, and some common problems in paperwork.

{|class="wikitable sortable" style="font-size: 85%; text-align: center;"
! Organization
! Gender
! Notes
|-
| American University
|
| Allows gender-neutral housing, "limited to the 'social justice' house for first years"<ref name="College">[https://docs.google.com/document/d/1iXcTiWKvTVfIYDx0ciZnZI5Bw5R_hfCdfTZKJPHpeHI/edit?pli=1 Applying to College as a Non Binary Trans Person]. October 21, 2013</ref>
|-
| Austin Community College
| 
| Students can submit their chosen name to be displayed in class rosters and online systems instead of their [[deadname]]. However, most official documents such as transcripts and diploma will use the student's legal name.<ref>https://www.austincc.edu/admissions/update-student-information/chosen-name</ref>
|-
| Bard College
|
| Allows gender-neutral housing<ref name="College" />
|-
| Bowling Green State University
|
| Allows gender neutral housing, but is limited to Founders Hall and one floor of MacDonald Hall for 2016-17 academic year<ref>https://www.bgsu.edu/residence-life/housing-options/gender-neutral-housing.html</ref><ref>http://www.toledoblade.com/Education/2016/05/01/BGSU-to-offer-less-expensive-all-gender-dorm.html</ref> Also has some gender neutral bathrooms accross campus <ref>https://www.bgsu.edu/content/dam/BGSU/multicultural-affairs/documents/gender-neutral-bathrooms.pdf</ref><ref>https://www.bgsu.edu/content/dam/BGSU/multicultural-affairs/documents/Gender%20Neutral%20Bathrooms_List+Campus%20Map.pdf</ref>
|-
| Burlington College
| style="background-color:#ffb;"| Can choose "I do not wish to identify"<ref name="College" />
||
|-
| College of Wooster
|
| Allows gender-neutral housing<ref name="College" />
|-
| Connecticut College
| style="background-color:#ffb;"| Uses the Common App, which asks for sex assigned at birth, and has free text field for gender identity<ref name="OConnor" />
| >
|-
| Dickinson College
|
| Allows gender-neutral housing, new to first years<ref name="College" />
|-
| Evergreen State College, the
| style="background-color:#ffb;"| Can choose "unspecified"<ref name="College" />
||
|-
| Gutenberg College
| style="background-color:#9f9;"| Paper application doesn't ask<ref name="College" />
||
|-
| Goucher College
| style="background-color:#f99;"| Application requires you to say whether your "sex" is M or F only, then asks a separate question in which you can write in your "gender."<ref name="College" />
||
|-
| Grinnell College
|
| Allows gender-neutral housing<ref name="College" />
|-
| Hampshire College
|
| Allows gender-neutral housing. Has gender-neutral bathrooms in all dorms and all over campus. Campus-wide student culture treats asking about preferred pronouns as a matter of basic etiquette.<ref name="College" />
|-
| Haverford
|
| Doesn't say it has gender-neutral housing, but "regularly offers singles even to first years, and some floors have gender-neutral bathrooms".<ref name="College" />
|-
| Ithaca College (Ithaca, NY)
|
| Has a gender-inclusive housing option that is friendly to genderqueer students. Has a speech pathology clinic to help transgender students with voice training for free.<ref name="Beemyn2012">Dr. [[Genny Beemyn]] and Shane Windmeyer. ''The Advocate.'' August 15, 2012. http://www.advocate.com/politics/transgender/2012/08/15/top-10-trans-friendly-colleges-and-universities?page=0,0 Mirror: http://www.campuspride.org/resources/top-10-trans/</ref>
|-
| Juniata College
|
| Allows gender-neutral housing, new to first years<ref name="College" />
|-
| Macalester College
| style="background-color:#ffb;"| Uses the Common App, which asks for sex assigned at birth, and has free text field for gender identity<ref name="OConnor" />
| Allows gender-neutral housing.<ref name="College" />
|-
| New College of Florida
|
| Doesn't say it has gender-neutral housing, but "has a campus community known for accepting gender-variant students—it works for some trans students because of the college’s informal acceptance, even if the school doesn’t have stated policies."<ref name="College" />
|-
| New York University (New York, NY)
|
| Has a trans student group and several popular transgender focused events.<ref name="Beemyn2012" />
|-
| Oberlin College
|
| Allows gender-neutral housing. Campus-wide student culture treats asking about preferred pronouns as a matter of basic etiquette.<ref name="College" />
|-
| Pitzer College
|
| Allows gender-neutral housing. Lets you "indicate a gender preference for your roommate (but won't guarantee you'll get your preference)" [...] Pitzer also has the best housing application I've seen in terms of trans-friendliness".<ref name="College" />
|-
| Prescott College
| style="background-color:#f99;"| Paper application has only M and F boxes<ref name="College" />
|
|-
| Princeton University (Princeton, NJ)
|
| Gives a lot of transgender focused programming and events, and works to be transgender-inclusive in its services.<ref name="Beemyn2012" />
|-
| Savannah Technical College
| style="background-color:#f99;"| Only "male" and "female" gender options available
| 
|-
| Shimer College (in Chicago, Illinois)
| style="background-color:#9ff;"| Online form lets you write in a gender as you wish<ref name="College" />
|
|-
| Skidmore College
|
| Allows gender-neutral housing<ref name="College" />
|-
| St. Johns College
| style="background-color:#9f9;"| Paper application doesn't ask<ref name="College" />
|
|-
| University of California - Los Angeles (UCLA)
|
| One of the first schools to cover transgender health care under its student health insurance, and makes it easy to access these benefits. The campus has gender-inclusive athletic facilities and more than 120 gender-inclusive bathrooms.<ref name="Beemyn2012" />
|-
| University of California - Riverside (UCR)
|
| Has trans and genderqueer focused events. <ref name="Beemyn2012" /> Allows gender-neutral housing, as do all U of California schools, but this particular one is said to be "especially good" with "many options" of that kind.<ref name="College" />
|-
| University of California - Santa Cruz (UCSC)
| Online application form gives about six gender options.<ref name="PracticalExamples">http://practicalandrogyny.com/2011/03/24/a-call-for-examples/</ref> Has separate questions for gender and for sex assigned at birth. Students can also indicate a preferred name and pronouns.<ref name="UCSC">{{Cite web |title=Gender Identity and Sexual Orientation Questions |author= |work=registrar.ucsc.edu |date=June 25, 2018 |access-date=May 11, 2020 |url= https://registrar.ucsc.edu/gender-identity/index.html}}</ref>
| Allows gender-neutral housing<ref name="College" />
|-
| University of Massachusetts, Amherst
|
| Formerly had actively transphobic faculty, but now works to be trans inclusive.<ref name="Beemyn2012" />
|-
| University of Michigan, Ann Arbor
|
| Works to be trans inclusive. Lets students be listed and called by a preferred name, in all contexts, rather than their legal name. Student culture accepts openly transgender students.<ref name="Beemyn2012" />
|-
| University of Oregon (Eugene, OR)
| style="background-color:#ffb;"| Can choose "unspecified"<ref name="College" />
| Works to be trans inclusive by introducing trans friendly policies before they're asked for. Rec centre has gender-inclusive locker rooms. Most buildings have gender-inclusive bathrooms.<ref name="Beemyn2012" /> Allows gender-neutral housing.<ref name="College" />
|-
| University of Pennsylvania (Philadelphia, PA)
|
| LGBT center has a two-story building. Student culture is accepting of openly transgender people. Student health service is knowledgeable about trans health issues.<ref name="Beemyn2012" />
|-
| University of Puget Sound
|
| Allows gender-neutral housing, new to first years<ref name="College" />
|-
| University of Vermont (UVM) (Burlington, VT)
|
| Nondiscrimination policy includes "gender identity/expression." Has trans focused events. Lets students become listed by their preferred name. Works to help other schools be transgender-inclusive.<ref name="Beemyn2012" />
|-
| University of Washington (UW) (Seattle, WA)
|
| Allows gender-neutral housing.<ref name="College" /> Has had a Q Center since 2005, which "welcomes students, staff, and faculty who are transgender". The University plans that in 2016 it will "broaden gender-neutral options for housing to include all of the new residence halls on west campus as well as Haggett Hall, which has provided gender-neutral bathrooms and living quarters for several years. ... UW staff is working on giving students an easy option to change their gender on University forms."<ref>Julie Garner, "True to self." ''Columns: The University of Washington Alumni Magazine'', September 10, 2015. [https://www.washington.edu/alumni/columns-magazine/september-2015/features/transgender/ https://www.washington.edu/alumni/columns-magazine/september-2015/features/transgender/]</ref>
|-
| Vassar
|
| Doesn't say it has gender-neutral housing, but "has gender-neutral bathrooms throughout campus and in all the dorms".<ref name="College" />
|-
| Warren Wilson college
| style="background-color:#f99;"| Application requires you to say whether your "sex" is M or F only, then asks a separate question in which you can write in your "gender."<ref name="College" />
|
|-
| Wesleyan University
|
| Allows gender-neutral housing<ref name="College" />
|-
| Western Washington University
| style="background-color:#ffb;"| Can choose "unspecified"<ref name="College" />
| Allows gender-neutral housing<ref name="College" />
|}

==Finance==

Banks, credit unions, and other financial institutions.

{|class="wikitable sortable" style="font-size: 85%; text-align: center;"
! 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<ref name="Mastercard">{{Cite web |title=Mastercard’s ‘True Name’ supports transgender and non-binary consumers |author= |work=WARC |date=11 June 2020 |access-date=21 June 2020 |url= https://www.warc.com/newsandopinion/news/mastercards-true-name-supports-transgender-and-non-binary-consumers/43710|archive-url=https://web.archive.org/web/20230510214458/http://www.warc.com/newsandopinion/news/mastercards-true-name-supports-transgender-and-non-binary-consumers/43710 |archive-date=17 July 2023 }}</ref><ref name="BMOH">https://www.bmoharris.com/main/personal/true-name/ [https://web.archive.org/web/20230404095507/http://www.bmoharris.com/main/personal/true-name/ Archived] on 17 July 2023</ref>
|-
| Capitol One (bank)
|
|
| Doesn't print title on debit or credit card.<ref name="PracticalExamples" />
|-
| Chase (bank)
|
|
| Doesn't print title on debit or credit card.<ref name="PracticalExamples" />
|-
| Daylight (neobank app)
| Doesn't use titles
| Doesn't ask about gender
| Users can set their chosen name and any pronouns in the Daylight app, and change them at any time. Only the chosen name is used (e.g. on debit card, with customer service, etc)
|-
| Mastercard
|
|
| "True Name" initiative enables customers to have their chosen name on their cards<ref name="Mastercard" />
|-
| SunTrust (bank)
|
|
| Doesn't print title on debit or credit card.<ref name="PracticalExamples" />
|-
| Wells Fargo (bank)
|
|
| Doesn't print title on debit or credit card.<ref name="PracticalExamples" />
|}

==Employment==

''See also our page on [[Employment]].''

In general, employment discrimination laws regarding gender identity and LGBT identity vary by state. See [[Wikipedia:Transgender_rights_in_the_United_States#Employment|Wikipedia: Transgender rights in the United States - Employment]].

===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.

{|class="wikitable sortable" style="font-size: 85%; text-align: center;"
! Organization
! Title
! Gender
! Notes
|-
| [https://web.archive.org/web/20170817022247/https://www.roberthalf.com/officeteam RobertHalf OfficeTeam] (office temping agency)
| style="background-color:#9f9;"| Doesn't ask
| style="background-color:#9f9;"| Doesn't ask
||
|}

==Government==

Federal and state governments

===Official documents of identity===
{{Outdated Information}}
[[File:Requirements for altering birth certificate sex in the US.svg|right|250px|thumb|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<br>
Lavender: Altering sex on birth certificate requires SRS<br>
Red: State does not alter sex on birth certificates]]

[[File:Birth certificate sex altering regulations in the US.svg|right|250px|thumb|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<br>
Lavender: Old birth certificate is amended to correct sex designation<br>
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.

{|class="wikitable sortable" style="font-size: 85%; text-align: center;"
! State
! Sex
! Change
! Notes
|-
| Alabama
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth">http://www.lambdalegal.org/know-your-rights/transgender/changing-birth-certificate-sex-designations [https://web.archive.org/web/20230623154938/https://lambdalegal.org/know-your-rights/transgender/changing-birth-certificate-sex-designations Archived] on 17 July 2023</ref>
|-
| Alaska
| style="background-color:#f99;"| M or F only<ref name="IGRPresources">"Resources." ''Intersex and Genderqueer Recognition Project.'' Updated 2019-06-23. Retrieved 2019-07-08. https://www.intersexrecognition.org/resources [https://web.archive.org/web/20230317134157/https://www.intersexrecognition.org/resources Archived] on 17 July 2023</ref>
| 
|-
| Arizona
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Arkansas
| style="background-color:#9ff;"| M, F, or X<ref>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 [https://web.archive.org/web/20230409135300/https://www.intomore.com/impact/arkansas-yes-arkansas-quietly-begins-issuing-gender-neutral-ids-to-non-binary-people/ Archived] on 17 July 2023</ref>
| style="background-color:#9ff;"| No documentation needed
|-
| California
| style="background-color:#9ff;"| The first state to allow a third option, "nonbinary," on birth certificates, starting when [[Gender Recognition Act (California Senate Bill 179)|SB 179, or the Gender Recognition Act]], was signed into law on October 15, 2017.<ref name="CA-NBC">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 [https://web.archive.org/web/20220529100554/https://www.nbcnews.com/feature/nbc-out/california-paves-way-nonbinary-birth-certificates-n813436 Archived] on 17 July 2023</ref>
| style="background-color:#9f9;"| Allows change without a hearing upon request.<ref>https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB179 [https://web.archive.org/web/20230708035626/https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB179 Archived] on 17 July 2023</ref><ref>https://www.buzzfeednews.com/article/jtes/california-just-got-one-step-closer-to-nonbinary-ids [https://web.archive.org/web/20230530220545/https://www.buzzfeednews.com/article/jtes/california-just-got-one-step-closer-to-nonbinary-ids Archived] on 17 July 2023</ref>
|-
| Colorado
| style="background-color:#f99;"| M or F only, with one exception where a birth certificate was changed to say "[[Intersex]]"<ref name="anunnaki">{{Cite web |title=I am Proudly the First in Colorado to get an Intersex Birth Certificate |author=Mx. Anunnaki Ray Marquez |work= |date=September 20, 2018 |access-date=November 14, 2020 |url= https://anunnakiray.com/2018/09/20/i-am-proudly-the-first-in-colorado-to-get-an-intersex-birth-certificate/|archive-url=https://web.archive.org/web/20230420184834/https://anunnakiray.com/2018/09/20/i-am-proudly-the-first-in-colorado-to-get-an-intersex-birth-certificate/ |archive-date=17 July 2023 }}</ref>
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Connecticut
| style="background-color:#9ff;"| M, F, or X
| style="background-color:#9ff;"| Allows people to change sex designation, no proof of surgery required.<ref name="LambdaBirth" />
|-
| Delaware
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| District of Columbia
| style="background-color:#9ff;"| M, F, or X
| style="background-color:#9ff;"| Allows people to change sex designation, requiring only a letter from a doctor, not surgery.<ref name="LambdaBirth" />
|-
| Florida
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Georgia
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Hawaii
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Idaho
| style="background-color:#f99;"| M or F only
| style="background-color:#f99;"| Doesn't allow anyone to change sex designation.<ref name="LambdaBirth" />
|-
| Illinois
| style="background-color:#9ff;"| M, F, or X
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Indiana
| style="background-color:#f99;"| M or F only
| style="background-color:#9ff;"| Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.<ref name="LambdaBirth" />
|-
| Iowa
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires a doctor's proof of "surgery or other treatment [so that] a sex change has occurred" to change sex designation.<ref name="LambdaBirth" />
|-
| Kansas
| style="background-color:#f99;"| M or F only
| style="background-color:#f99;"| Doesn't allow anyone to change sex designation.<ref name="LambdaBirth" />
|-
| Kentucky
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Louisiana
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Maine
| style="background-color:#9ff;"| M, F, or X<ref name="Milton2020">{{Cite web |title=Non-binary people win vital legal recognition as Maine becomes 12th state to issue ‘X’ gender birth certificates |last=Milton |first=Josh |work=PinkNews |date=20 July 2020 |access-date=23 July 2020 |url= https://www.pinknews.co.uk/2020/07/20/maine-non-binary-birth-certificates-x-legal-recognition/|archive-url=https://web.archive.org/web/20220819130610/https://www.pinknews.co.uk/2020/07/20/maine-non-binary-birth-certificates-x-legal-recognition/ |archive-date=17 July 2023 }}</ref>
| style="background-color:#9ff;"| 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.<ref name="maine">{{Cite web |title=Gender Marker Change on Birth Certificates: Frequently Asked Questions |work=maine.gov |date= |access-date=23 July 2020 |url= https://www.maine.gov/dhhs/mecdc/public-health-systems/data-research/vital-records/documents/pdf-files/QA%20for%20gender%20marker.pdf|archive-url=https://web.archive.org/web/20220928234009/https://www.maine.gov/dhhs/mecdc/public-health-systems/data-research/vital-records/documents/pdf-files/QA%20for%20gender%20marker.pdf |archive-date=17 July 2023 }}</ref>
| "At the time of birth, parents may opt to have a nonbinary designation on the [baby's] birth certificate."<ref name="maine" />
|-
| Maryland
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Massachusetts
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Michigan
| style="background-color:#9ff;"| M, F, or X
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Minnesota
| style="background-color:#f99;"| M or F only
| style="background-color:#9ff;"| Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.<ref name="LambdaBirth" />
|-
| Mississippi
| style="background-color:#f99;"| M or F only
| style="background-color:#9ff;"| Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.<ref name="LambdaBirth" />
|-
| Missouri
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Montana
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Nebraska
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Nevada
| style="background-color:#f99;"| M or F only
| style="background-color:#9ff;"| Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.<ref name="LambdaBirth" />
|-
| New Hampshire
| style="background-color:#f99;"| M or F only
| style="background-color:#9ff;"| Allows people to change sex designation upon request, without requiring a letter from a doctor or surgery.<ref name="LambdaBirth" />
|-
| New Jersey
| style="background-color:#9ff;"| M, F, or undesignated/nonbinary. The latter became available on February 1, 2019, making this the 6th state to offer nonbinary birth certificates.<ref name="PinkNewsNJ">https://www.pinknews.co.uk/2019/01/30/new-jersey-gender-neutral-birth-certificates/ [https://web.archive.org/web/20220820003721/https://www.pinknews.co.uk/2019/01/30/new-jersey-gender-neutral-birth-certificates/ Archived] on 17 July 2023</ref>
| style="background-color:#9ff;"| In 2019, proof of medical transition or surgery is no longer required to change your birth certificate in this state. <ref name="PinkNewsNJ" /><ref name="LambdaBirth" />
|-
| New Mexico
| style="background-color:#9ff;"| M, F, or X since 2019
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| New York
| style="background-color:#9ff;"| "X" available on birth certificates since 2019.
| style="background-color:#9ff;"| Allows people to change sex designation, requiring only a letter from a doctor, not surgery.<ref name="LambdaBirth" />
|-
| North Carolina
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| North Dakota
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Ohio
| style="background-color:#ffb;"| 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]]."<ref name="Litigation">{{cite web|title=Litigation|website=Intersex & Genderqueer Recognition Project|url=http://www.intersexrecognition.org/litigation.html |archive-date=11 July 2017 |archive-url= https://web.archive.org/web/20170711102713/http://www.intersexrecognition.org/litigation.html</ref> As of November 2021, a nonbinary option had been offered briefly but is is in legal dispute.<ref>{{Cite web |title=Oklahoma Gov. Stitt Signs Order Halting The State From Issuing Nonbinary Birth Certificates |last=Leesman |first=Madeline |work=Townhall |date=12 November 2021 |access-date=18 November 2021 |url= https://townhall.com/tipsheet/madelineleesman/2021/11/12/oklahoma-gov-stitt-signs-order-halting-the-state-from-issuing-nonbinary-birth-ce-n2598993|archive-url=https://web.archive.org/web/20220217015408/https://townhall.com/tipsheet/madelineleesman/2021/11/12/oklahoma-gov-stitt-signs-order-halting-the-state-from-issuing-nonbinary-birth-ce-n2598993 |archive-date=17 July 2023 }}</ref>
| style="background-color:#f99;"| Doesn't allow anyone to change sex designation.<ref name="LambdaBirth" />
|-
| Oklahoma
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Oregon
| style="background-color:#ffb;"| M or F, with one exception where a birth certificate was changed to say "[[Nonbinary]]"<ref name="OHaraShupe">{{Cite web |title='Nonbinary' is now a legal gender, Oregon court rules |last=O'Hara |first=Mary Emily |work=The Daily Dot |date=10 June 2016 |access-date=14 November 2020 |url= https://www.dailydot.com/irl/oregon-court-rules-non-binary-gender-legal/|archive-url=https://web.archive.org/web/20230516145244/https://www.dailydot.com/irl/oregon-court-rules-non-binary-gender-legal/ |archive-date=17 July 2023 }}</ref>
| style="background-color:#9ff;"| 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. <ref name="OHaraShupe" />
|-
| Pennsylvania
| style="background-color:#f99;"| M or F only
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| Rhode Island
| style="background-color:#9ff;"| M, F, or X
| style="background-color:#ffb;"| Requires proof of surgery to change sex designation.<ref name="LambdaBirth" />
|-
| South Carolina
| style="background-color:#f99;"| M or F only
| Allows people to change sex designation.<ref name="LambdaBirth" />
|-
| Tennessee
| style="background-color:#f99;"| M or F only
| style="background-color:#f99;"| 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."<ref name="LambdaBirth" />
|-
| Texas
| style="background-color:#f99;"| M or F only
| Allows people to change sex designation.<ref name="LambdaBirth" />
|-
| Utah
| style="background-color:#ffb;"| M, F, or X but requires court order
| Allows people to change sex designation.<ref name="LambdaBirth" />
|-
| Vermont
| style="background-color:#9ff;"| M, F, or X
| style="background-color:#9ff;"| Allows people to change sex designation, requiring only a letter from a doctor saying they've had a transition, not strictly surgery.<ref name="LambdaBirth" />
|-
| Virginia
| style="background-color:#9ff;"| M or F or X since July 1, 2020.<ref>{{Cite web|url=https://www.gazettejournal.net/new-virginia-dmv-laws-now-in-effect/|title=New Virginia DMV laws now in effect – Gazette Journal|language=en-US|access-date=2020-09-09|archive-url=https://web.archive.org/web/20230328160731/https://www.gazettejournal.net/new-virginia-dmv-laws-now-in-effect/|archive-date=17 July 2023}}</ref> 
| style="background-color:#9ff"| 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. <ref>{{Cite web|url=https://transequality.org/documents/state/virginia|title=Virginia|website=National Center for Transgender Equality|language=en|access-date=2020-09-09|archive-url=https://web.archive.org/web/20230603181152/https://transequality.org/documents/state/virginia|archive-date=17 July 2023}}</ref>
|-
| Washington
| style="background-color:#9ff;"| M, F, or X, since January 27, 2018, per rule WAC 246-490-075.<ref name="WA-state-birth">"Sex Designation Change on a Birth Certificate." ''Washington State Department of Health.'' Retrieved 2019-07-08. https://www.doh.wa.gov/LicensesPermitsandCertificates/BirthDeathMarriageandDivorce/SexDesignationChangeonaBirthCertificate [https://web.archive.org/web/20230531091851/https://doh.wa.gov/LicensesPermitsandCertificates/BirthDeathMarriageandDivorce/SexDesignationChangeonaBirthCertificate Archived] on 17 July 2023</ref> 
| style="background-color:#9ff;"| 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."<ref name="WA-state-birth"></ref>
|-
| Wisconsin
| style="background-color:#f99;"| M or F only
| Allows people to change sex designation.<ref name="LambdaBirth" />
|-
| Wyoming
| style="background-color:#f99;"| M or F only
| Allows people to change sex designation.<ref name="LambdaBirth" />
|}

====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,<ref>"Driver's License Policies by State." National Center for Transgender Equality. Accessed June 20, 2012. http://transequality.org/Resources/DL/DL_policies.html [https://web.archive.org/web/20230502144509/https://transequality.org/Resources/DL/DL_policies.html Archived] on 17 July 2023</ref> 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.

{|class="wikitable sortable" style="font-size: 85%; text-align: center;"
! State
! Sex
! Change process
! Notes
|-
| Arkansas
| style="background-color:#9ff;"| M, F, or X since 2010.
|
|
|-
| California
| style="background-color:#9ff;"| M, F, or "nonbinary," which became available on driver's licenses in October 15, 2017.<ref name="CA-NBC"></ref>
|
|
|-
| Colorado
| style="background-color:#9ff;"| Since November 30, 2018, drivers licenses and ID cards can have an M, F, or X marker.<ref name="colo_Colo">{{Cite web |title=Colorado to offer non-binary sex identifier on driver licenses and IDs |author= |work=Department of Revenue - Motor Vehicle |date= |access-date=3 August 2020 |url= https://www.colorado.gov/pacific/dmv/colorado-offer-non-binary-sex-identifier-driver-licenses-and-ids|archive-url=https://web.archive.org/web/20230513034258/https://www.colorado.gov/pacific/dmv/colorado-offer-non-binary-sex-identifier-driver-licenses-and-ids|archive-date=17 July 2023}}</ref>
| 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.<ref name="colo_Colo" />
|
|-
| District of Columbia
| style="background-color:#9ff;"| M, F, or X (X available since June 2017)<ref name="gove_HowG">{{Cite web |title=How Governments Are Transitioning Their Gender Policies to Nonbinary |last=Norwood |first=Candice |work=governing.com |date=June 2019 |access-date=14 April 2020 |url= https://www.governing.com/topics/health-human-services/gov-nonbinary-lgbtq-legislation-regulations.html|archive-url=https://web.archive.org/web/20230221230623/https://www.governing.com/topics/health-human-services/gov-nonbinary-lgbtq-legislation-regulations.html |archive-date=17 July 2023 }}</ref>
|
|
|-
| Hawaii
| style="background-color:#9ff;"| M, F, or X since July 1, 2020.<ref>https://transequality.org/documents/state/hawaii [https://web.archive.org/web/20230626074332/https://www.transequality.org/documents/state/hawaii Archived] on 17 July 2023</ref>
|
|
|-
| Indiana
|style="background-color:#9ff;"|"M", "F", or "X" available since 2019.<ref name="IndianaDL">{{Cite web |title=Indiana becomes the 6th state to offer a new gender option on driver's licenses |author=Hwang, Kelley |work=The Indianapolis Star |date=March 12, 2019 |access-date=November 11, 2020 |url= https://www.indystar.com/story/news/2019/03/12/indiana-drivers-licenses-now-have-x-gender-option/3138447002/|archive-url=https://web.archive.org/web/20230406210324/https://www.indystar.com/story/news/2019/03/12/indiana-drivers-licenses-now-have-x-gender-option/3138447002/ |archive-date=17 July 2023 }}</ref>
|Must visit the Bureau of Motor Vehicles with supporting documentation.<ref>{{Cite web|url=https://www.in.gov/bmv/licenses-permits-ids/learners-permits-and-drivers-licenses-overview/drivers-license/amending-your-drivers-license-or-identification-card/|title=Amending Your Driver’s License or Identification Card|last=Licenses|first=Permits|date=2020-07-01|website=Licenses, Permits, & IDs|language=en|access-date=2020-11-11|archive-url=https://web.archive.org/web/20230401162732/https://www.in.gov/bmv/licenses-permits-ids/learners-permits-and-drivers-licenses-overview/drivers-license/amending-your-drivers-license-or-identification-card/|archive-date=17 July 2023}}</ref>
|
|-
| Maine
| style="background-color:#9ff;"|X marker available since June 2018.<ref name="maineDL">{{Cite web |title=Maine BMV to offer non-binary gender designation on driver’s licenses, ID cards |author= |work=maine.gov |date=June 11, 2018 |access-date=November 11, 2020 |url= https://www.maine.gov/sos/news/2018/genderdesignationdlid.html|archive-url=https://web.archive.org/web/20230520000840/https://www.maine.gov/sos/news/2018/genderdesignationdlid.html |archive-date=17 July 2023 }}</ref>
|Fill out the [https://www.maine.gov/sos/bmv/forms/GENDER%20DESIGNATION%20FORM.pdf Gender Designation Form]. Standard renewal and duplicate license fees apply.
|
|-
| Maryland
| style="background-color:#9ff;"| M, F, or X since 2019.
|
|
|-
| Massachusetts
| style="background-color:#9ff;"| M, F, or X options since November 2019.<ref name="Vaughn">{{Cite web |title=The RMV Officially Recognizes a Non-Binary Gender Option Now |last=Vaughn |first=Alyssa |work=Boston Magazine |date=13 November 2019 |access-date=5 June 2020 |url= https://www.bostonmagazine.com/news/2019/11/13/massachusetts-rmv-gender-neutral-drivers-licenses/|archive-url=https://web.archive.org/web/20221207200502/https://www.bostonmagazine.com/news/2019/11/13/massachusetts-rmv-gender-neutral-drivers-licenses/ |archive-date=17 July 2023 }}</ref>
|
|
|-
| Michigan
| style="background-color:#9ff;"| M, F, or X options since November 10, 2021.<ref name="Powers-Michigan">{{Cite web |title=Nonbinary Designation Added For Michigan Driver's Licenses |last=Powers |first=Sara |work=CBS Detroit |date=3 November 2021 |access-date=4 November 2021 |url= https://detroit.cbslocal.com/2021/11/03/nonbinary-designation-added-for-michigan-drivers-licenses/|archive-url=https://web.archive.org/web/20220705194050/https://detroit.cbslocal.com/2021/11/03/nonbinary-designation-added-for-michigan-drivers-licenses/ |archive-date=17 July 2023 }}</ref>
| No medical or legal documentation requirements to change marker<ref name="Powers-Michigan" />
|
|-
| Minnesota 
| style="background-color:#9ff;"| X marker available since late 2018.<ref name="MinnesotaDL">{{Cite web |title='X' is new gender choice on Minnesota driver's licenses |last=Nelson |first=Tim |work=MPR News |date=October 2, 2018 |access-date=November 11, 2020 |url= https://www.mprnews.org/story/2018/10/02/real-id-minnesota-licenses-new-gender-choice-x|archive-url=https://web.archive.org/web/20221108205651/https://www.mprnews.org/story/2018/10/02/real-id-minnesota-licenses-new-gender-choice-x |archive-date=17 July 2023 }}</ref>
|
|-
| New Hampshire
| style="background-color:#9ff;"| M, F, or X options since January 1, 2020.<ref name="Feely">{{Cite web |title=Bill allowing 'X' to mark gender on NH licenses becomes law |last=Feely |first=Paul |work=New Hampshire Union Leader |date=July 11, 2019 |access-date=October 30, 2020 |url= https://www.unionleader.com/news/safety/bill-allowing-x-to-mark-gender-on-nh-licenses-becomes-law/article_054ba80d-0066-53cf-a7e9-98118d2ac907.html|archive-url=https://web.archive.org/web/20230516132423/https://www.unionleader.com/news/safety/bill-allowing-x-to-mark-gender-on-nh-licenses-becomes-law/article_054ba80d-0066-53cf-a7e9-98118d2ac907.html |archive-date=17 July 2023 }}</ref>
|
|
|-
| New Jersey
| style="background-color:#9ff;"| M, F, or X. X became available in April 2021.<ref name="Sobko">{{Cite web |title=New Jersey adds 'X' as gender option on MVC driver's licenses |last=Sobko |first=Katie |work=North Jersey Media Group |date=April 19, 2021 |access-date=April 19, 2021 |url= https://www.northjersey.com/story/news/transportation/2021/04/19/nj-drivers-license-gender-options-now-include-x-nonbinary/7286526002/|archive-url=https://web.archive.org/web/20230327192944/https://www.northjersey.com/story/news/transportation/2021/04/19/nj-drivers-license-gender-options-now-include-x-nonbinary/7286526002/ |archive-date=17 July 2023 }}</ref>
| "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."<ref name="Sobko" />
|
|-
| New Mexico
| style="background-color:#9ff;"| M, F, or X.
|
|
|-
| New York
| style="background-color:#9ff;"| M, F, or X.
|
|
|-
| Oregon
| style="background-color:#9ff;"| M, F, or X. The X became available on driver's license forms on 2017-07-01.<ref name="IGRPresources" />
|
|
|-
| Pennsylvania
| style="background-color:#9ff;"| "X" gender designation available since July 2020.<ref name="Limberg">{{Cite web |title=PA Now Offering Nonbinary Option for Driver License and IDs |last=Limberg |first=Andrew |work=1010 WINS |date=23 July 2020 |access-date=23 July 2020 |url=https://1010wins.radio.com/articles/radiocom/pa-now-offering-non-binary-option-for-driver-licenseid |archive-url=https://web.archive.org/web/20230721055302/https://www.audacy.com/kdkaradio/articles/pa-now-offering-non-binary-option-for-driver-licenseid |archive-date=21 July 2023 |url-status=bot: unknown }}</ref>
|Fill out a form and bring it to DMV in person. No medical or social service documentation is needed.<ref name="dmvPA">{{Cite web |title=Gender-Neutral Designation |author= |work=PennDOT Driver & Vehicle Services |date= |access-date=23 July 2020 |url= https://www.dmv.pa.gov/Driver-Services/Driver-Licensing/Pages/Gender-Neutral-Designation.aspx|archive-url=https://web.archive.org/web/20230605141145/https://www.dmv.pa.gov/Driver-Services/Driver-Licensing/Pages/Gender-Neutral-Designation.aspx|archive-date=17 July 2023}}</ref>
|
|-
| Vermont
|style="background-color:#9ff;"|"M", "F", and "Other" available.
|Fill out [https://web.archive.org/web/20200918115655/https://dmv.vermont.gov/sites/dmv/files/documents/VL-040-Replacement_License_1.pdf this form] and pay the applicable fee.
|
|-
| Virginia
| style="background-color:#9ff;"| M, F, or X since 2020.
|
|
|-
| Washington
| style="background-color:#9ff;"| M, F, or X.<ref>{{cite web|url=https://www.dol.wa.gov/forms/520043.pdf|title=Change of Gender Designation|publisher=Washington State Department of Licensing|archive-url=https://web.archive.org/web/20230531091855/https://www.dol.wa.gov/forms/520043.pdf|archive-date=17 July 2023}}</ref>
|
|
|}

====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,"<ref>"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 [https://web.archive.org/web/20230606073906/http://www.state.gov/documents/organization/143160.pdf Archived] on 17 July 2023</ref> and no longer requires proof of surgery.<ref>"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 [https://web.archive.org/web/20230606073906/http://www.state.gov/documents/organization/86784.pdf Archived] on 17 July 2023</ref>

====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.<ref>"Frequently Asked Questions" ''Transgender American Veterans Association'' [http://www.tavausa.org/faq.htmlhttp://www.tavausa.org/faq.html]</ref>

====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."<ref><em>See</em> Social Security Administration, <em>Changing Numident Data for Reasons Other Than Name Change</em>, [https://secure.ssa.gov/poms.nsf/lnx/0110212200 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. <em>Compare</em> <em>id.</em> <em>with</em> [http://www.state.gov/documents/organization/143160.pdf#page=3 7 U.S. Dep't of State, Foreign Affairs Manual § 1300 appx. M, at 3-4].</ref>

===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.<ref>http://practicalandrogyny.tumblr.com/post/7025100121/gender-free-marriage-certificate-from-cambridge [https://web.archive.org/web/20180903003925/http://practicalandrogyny.tumblr.com/post/7025100121/gender-free-marriage-certificate-from-cambridge Archived] on 17 July 2023</ref>

===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 [[Wikipedia:Transgender rights in the United States#Employment_discrimination|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:<ref>http://nonbinary-support.tumblr.com/post/113431196413/states-where-it-is-the-law-for-insurance-to-cover [https://web.archive.org/web/20180902203756/http://nonbinary-support.tumblr.com/post/113431196413/states-where-it-is-the-law-for-insurance-to-cover Archived] on 17 July 2023</ref>
* [https://web.archive.org/web/20170729153907/https://transgenderlawcenter.org/archives/4273 California] (April 2013)
* [https://web.archive.org/web/20170805185939/http://www.one-colorado.org/what-coloradans-need-to-know-about-the-division-of-insurance-recent-bulletin-on-health-insurance/ Colorado] (March 2013)
* [http://www.advocate.com/politics/transgender/2013/12/31/connecticut-becomes-fifth-state-require-transgender-medical-coverage Connecticut] (December 2013)
* [https://web.archive.org/web/20140803221129/http://www.aidschicago.org/illinois-news/915-illinois-advocates-hail-great-first-step-to-end-discrimination-against-transgender-individuals-in-health-insurance-coverage Illinois] (July 2014)
* [http://www.advocate.com/politics/transgender/2014/06/23/trans-residents-celebrate-monumental-health-care-ruling-mass Massachusetts] (June 2014)
* [http://www.nytimes.com/2014/12/11/nyregion/in-new-york-insurance-must-cover-sex-changes-cuomo-says.html?_r=0 New York] (December 2014)
* [https://web.archive.org/web/20150906174923/http://www.basicrights.org/featured/historic-news-oregon-removes-barriers-to-transition-related-care/ Oregon] (January 2013)
* [https://web.archive.org/web/20161002122248/http://transgenderlawcenter.org/archives/7506 Vermont] (April 2013)
* [https://web.archive.org/web/20170710093730/https://transgenderlawcenter.org/archives/10537 Washington] state (June 2014)
* [http://mayor.dc.gov/release/mayor-gray-announces-steps-protect-glbt-community-discrimination-health-care Washington D.C.] (February 2014)

The Human Rights Campaign (HRC) maintains a list of health insurance companies and their relevant policies: "[https://web.archive.org/web/20150424015811/http://www.hrc.org/resources/entry/finding-insurance-for-transgender-related-healthcare 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.<ref name="redcross">{{Cite web |title=LGBTQ+ Donors |author= |work=redcrossblood.org |date= |access-date=6 June 2020 |url= https://www.redcrossblood.org/donate-blood/how-to-donate/eligibility-requirements/lgbtq-donors.html|archive-url=https://web.archive.org/web/20230308194049/https://www.redcrossblood.org/donate-blood/how-to-donate/eligibility-requirements/lgbtq-donors.html|archive-date=17 July 2023}}</ref>

==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==
* [https://web.archive.org/web/20170729192006/http://www.intersexrecognition.org/home.html Intersex &amp; 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."
* [https://www.lgbtmap.org/equality-maps/identity_document_laws/ Movement Advancement Project: Identity Document Laws and Policies]
* [https://www.lambdalegal.org/x-markers Lamda Legal: X Gender Markers by State]

==References==
<references/>


[[Category:Practical resources by country]]
[[Category:Recognition]]
[[Category:USA]]