States Easing Some|Transgender Rules

HONOLULU (CN) - Transgender Hawaiians may apply for a gender change in their birth certificates without the sex-change operation, as Gov. David Ige signed a bill eliminating the reassignment surgery requirement before making it official.

Ige on Monday signed HB 631 into law as Act 226, simplifying the physician affidavit requirement into a doctor's note that attests treatment and physician-patient relationship. The law took effect immediately.

Under the old law, applicants needed an affidavit from a physician stating: "The birth registrant has had a sex change operation and the sex designation on the birth registrant's birth certificate is no longer correct."

Now applicants need only a doctor's note stating that "the physician has a bona fide physician-patient relationship with the birth registrant" and "has treated and evaluated the birth registrant and has reviewed and evaluated the birth registrant's medical history."

The physician's note must confirm that "the birth registrant has appropriate clinical treatment for gender transition to the new gender and has completed the transition to the new gender and the new gender does not align with the sex designation on the birth registrant's birth certificate."

The new birth certificate will be considered a substitute for the original certificate, not an amendment to the language of the old birth certificate.

"The original certificate and the evidence supporting the preparation of the new certificate shall be sealed and filed," under the new law. The sealed documents can be opened only through a court order or by request of the birth registrant.

Hawaii joined a few other states to make similar changes to their birth certificate laws, including Connecticut, California, Iowa, New York and Vermont. Washington, D.C. passed a similar measure.

Two days before the Supreme Court struck down state bans against gay marriage, Connecticut Gov. Dannel Malloy signed HB 7006 , now PA 15-132, eliminating the surgical requirements.

Unlike Hawaii's law, Connecticut's version considers the new gender an amendment rather than a substitute to the original. It adds advanced practice registered nurses and psychologists as authorized medical practitioners who can attest to a birth registrant's gender transition.

The Connecticut law takes effect Oct. 1.

The American Medical Association last year called on states to abandon the sex change operation requirement, because the choice for a "needless operation" should be decided by the patient and physician, not the government.

The AMA said there are instances when a combination of mental health care, social transition and hormone therapy is more medically appropriate than a "gender affirmation surgery."

The AMA statement came following California Gov. Jerry Brown's signed AB 1121 in October 2013, eliminating the court order and local newspaper publication requirements for transgender people.

Since Jan. 1, 2014, a California-born transgender need only submit a form and a doctor's note to the state health department with a $23 fee to show an identity-appropriate gender in birth certificate. Under the old law, a transgender had to present a court order to amend the original birth certificate.

California-born transgender people seeking a name change to better match their gender identity are no longer required to publish the change in a local newspaper. Nor are they required to attend a court hearing unless someone challenges the name change request.

The California transgender law does not automatically seal the documents unless the birth registrant requests the court to do so. It spells out a basis for granting the request to seal documents, such as "overriding interest that overcomes the right of public access to the record," among others.

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