Under current federal policy, you cannot change the gender marker on your passport, Social Security record, or immigration documents; those now reflect sex assigned at birth. You can still change your gender marker on government documents at the state level, including your driver’s license, state ID, and in most states your birth certificate, though the exact steps depend on where you live and where you were born.
What You Can and Cannot Change at the Federal Level
Executive Order 14168, signed on January 20, 2025, directs every federal agency to record sex based on biological classification at birth and eliminates the X (non-binary) marker from federal documents.1Federal Register. Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government A federal district court in Massachusetts blocked the passport portion in June 2025, but the U.S. Supreme Court stayed that injunction on November 6, 2025, so the policy is in full effect while the appeal continues in the First Circuit.2Supreme Court of the United States. Trump v. Orr – 25A319 Check current status before applying, because the litigation may still shift things.
Passports
The State Department no longer issues passports or Consular Reports of Birth Abroad with an X marker and no longer honors self-attestation requests. New and renewed passports carry only an M or F marker matching biological sex at birth, and the application is signed under penalty of perjury. A passport already in your possession with an X marker remains valid until it expires, you replace it, or the government invalidates it; the replacement will carry only M or F.3U.S. Department of State. Sex Marker in Passports
Social Security
As of January 31, 2025, the Social Security Administration no longer processes changes to the sex designation on Social Security records. The 2022 self-attestation policy has been rescinded.1Federal Register. Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government Practically, the sex field in your SSA record has limited daily reach: employers do not see it when verifying your Social Security number through the Social Security Number Verification Service, and SSA only shares the data with other agencies that provide written program justification.4Social Security Administration. Verify Sex Field in Social Security Number Verifications and Data Exchanges
Immigration Documents
USCIS updated its policy to recognize only two biological sexes. The agency no longer issues documents with an X marker and will not issue documents showing a sex different from the birth certificate issued at or near the time of birth. Leaving the sex field blank or listing a different sex on an application may cause processing delays.5U.S. Citizenship and Immigration Services. USCIS Updates Policy to Recognize Two Biological Sexes
Changing Your State Driver’s License or ID
The executive order does not touch state-issued identification. About 22 states plus Washington, D.C. offer an X or non-binary marker on driver’s licenses. Florida, Arkansas, Kansas, Tennessee, and Texas have moved to prohibit X markers or restrict gender marker changes on state documents. The remaining states offer M and F with varying requirements to change between them.
State processes fall into three categories:
- Self-attestation states let you select your gender marker at the DMV without any supporting documentation. This is the fastest route and is spreading.
- Medical documentation states require a signed letter from a licensed healthcare provider confirming your gender identity. Provider qualifications and letter content vary.
- Court order states require a court order formally recognizing the gender change before the DMV will update your record.
Fees at the DMV typically run from $5 to $37, and some states waive the fee if you are only updating the gender marker.
Amending Your Birth Certificate
Birth certificate changes go through a separate office from the DMV, usually the state department of health or office of vital statistics, and requirements can be stricter than for a driver’s license even within the same state. A few states do not permit birth certificate amendments for gender at all.
The state that recorded your birth is the state that handles the amendment. If you were born in one state and now live in another, you must work with the state of birth regardless of where you live. Amendment fees generally run from $15 to $55, and you will usually want to order several certified copies at once, because each copy carries its own fee and other agencies often want an original.
Getting a Court Order
If your state requires a court order, or if you want one to simplify updates across multiple agencies, the process starts with a petition filed in a local court asking for legal recognition of your gender change. You complete the court’s forms, pay a filing fee, and in some jurisdictions appear before a judge. Filing fees run from roughly $100 to over $450 depending on the jurisdiction, and fee waivers are widely available for people who cannot afford the cost.
Some states let you combine the gender marker change with a legal name change in one petition; others require separate filings. The clerk’s office or the court’s self-help resources can point you to the correct forms. Once the order issues, request certified copies; you will present them to the DMV, vital records office, and any other agency that requires proof.
What It All Costs
- Birth certificate amendment: $15 to $55, paid to the state vital records office.
- Driver’s license or state ID update: $5 to $37, sometimes waived.
- Court order filing fee: roughly $100 to $450 or more, with waivers available.
- Passport book: $130 for an adult; passport card alone $30.6U.S. Department of State. Passport Fees
Budget for at least two or three certified copies of any court order or amended certificate, since agencies routinely keep the original you submit.
Traveling With Mismatched or X Markers
A valid passport with an X marker still works for travel until it expires, and the State Department has confirmed no domestic restrictions on using one, though other countries may impose their own.3U.S. Department of State. Sex Marker in Passports On international flights, U.S. Customs and Border Protection now requires airlines to enter either M or F for every passenger regardless of what the passport shows, so an airline will assign one of those in its reservation system if your passport has an X. The rule does not currently apply to domestic flights or land border crossings.
If your driver’s license and passport show different gender markers, expect occasional questions at security checkpoints. Carrying a court order or amended birth certificate can help resolve them, though nothing legally requires you to explain the discrepancy.
Health Insurance and Medical Billing
Insurance billing systems flag claims that appear to conflict with the patient’s recorded sex. A gynecological exam billed under a male record, or a prostate screening billed under a female record, will often trigger an automatic denial. These are computer-generated coding rejections, not policy denials, and they are fixable. Providers can append modifier code KX to procedure codes that conflict with the recorded sex, and institutional providers can add condition code 45 to flag the claim as intentional. Many billing offices that rarely see transgender patients simply do not know the workaround exists, so it is worth telling them.
You should not need to change your gender marker back to access sex-specific care. If an insurance representative insists otherwise, ask for a supervisor, and consider a civil rights complaint if that fails.
Selective Service
Selective Service registration is based on sex assigned at birth. People assigned male at birth are required to register even after changing their gender marker to female; people assigned female at birth are not required to register even after changing their marker to male.7Selective Service System. Who Must Register Chart Registration is tied to federal student aid, federal job eligibility, and naturalization, so it matters. If you were assigned female at birth and an agency questions the absence of a registration record against your male marker, request a Status Information Letter from Selective Service to document that you were not required to register.8Selective Service System. Status Information Letter (SIL)
Keeping Records Consistent
There is no unified “legal sex” in the United States. Your passport, Social Security record, birth certificate, driver’s license, and insurance file can all show different markers at once, because each agency operates independently. Under current federal policy, your federal documents will reflect sex at birth while your state documents may reflect a different marker if your state permits changes.
The inconsistency is not illegal, but it can create friction. Background checks, employment verification, and benefit applications sometimes cross-reference multiple agencies, and mismatches trigger manual review. Whenever you update one document, work through everything else that references your gender: employer records, bank accounts, academic transcripts, professional licenses, and voter registration are the easy ones to forget. Keep certified copies of any court orders, amended certificates, and prior IDs in one folder so you can answer questions quickly when they come up.