It is easy to change documents at a federal level; it's when you get to the state level that you run into issues.
US Passports - EasyHere are the short form guidelines for US Passport change:
http://travel.state.gov/passport/get/first/first_5100.htmlBasically what it says is that you need a letter from your doctor verifying that you are in the process of a gender-related transition (read: HRT, which will get you a limited, 2 year passport that can be upgraded, for free, after completing transition) or that you have completed the process of gender-related transition (which will get you the 10 year passport).
Fortunately for us, the guidelines are vague about defining "in the process of" and "completed". They do not explicitly state that you must have been on HRT for x months, or that you must have had x, y, or z surgeries. Of course defining those will be at the discretion of your doctor, but what it means is that you could have a surgery out of the US and simply have your doctor verify that the surgery was completed.
For more detailed guidelines (this is what State Dept. employees would use), see:
http://www.state.gov/documents/organization/143160.pdf7 FAM 1320 APPENDIX M DOCUMENTS TO BE SUBMITTED WITH PASSPORT APPLICATION
Section b. (1)
Section b. (1) (f) and (g)
Section b. (2) (b)
US Social Security Card - EasyGuidelines:
http://ssa-custhelp.ssa.gov/app/answers/detail/a_id/1667/~/change-gender-on-your-social-security-recordThese are even more brief than those for the passport. All that is required to document your gender is a letter from "your surgeon or attending physician verifying that the sex change surgery was completed". Again, they do not explicitly define what "sex change surgery" is, so that is up to your doctor's discretion, but the good news is you could have your surgery outside of the US and simply have it verified here by your own doctor.
Drivers License and Birth Certificates - ? Depends on where you liveThese two are the tricky ones, as each state has their own rules and regulations. A good place to start would be this site's wiki:
https://www.susans.org/wiki/Changing_sex_on_driver%27s_licenses_in_the_UShttps://www.susans.org/wiki/Changing_sex_on_birth_certificates_in_the_USFor my state, Florida, the DMV recently changed their guidelines to match those of the US Passport agency.
https://docs.google.com/file/d/0B2lhPVLM4mvkMzM1ODQyYTEtMzMyMy00YjYxLTkwODQtMzNmMmFhYmRkNTcy/edit?hl=en&authkey=CPGAvZICThe only difference is that the DMV guidelines specify the letter must be from an endocrinologist, urologist, gynecologist, internist, or psychiatrist. However, since their guidelines are based on the more loosely defined passport rules, the ninja in me wonders if this might be a case where you could sneak under the radar with a letter from another physician. Either way, the point is that depending on your state, you may not even need a completed surgery to change a drivers license; you may just need a letter verifying HRT is underway.
For a Florida birth certificate, the instructions for a birth certificate amendment only state that the amendment request be "accompanied by original, certified, or notarized supporting documentary evidence."
http://www.doh.state.fl.us/planning_eval/vital_statistics/DH_660_Instructions_for_Amending_a_Certificate_of_Live_Birth.pdfAgain, they don't explicitly state what that evidence is. I've had a lot of trouble locating their exact guidelines (some sources say the letter must be from your surgeon; others from any physician). Obviously the best thing to do in this case is make a phone call to that agency because each state has different rules.
So, in summary, it MAY be possible to have surgeries outside of the US work for changing documents; it just depends on your state's rules and definitions. Also note: some surgeons may be licensed in the US as well - I think I recall reading that Brassard in Canada is licensed in Michigan, and thus has a US license number as well.
@mintra - You mentioned "citizenship certificate"; I'm not exactly sure to which document you are referring; however, given that that is a federal document and that federal documents are a bit easier to change than state documents, I would imagine that changing the gender marker wouldn't be a problem even with surgery outside of the US.
