http://www.huffingtonpost.com/2013/06/15/transgender-id-cards_n_3447240.html?utm_hp_ref=gay-voices&ir=Gay%20VoicesAuthor: Lisa Leff Source: Huffington Post
"The rules vary from state to state, agency to agency and even clerk to clerk. But a transgender applicant generally has been required to submit both a court order approving the gender change and a letter from a surgeon certifying that the person underwent irreversible sex reassignment surgery before obtaining a new document.
Over the last few years, though, the emerging movement for transgender rights has been quietly pressing the issue, persuading state lawmakers and federal and state agencies to simplify the lengthy and often costly process. Advocates recorded their latest victory Friday, when the Social Security Administration announced that it would no longer require proof of surgery to alter the gender identification of individuals in its computers and records."
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This article seems like it didn't get the post that Mrs O'Brien just posted (or maybe I just missed it while reading it, so also see here for a state-specific (Oregon) discussion of similar issues:
https://www.susans.org/forums/index.php/topic,142606.0.html