A letter from my urologist he looked at my orchi scar and said that I had "irreversible genital surgery" I had my hair and makeup done up and a very cute spaghetti strap flower print sun dress went to the county court house filed the forms for a name change didn't need the letter, the judge asked a few questions smacked her gavel pay the clerk Cyndi name change granted, I mailed the name change order and surgery letter to Hawaii where I was born, plus the forms and fees, in two weeks a new birth certificate with new name and gender marked female took all 3 to DMV walked out with my new DL took ALL that social security and they changed there info, but every state is different good luck sweetie :-)