WA makes it really easy to change the gender marker (you will first need to get a WA ID the normal way, I think - then update it using what the link below says):
http://www.dol.wa.gov/driverslicense/genderchange.htmlThere is a form a medical professional must fill out:
they just need to be someone who can check this box on the form -
The applicant has undergone the appropriate gender transition clinical treatment. Yes/No (what is 'appropriate' is left up to the medical professional fills out the form, AFAIK)
Here is who can fill out the form authorizing the marker change:
a licensed medical physician, internist, endocrinologist, gynecologist, urologist,
osteopathic physician, psychiatrist, psychologist, or a Washington State licensed naturopathic physician, advanced
registered nurse practitioner, physician assistant, or certified osteopathic physician assistant familiar with your treatment
