Sadly, birth certificates are not dispositive of whether a state will accept you as that gender. There are a number of cases of post-op transsexuals with conforming birth certificates being denied marriage to their partners: Littleton v. Prange (Texas App.), In Re Nash (Ohio), Kantaras v. Kantaras (Florida), and In Re Gardiner's Estate (Kansas). While an amended birth certificate may help the state recognize the marriage as "valid" (read: heterosexual), a number of states have stated that the agency issuing marriage licenses can ignore gender markers on them in favor of birth sex. So, relying purely on your birth certificate may not help.
Second, the rules for amending the gender marker on your birth certificate is that you must have reassignment surgery.* Unfortunately, you can only amend your birth certificate in the state of your birth** So, if you want to amend your birth certificate, then you are kind of stuck with surgery and a recovery vacation to Hawaii. The good news is that states are beginning to back away from surgical requirements, the bad news is this is slow.
Finally, while you may not want a "gay" marriage (I totally understand), it may be all that there is. Kentucky is part of the 6th Circuit Court of Appeals and there is a case going on there that may legalize gay marriage in Michigan, Ohio, Kentucky, and Tennessee. While this alone is good news, the collateral effect is that a state cannot just look into your past and void your marriage license because it found out you are trans. So, as HereKitten pointed out, you could get a "heterosexual" marriage if you have a driver's license listing you as female, and if the state looked into your past (and gay marriage is allowed), the state still must accept.
But, the problem with Kentucky is that it will not amend the gender marker on your driver's license unless you present an amended birth certificate or receive SRS.*** So, if you want to get the license to reflect female, to get the heterosexual marriage, then you're sadly out luck. The only advice I can give you would be to move to Virginia or Maryland, get a driver's license there, and then get married there and go to Kentucky. From my experience, VA amended my name and gender marker on my license with only a therapist recommendation and $41 in state fees. But, I doubt moving is a realistic, or ideal, solution.
Best of luck with everything, though. Hopefully some of these policies change a bit by the time you meet Mr. Right and planning that wedding.
*Haw. Rev. Stat. Ann. § 338-17.7(a)(4)(B) (2005)(stating "(a)The department of health shall establish, in the following circumstances, a new certificate of birth for a person born in this State [if]... (4)(B) The birth registrant has had a sex change operation and the sex designation on the birth registrant's birth certificate is no longer correct; provided that the director of health may further investigate and require additional information that the director deems necessary;")
**There is an exception in which Connecticut allows its courts to issue amended birth certificates for Connecticut citizens born elsewhere.
***The Kentucky DMV, like most state DMV's, does not make this information readily findable on google. In its place, I found two conflicting reports about what Kentucky requires:(1) from Lambda Legal requiring an amended birth certificate, and (2) a great article by Dean Spade called "Documenting Gender" that requires SRS, but not necessarily an amended birth certificate.
