I see my hormone doctor on the 3rd (I think. This office is bad at explaining what to expect with each visit XD I'm kind of just rolling with it right now) And I intend to ask her. When I find anything out, I'll make a new topic if this one dies out (which it probably will, since it's not a hot press topic, just to us Virginians

)
Arch, I've seen one place quote genital reassignment surgery, and another quote irreversible surgery. I'm not sure which source is more recent, but I'm hoping the irreversible one is, because that would be easier to get around, with the clitoral release or hysto.
EDIT: Okay I found another site talking about what's required.
12 VAC. 5-550-320. Change of Sex.
Except as provided in 12VAC 5-550-450-C upon presentation of acceptable
evidence (preoperative diagnosis, postoperative diagnosis and description of
procedure), and a notarized affidavit from the physician performing the surgery, a new
certificate of birth may be prepared by the State Registrar for a person born in this
Commonwealth whose sex has been changed by surgical gender reassignment
procedure. A certified copy of the court order changing the name of the registrant as
well as designating the sex of the registrant must be in the possession of the State
Registrar together with a request that a new certificate be prepared.
End of EDITAnd, man, if you think VA is militant, I feel bad for those that don't allow amendments at all, like Idaho and a few others.