you can change your birth certificate in Michigan and I believe Michigan is coming close to allowing same sex marriages (my girl is from Michigan (the flint area), I was there last month) anyway, I know its hard when your from a state that isn't will say "gay friendly", but you can always move to a more liberal state. Far as surgeries go, I think it depends on the state, I think most its only top surgery that is necessary to change your birth certificate. Social Security and Drivers license, I think you just need a doctor or therapist to sign off that you are transitioning.