Just to clarify, it appears from the nctequality.org website link posted by Sebastien that a gender marker change on a passport requires (among other things) a form of identification -- this can be a birth certificate but can also be a driver's license, or any other kind of official government ID.  So it looks like even if you can't get the gender marker changed on your birth certificate, this shouldn't keep you from having it changed on a passport.

from Josh: The individual must have had complete srs surgery (mtf)... The individual will need a letter from the surgeon stating this fact... also, it helps if the individual has already had the name change done... that way they could take the court papers and have that changed on the license...
The irony of this.. is that ftm's have to have only one of the surgeries to qualify as having srs, and they do prefer the top surgery since the chest is readily seen... also they will not change the gender marker if the individual has had no surgery...so those that cannot afford treatment face more harrassment and discrimination because nothing can be changed... uuuggghhh!!!!

Your welcome... It is a heartbreaking situation right now... On the upside, there are a few people that are involved with Equality Ohio, that happen to be trans, that are actually working on this problem. The head of the BMV is involved with getting the policy changed... because it's not a law, but policy, there could be changes made within the year.... so keep your fingers crossed!!! Have a great day!

This is the info that I got for you!

thank you to Josh, since i can't log into yahoo currently for some stupid reason.

I also live in Ohio, but was not born here. I haven't changed my documentation yet, but will be next month. I have my letter from my surgeon and I'm just waiting for my name change to be completed. I know other transfolk in the state who have changed their licenses, so I'm hoping everything goes smoothly. I'll report back once everything is completed.

Anyone know about changing Florida birth certificates? I've heard its possible but very difficult. Thanks!

lol I dont think I've ever been so happy to have been born in PA xD anywhoooo I have heard of people using sharpies to change there gender marker on there ID and driver license buuuuut I dunno how well it'd work or how much trouble you'd get in if someone busted you lol