Uhm, I'm in the process of getting my name changed and I've asked a ton of questions to a woman from the Directeur de l'état civil, so I think I have it right.
You don't need 3 letters. Only 2. One from your treating doctor (endo), and one from a mental health professional who's been seeing you (most probably a psychiatrist). Also, there is no such thing as a requirement for having been using the name for some time or anything. No letter from a family member either. And no lengthy explanation needed from you either. Mine is one line long and they said it was okay: "Je suis une transsexuelle homme vers femme en transition." ("I am a male to female transsexual in transition.")
As for proving, my psychiatrist's letter is really simplistic, and he says that pretty much the very same letter has always been accepted for the tens of name changes he's supported. And the lady at the Directeur de l'état civil said it was okay, and that a similar thing from my endo would be perfect. So don't sweat it.
Apart from trans specific stuff (which pretty much amounts to those two letters), you need to make publications, once per week, for two consecutive weeks, in a newspaper published in your judiciary district (they had no details for me, but apparently, if you tell them that you need an publication for a name change, they know what to do) as well as in the Gazette officielle du Québec (comes with the form).
One interesting fact, you don't -need- to fill in the preliminary thingie. When I contacted the Directeur de l'état civil with questions, the lady told me on the phone that it was clear my situation required a name change request, and sent me the forms directly. Once they get your forms with all the required papers, it takes 4 months to be treated, + a 30-day delay for anyone who might want to make observations or comments on your name change.
After that you get your certificate. Interesting fact, the delivery of that official paper changes nothing officially, except in the Directeur de l'état civil's data. So you can make the request in advance, and then, when you're ready (e.g. between two school terms), you can start presenting it to Service Québec, your bank, your employer, your school, etc. so it's applied. A bit of a worry that you have to make sure you don't forget anyone, though.
As for the gender change, yush, you do need surgery to have "primary sexual characteristics altered". That's SRS for MTFs, but I'm not sure exactly what it implies for FTMs.
If you have any questions, feel free to PM me. I should know pretty much everything there is to know about this with all the questions I asked. I also still have all the forms and the guide next to me, as well as the letter from my psychiatrist, all filled out but not sent, and validated as correct through email by the employee who's taking care of my case. I don't mind showing you any of that that you'd be curious about.
Funny fact: if you change your gender marker, there are no additional requirements or costs for changing your name to one of the opposite gender at the same time. No publications required at all, either. So we pay double or triple for the whole process. But to be honest, who can satisfy the criteria of 6-12 months of RLE for SRS with their old name? Unless it's already androgynous.
Pretty illogical, but the law is still that way, and apart from maybe Québec Solidaire, I don't think there's the slightest political will to change that. It takes effort, and people will say "we're spending for a non-essential problem instead of paying the debt" like they did when SRS became covered more easily. And probably no party right now would want to take that sort of political risk, however small, for the small part of the population that we are... So yeah. I think we have to brace ourselves and deal with it.
So, uhm, anyway. The process is a pain, but not as hard as
santetranshealth.org says it is.
