Wednesday, December 29, 2010

Difficulties With the New Passport Guidelines for Gender Marker Change

I am having issues getting my gender marker set correctly on my passport. Yesterday, I got a letter back from the State department stating that I needed to provide a letter from an endocrinologist or other accepted professional stating that I had clinically transitioned to female. I had submitted one from my endocrinologist and one from my therapist, both in Kentucky. The letter from the Department of State didn't detail what exactly was not sufficient and I have been having difficulties trying to elicit that information. I dropped the following letter off a few minutes ago at the US Department of State website.

Attn: United States Secretary of State Hillary Rodham Clinton

Dear Ms. Clinton,

I understand that the new guidelines for gender marker change were targeted to make things easier for non-operative transsexuals to obtain a passport in their target gender.

It does do that, but it makes it much more difficult for pre-operative transsexual women like myself to obtain a gender appropriate passport for flying overseas to have gender reassignment surgery. They fly to a foreign country because they have to pay for the procedure out of their own pocket due to the fact they are often refused coverage for AMA-deemed necessary coverage by health insurance organizations via the default standard policy with discriminatory exclusions that most employers don't see.

The difficulty comes in the fact that what referring health care providers used to deliver for a passport to have surgery in a foreign country now does not meet the guidelines, and they assume otherwise, since the standard has been established for some years. This results in wasted time for the patient having to prove to the doctor via US DOS notification that the guidelines were not met--essentially, proof by rejection.

Doctors are busy people and having to redo a recommendation letter takes time--valuable time.

I submitted my passport application about 4 weeks ago with original documentation for my court-ordered name change, birth certificate, and two letters of recommendation detailing my readiness for surgery--one from my therapist (an LCSW) and one from my endocrinologist.

I received by mail 2 days ago a letter that stated that I needed to provide a letter from an accepted provider that had 7 specific bullet points. I know at least some of those bullet points were more that adequately addressed. Because it took a week for the notification to arrive, I was greeted with the bad news that I had 83 days left to provide the information--76 days if you account for the mail taking the same time to return--before I am issued a passport in my birth-assigned gender. This is going to cause an issue for me because I already reserved the flight tickets with a female gender.

I immediately contacted the State Department help line so they could give me a better clue as what was exactly wrong with the doctor's recommendation so I could provide feedback to my endocrinologist to make the necessary corrections. I was told that the information was not available on line and they would call me back within 48 hours. It has now been over 50 hours since the contact request has been made and I have not had a response yet.

Without an accurate response, the likelihood of my doctor writing another not-good-enough recommendation is significant, and I still don't have my original documents back.

Furthermore, when I called yesterday, the support staff risked the exposure to the fact that I am transsexual to my coworkers by requiring me to read the entire letter, which includes very sensitive and therefore private information, to her over the phone, saying she understood my humiliation.

This procedure should not be this difficult, nor should the burden of responsiveness rest solely on my shoulders and not be shared by the agents processing the application.

Thank you for consideration in this matter.


Sophia Jean Hawes


  1. You're trying to re-invent the wheel. Just use the sample letter as written in the State Department's guidelines for changing gender. NCTE's website gives good guidance on how to go about this.

    Attending Physician’s Letterhead
    (Physician’s Address and Telephone Number)

    I, (physician’s full name), (physician’s medical license or certificate number), (issuing State of medical license/certificate), (DEA Registration number), am the attending physician of Sophia Jean Hawes, with whom I have a doctor/patient relationship. (The letter must indicate that the physician is either an internist, endocrinologist, gynecologist, urologist or psychiatrist.)

    Sophia Jean Hawes has had appropriate clinical treatment for gender transition to the new gender (female).

    I declare under penalty of perjury under the laws of the United States that the forgoing is true and correct.


  2. Thanks, Grace. I may fax this on to my doctor who will be back in the office on Tuesday. I'm sure she will find this useful.

    I tried pointing her to the new standards and have even faxed her a copy of the standards. My doctor apparently saw no reason to change what was already working.

  3. That was IIRC the letter my doctor had on file and used for me. The State Department was very understanding and helpful. But, of course, that was 2006.