Montana's Birth Certificate A transgender woman involved in a dispute

At the age of 10, Susan Howard knew she was a girl, despite another statement on her birth certificate. Residents of Montana agreed thattransgender

Howard had undergone hormonal therapy and sex verification surgery last year 62. It was when I was old. She, and in her official documents, she began to change her name and her gender. "It was a heavenly blessing for me," Howard said. "I feel very right and reassured to myself for the first time in so many ways."

She has her social security card, her driver's license, and her pension account. I was able to change. But she couldn't change one important part of her personal identification. "Everything has changed except my birth certificate," Howard said. "That's the only thing that hangs. Everyone else admits my gender, but they don't."

Due to a series of legislative and administrative measures, Montanais nearly impossible for transgenders to modify their birth certificate. Became one of four states. Man.

Montana health officials are advocating restrictions as a way to maintain the accuracy of important records. Proponents of LGBTQ + say they are depriving transgender people of their dignity and denying equal protection under the law.

In June 2021, the American Medical Associationadvocated the removal of gender designations from publicly available birth certificates to protect people's privacy and prevent discrimination} Was adopted. AMA stated that under this policy, individual gender designations at birth will continue to be collected and submitted for medical, public health, and statistical use. The idea that the

AMA has "Gender Medical Spectrum" andthe right to determine gender identityand the government's gender designation. There was already a policy to admit. document.

Dr. Nicole Clark, AMA's representative of Montana, said the Montana Medical Association has accepted AMA's birth certificate policy.

In most states, the process for transgender people to update their documents is relatively straightforward, with no administrative hurdles like those created by Montana. Three exceptions other than Montana include Tennessee, which has a law prohibiting trance people from amending their birth certificates. (The state has foughta lawsuit against the policysince 2019.) In Oklahoma, Governor Kevin Stitt signed aenforcement orderin November and trans. Gender banned changing birth certificates. In West Virginia, the Circuit Court had previously approved changes to the gender designation of birth certificates, but the 2020State Supreme Court rulingwill create them with the State Health Department. I said I can't order.

Cathryn Oakley, State Legal Director and Senior Advisor to LGBTQ + advocacy organization Human Rights Campaign, said that depriving a person of the opportunity to change his birth certificate gives him "the ability to be a complete and complete member." He said he would deny it. society. "

" Ignore all modern medical knowledge about what transgender means and oppose the American Psychological Association, the American Medical Association, and the American Association of Social Welfare Workers. In their best interests, "Oakley said.

In April 2021, Montana Governor Greg Gianforte signed the billSenate Bill 280is a birth certificate only after the state's Ministry of Health and Welfare has been ordered by the court. Said that the person's gender was changed surgically.

The law has replaced the 2017 rule that requires transgender people to simply verify their gender in order to change their birth certificate. This rule did not require gender verification surgery or other surgical procedures, which can be unnecessary or costly. Two Montanans, represented by the

American Civil Liberties Union , sued the state, challenged the 2021 law for constitutional reasons, and were vague, privacy and equal. Claimed to be infringing on protection rights.

In April 2022, Judge Michael Moses of the Yellowstone County District Court temporarily banned the Ministry of Health from enforcing the law during the litigation. Transgender proponents hoped that the order would reinstate the 2017 rules and allow trans people to fill out forms to revise their birth certificates. However, the Ministry of Healthrefused to comply

A month later, the Ministry of Health issued a more restrictive emergency rule than the SB280. A priest's mistake, or when people use a DNA test to prove that their gender was misidentified at birth. "Gender, unlike gender, is an invariant genetic fact that cannot be changed by surgery," the rule states.

The State Health Department is trying to maintain the new ruleas long as Moses' injunction of the 2021 Act is in effect.

Health Department spokesperson Jon Ebelt said the judge's injunction created a regulatory gap in processing the required birth certificate. "There were no rules that the department could undo, and the department is obliged to guarantee the accuracy of important records," Eberto said in an email.

Montana's ACLUhas filed a petitionrequesting Moses to clarify the requirements for an injunction and order the Department of Health to comply with the more forgiving 2017 rules.

"It is very dangerous to leave transgender Montanan without access to an accurate and usable birth certificate," said ACLU lawyer Marita Picasso. "It's hard to emphasize how extreme the move is."

On May 18, a few months after Howard began the process of changing his birth certificate, she was gender. Has been ordered by a judge to confirm that has been surgically changed. Following the requirements of the 2021 law, she sent the document to the health department by certified mail two days later. She was hoping for final approval on May 23, which turned out to be the day the emergency rules came into effect.

After hearing nothing for a few days, Howard called the Vital Records Department of the Health Department. Her form was received, but the new rules stated that despite her court order, the gender of her birth certificate could not be changed. Howard was told that the state did not handle the gender change of the birth certificate.

"I don't know how to explain how discouraged it was at that moment," Howard said. "It just felt terrible."

Dr. Karl Stred Jr., assistant professor at the University of Boston School of Medicine and research leader at the Transgender Medical Surgery Center at the Boston Medical Center, said the gender of the birth certificate. The marker "does not reflect the reality of human meaning, biology, gender, gender because there are several chromosomal variations besides XX and XY.

Primary Identity stress can have a negative impact on a person's health and can lead to "serious mental health and distress in the long run," said Stred, a care doctor.

Renewing the birth certificate does not retroactively change the public health statistics already reported, he added.

According to the Williams Institute of UCLA, which studies sexual orientation and gender identity law and public policy, an estimated 3,900 transgender people over the age of 13 live in Montana. One of those people is Howard.

There were times when Howard didn't want to live before she made the transition. But now she looks forward to every day and she loves to be free to be herself.

"I can't think of any other way to define myself as a person. I'm a transgender woman living a life at the age of 63," Howard said. "If you want to change the gender marker, what's the big deal? Why do you care if you change the gender marker? I don't change your gender marker. I don't understand hostility."

KHN(Kaiser Health News) is a national news room that produces detailed journalism on health issues. KHN, along with policy analysis and polling, is one of the three major operational programs of the KFF(Kaiser Family Foundation). KFF is a donated non-profit organization that provides the country with information on health issues.