USCIS issues a variety of documents that show identity and immigration status in the United States. These include, but are not limited to, Employment Authorization Documents, Refugee Travel Documents, Permanent Resident Cards, and Naturalization Certificates. Individuals who claim to have changed their gender may seek issuance of these types of documents reflecting the new gender through filing of the appropriate form. While some of these documents indicate the individual's gender, and the applicant's gender may sometimes have bearing on underlying issues of eligibility for immigration benefits (such as an approval of a Petition for Alien Relative, derivative spouse status, or marriage to a U.S. citizen for section 319(a) naturalization), the purpose of the document itself is to document the individual's identity and immigration status. Note, this guidance applies only to determining the appropriate gender for issuing a document and does not override or contravene other eligibility requirements for issuance of a new or amended document. Therefore, USCIS will issue an initial or amended document reflecting the individual's post-transition gender if the individual presents the following:

• An amended birth certificate, passport, or court order recognizing the new gender; or
• Medical certification of the change in gender from a licensed physician (a Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.)). This is based on standards¹ and recommendations² of the World Professional Association for Transgender Health who are recognized as the authority in this field by the American Medical Association.³  Medical certification of gender transition received from a licensed physician (an M.D. or D.O.) is sufficient documentation, alone, of gender change. Additional information about medical certifications:
  • For the purposes of this chapter, only an M.D. or a D.O. qualifies as a licensed physician. Officers may accept medical certifications from any number of specialties as well as from general practitioners.
  • Statements from persons who are not licensed physicians, such as psychologists, physician assistants, nurse practitioners, social workers, health practitioners, chiropractors, are not acceptable.
  • The medical certification should include the following information:
    • Physician's full name;
    • Medical license or certificate number;
    • Issuing state, country, or other jurisdiction of medical license/certificate;
    • Drug Enforcement Administration registration number assigned to the doctor or comparable foreign registration number, if applicable;
    • Address and telephone number of the physician;
    • Language stating that the individual has had appropriate clinical treatment for gender transition to the new gender (male or female);
    • Language stating that he/she has either treated the applicant in relation to the applicant's change in gender or has reviewed and evaluated the medical history of the applicant in relation to the applicant's change in gender and that he/she has a doctor/patient relationship with the applicant; and
• Evidence that any name change was completed according to the relevant state or foreign law;
• The applicant may also be asked to submit acceptable evidence of identity in the new gender, if available. State law and foreign laws vary as to whether a driver's license or other form of government issued identity document may be issued reflecting a gender change. If evidence of change of gender in the identity documents is not obtainable because of state, local or foreign requirements, the document may still be issued in the new gender based on the medical certification; and
• A recent facial photograph that reflects a good likeness of, and satisfactorily identifies the applicant must be submitted. The photograph must agree with the submitted identification evidence and reflect the applicant's current and true appearance. This can be submitted with the application or provided through biometrics collection at an ASC.

NOTE:  Proof of sex reassignment surgery is not required to issue the requested document in the new gender and evidence of such surgery will not be requested. USCIS will not ask for records relating to any such surgery.

NOTES

¹ Standards of Care, 7th Version (2011), World Professional Association for Transgender Health (WPATH), http://www.wpath.org/publications_standards.cfm

² Identity Recognition Statement (2010), World Professional Association for Transgender Health (WPATH), http://www.wpath.org/announcements_detail.cfm?pk_announcement=18

³ American Medical Association. Res. 122; A-08, Removing Barriers to care for Transgender Patients (2008), http://www.ama-assn.org/ama1/pub/upload/mm/16/a08_hod_resolutions.pdf