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Transgender in North Carolina - Updating Gender/Sex Marker on your Birth Certificate

Up until 2022, if you were born in North Carolina and your gender identity didn’t match what your birth certificate indicated, you had one significant requirement to change it. You needed to go through sex reassignment surgery.

But all that recently changed, now (April 2023) North Carolina Vital Records has a more reasonable set of requirements for changing the sex marker on your birth certificate.

From the NC Birth Certificate Modification Application:

Modifying Sex Designation

Modification To Correct Sex Designation: Unless otherwise ordered by a court of competent jurisdiction, acceptable supporting documentary evidence to correct sex designation include any of the options below.

Option 1: Identification:

  1. A valid North Carolina Driver’s License or valid State ID card issued by the North Carolina Division of Motor Vehicles that reflects your sex as you are requesting it to be corrected on your birth certificate; OR
  2. A valid United States passport that reflects your sex as you are requesting it to be corrected on your birth certificate.

Option 2: Certification of Gender Identity:

A certification signed by a physician, psychiatrist, physician’s assistant, licensed therapist, counselor, psychologist, case worker, or social worker stating, based on their professional opinion, the gender identity of the registrant.


There are now a lot of professionals who can write a letter supporting your or your loved one’s sex marker change. As of April 2023, the office of North Carolina Vital Records doesn’t have an official letter format, they only require a letter, with a letterhead and they prefer a wet signature, instead of a computer generated signature. The letter, along with the fee and the NC Birth Certificate Modification Application is all you need to have your sex marker updated to match your gender identity. I am not sure if you can have a non-binary marker yet, if not, I hope this is updated soon.

Thank you for reading and don’t hesitate to leave a comment/question.



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