Prior to the change, the State Department required that individuals undergo gender affirmation surgery in order to update their gender marker. This, unfortunately, was a common, misguided, and burdensome policy that effectively put a $20,000 (or more) charge on accurate identity documents. And that’s just for those who plan on having gender affirmation surgery. Many in the community never do, because they feel like they do not need it, they can’t undergo surgery for medical reasons, or they can’t afford it.
