Passports | National Center for Transgender Equality

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Passport gender change

In June 2021, the State Department announced that it would no longer require passport applicants to submit medical certification to change the gender marker on their passports. Under this policy, a transgender person can obtain a passport reflecting their gender by submitting an application with the chosen gender marker selected. This policy replaced the Department’s old policy requiring certification by a physican of appropriate clinical treatment for gender transition, which had been in place since 2010.

As of summer 2021, applicants may self-select an M or F gender marker for their passport. In the same policy announcement, the State Department stated that an X gender marker would also be available for selection in the near future.

Can I Get a Passport With My Current Gender?

Under the current policy, you can obtain a full ten-year passport with an updated gender marker if you have had clinical treatment determined by your doctor to be appropriate in your case to facilitate gender transition. No specific details are required about what type of treatment is appropriate for you.

Applicant Advice: We understand that people experience hiccups in the gender change application process. Many physician letters get rejected because they do not follow the exact language of the model letter, so please ask your physician to use the model language word for word. If you receive a letter from the State Department that they need additional information for your application, do not be alarmed. Follow the instructions of the letter from the State Department and send in any additional documentation within 90 days. Keep copies of everything you submit, and ask your physician for extra originals of their signed letter if you can. Please do not hesitate to reach out to NCTE if you encounter problems.

The State Department website explaining Sex Designation Changes is available here:

The official State Department policy on Gender Changes is available here:

Do I Need a Physician’s Certification?

If you have not yet had a passport issued with your correct gender marker, you should submit medical certification along with your application, even if you have updated your gender marker on all of your other documents. Instructions on the Department of State website explain that they still need medical certification because the requirements for amending the gender marker on birth certificates and other domestic documents vary from state to state.


Who Can Write a Letter to Certify Appropriate Treatment?

You will need a letter signed by a licensed physician with whom you have a doctor-patient relationship and who is familiar with your transition-related treatment. This may be any physician who is familiar with your treatment, including a primary care physician or specialist.

If you receive your primary care from someone who is not a physician (not an MD or DO), the supervising licensed physician must sign this letter. Signatures from other types of medical providers,such as psychologists, physician assistants,  ornurse practitioners, are not acceptable,


What Should the Physician Certification Include?

The State Department policy provides model language for physician certifications. Certifications must be on the physician’s office letterhead and include all of the information seen here, including the physician’s license or certificate number. Ask your physician to use the exact language of the below model - the letter should not include any additional language or information.

Additional tips: Ask your physician to sign this letter in blue ink so the State Department can tell it is an original signature. Also ask for multiple original copies so you can keep extras just in case!


I, Physician’s Full Name, Physician’s medical license or certificate number, Issuing U.S. State/Foreign Country of medical license/certificate, am the physician of Name of Patient​Date of Birth of Patient, with whom I have a doctor/patient relationship and whom I have treated (or with whom I have a doctor/patient relationship and whose medical history I have reviewed and evaluated).

Name of Patient has had appropriate clinical treatment for transition to (specify male or female).

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

Signature of Physician
Typed Name

You can download the model physician letter.


What is "appropriate clinical treatment for gender transition"?

People’s gender transition needs vary, and treatment options are decided between individuals and health care professionals on a case-by-case basis. The phrase “appropriate clinical treatment for gender transition” is meant to capture a range of treatments that may be appropriate, in each individual case, to facilitate gender transition. Clinical treatment methods are outlined in the World Professional Association for Transgender Health Standards of Care, and treatment can include psychotherapy, changes in gender expression and role, hormone therapy, or surgery, or any combination thereof. No specific treatment is required, and details of your treatment need not be provided. In fact, NCTE encourages you and your provider to only state in the letter that you have had appropriate clinical treatment for gender transition. Details about surgery, hormone treatment, or other treatments are unnecessary and not helpful.

The State Department will issue a limited, two-year passport with an updated gender based on a physician’s letter stating that the applicant “is in the process of gender transition.” We believe there is no reason for a transgender person to apply for the limited passport. However, if your physician will not state that you have had appropriate treatment, this option is open to you.

Does the State Department Need Other Medical Information?

Other than the required certification from your physician, do not submit any additional details or documentation regarding your medical history or treatment. Your doctor does not need to certify that you have undergone any specific treatment or procedure and we recommend, for the sake of your privacy and in order to not confuse the process, that they not do so.


Can Transgender Children Get Updated Passports?

The current gender change policy applies to both adults and minors. All passport applications for minors are subject to special parental consent requirements. (These requirements apply to all minors, not just transgender minors.) See the State Department instructions on applying for a passport for children under 16 or for applicants age 16 and 17.



How Do I Apply for a Passport?


Updating Your Gender Marker on an Existing Passport or Getting a Passport for the First Time

If you are applying to change your gender marker, submitting a passport application for the first time, or applying for a passport when your old passport has expired, you must apply in person.

You will need to complete and submit: 

  1. Application for U.S. Passport (Form DS-11);
  2. Proof of U.S. Citizenship (such as a previous U.S. Passport, certified Birth Certificate, Certificate of Naturalization, or Report of Birth Abroad);
  3. Proof of Identity that contains your signature and photograph that is “a good likeness to you” (such as a previous U.S. Passport, a Driver’s License, a Certificate of Naturalization, Military Identification, or a Government Employee Identification Card). You must present the original AND provide a photocopy of the front and back side with your application;
  4. A recent color photograph 2x2 inches in size;
  5. If you are changing your name on your passport, an Order for Name Change (certified copy showing a seal and officiate/judge signature);
  6. A letter from your Physician confirming your gender transition (the requirements for this letter are listed below); and
  7. Fee (See Department of State Passport Fees for cost). 
Take these documents and fees in person to any Passport Acceptance Facility. To find the acceptance facility closest to you, visit the State Department’s website, Passport Acceptance Facility Search Page, at or call the National Passport Information Center at 1-877-487-2778.
Updating Your Legal Name Only (no gender marker update) on an Existing Valid Passport

When you already have a valid Passport, you may submit a Passport Renewal Application to change your legal name on the passport by mail. You will need to complete and submit: 

  1. A Passport Renewal Application (Form DS-82);
  2. Your most recent Passport (book or card);
  3. A recent color photograph 2x2 inches in size;
  4. Order for Name Change (certified copy showing a seal and officiate/judge signature);
  5. Fee (See Department of State Passport Fees for cost). 

What is a Passport Card and How Do I Apply For One?

A U.S. passport card is a wallet-sized card that looks like a driver’s license. A passport card is significantly less expensive than a traditional passport book but cannot be used for international travel by air. A passport card may be used as everyday identification within the United States and may be used to enter the United States from Canada, Mexico, the Caribbean and Bermuda at land border crossings or sea ports-of-entry. Application forms and documentation requirements for a passport card are the same as for a passport book; simply check “passport book” on the application form.


How Do I Change a Limited Validity to a Full Validity Passport?

The State Department's policy still distinguishes between a transition that is “in process” and one that is “complete.” This distinction was originally intended for applicants who had recently begun a gender transition and needed documentation to travel abroad, before the requirement for undergoing a surgical procedure was removed. The language we recommend in our sample letter indicates to the Department of State that the transition is “complete.” However, if you submit a letter that indicates your transition is “in process” you will be issued a limited validity two-year passport. 

If you are issued a limited validity two-year passport, to extend to a full validity ten-year passport you should submit the following by mail within two years of the issue date of the limited validity two-year passport:

  • A completed Form DS 5504, Application for a U.S. Passport (Name Change, Data Correction and Limited Passport Book Replacement), along with any necessary documentation indicated in the form;
  • A physician certification, as described in our sample, stating that you have had appropriate clinical treatment for gender transition; and
  • Unless you request expedited service, no new fee is required.

You may mail in your application to the National Passport Processing Center or drop-off your completed application and required documentation to your local State Department Office.  Note that any documents you mail in will be returned if not damaged.  

By Mail, Routine Service: National Passport Processing Center, P.O. Box 90107, Philadelphia, PA 19190-0107

By Mail, Expedited Service (Additional Fee): National Passport Processing Center, P.O. Box 90907, Philadelphia, PA 19190-0107

In Person: To locate your local Passport Acceptance Facility, please visit

Can I update a Consular Record of Birth Abroad?

A Consular Record of Birth Abroad (CRBA) is the equivalent of a birth certificate for American citizens born abroad. The policy for passports also applies for updating a CRBA.

To Amend a Consular Report of Birth Abroad, You Must Submit:

  1. A notarized written (or typed) request detailing the amendment or correction needed;
  2. Certified copies of documents justifying the amendment requested, in this case: a) court ordered name change, if applicable, and b) original letter from physician on letterhead (see template letter for passports above);
  3. An original or replacement consular report of birth abroad: any birth record issued from the Department of State such as an FS-240 (for birth after January 3, 2011), replacement FS-240,  Certification of Report of Birth DS-1350 (for birth Nov 1, 1990 - Jan 2, 2011) or Certification of Birth Abroad FS-545 (for birth prior to November 1, 1990); or a notarized affidavit stating the whereabouts of the original or any replacement FS-240, DS-1350, FS-545 issued from the Department of State;
  4. A copy of requester’s valid identification;
  5. A $50.00 check or money order made payable to “Department of State”. The Department will assume no responsibility for cash lost in the mail.

Mail to:

Department of State
Passport Vital Records Section
44132 Mercure Cir.
PO Box 1213
Sterling, VA 20166-1213

To check the status of your FS-240 request, call 202-485-8300. You can find information about amendments on the State Department website here:

What If I Face Problems Updating my Passport?

The current policy specifically instructs passport specialists to treat transgender applicants with respect, including using appropriate pronouns and not asking unrelated questions. If you encounter improper requests for information, unprofessional behavior, or other difficulties obtaining a passport, you can call the National Passport Information Center at 1-855-865-7755 to make a complaint or submit a complaint online through the Department of State's Customer Survey. You can also contact NCTE, your Regional Passport Office, or your U.S. Senator’s Office. NCTE is consistently monitoring implementation of this policy.

If you encounter discrimination, harassment or other serious difficulties relating to being transgender while traveling abroad, contact the closest U.S. Consulate or Embassy immediately.

Additional Resources

Full text of the gender change policy - US State Department Foreign Affairs Manual, 8 FAM 403.3 Gender Change:

US State Department Gender Designation Information:

US State Department Passport Home:

US State Department, Change Your Name in Your Passport:

US State Department, Frequently Asked Questions on Passports and Citizenship Documents:

Call the National Passport Information Center for Information or Complaints:

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