Sex Designation Change on a Birth Certificate

We are currently processing requests in three (3) business days. Please allow up to two (2) weeks for delivery and mail time for ordered certificates.

  • If you submitted an application with a processing fee, the date your check or money order is cashed is the date we received your request. This can help you estimate how much time is left for processing your request.
  • We are committed to processing these requests in a timely manner. The time it takes to process and mail your request may fluctuate due to staffing availability and mail delivery timelines.

People who were born in Washington state can change the sex designation on their birth certificate by submitting a completed request form to the Washington State Department of Health Center for Health Statistics. A Washington State birth certificate has three options for sex designation: M, F, and X. You can use the  Request to Change Sex Designation on a Birth Certificate for an Adult form (DOH 422-143)(PDF) to change your sex designation to any of the options available. You will find Request to Change Sex Designation on a Birth Certificate forms for adults and minors below. These forms comply with WAC 246-490-075.

What is the “X” sex designation?

 “X” refers to a gender that is not exclusively male or female – including, but not limited to, intersex, agender, amalgagender, androgynous, bigender, demigender, female-to-male, genderfluid, genderqueer, male-to-female, neutrois, nonbinary, pangender, third sex, transgender, transsexual, Two Spirit, and unspecified. WAC 246-490-075 added “X” as a third sex designation option.

What forms are required to change a sex designation on a birth certificate?

Complete the appropriate Sex Designation Change request form for adults, emancipated minors, or minors who are not emancipated. Follow the instructions below to ensure your application is complete.

Submitting the form is required as of January 27, 2018. A court order or a letter from your physician will not be accepted.

Adults (over 18 years of age) and emancipated minors: Form and instructions

  1. Fill out the Request to Change Sex Designation on a Birth Certificate for an Adult form (DOH 422-143)(PDF)
  1. Sign in front of a Notary Public
  1. If applicable, provide legal name change documentation
    • If your full current legal name is different than the name listed on your birth certificate, you must provide a certified legal name change court order with the Court Order Legal Name Change Request (422-126)(PDF).
    • If you want your full current legal name amended on your birth certificate, indicate by checking the appropriate box. Additional proof documentation might be requested.

Minors (under 18 years of age): Forms and instructions

  1. Fill out the Request to Change Sex Designation on a Birth Certificate for a Minor form (DOH 422-144)(PDF)
    1. The Request to Change Sex Designation on a Birth Certificate for a Minor form (DOH 422-144)(PDF) must be completed and signed by a parent or legal guardian on behalf of the minor who wants to change the sex designation on their birth certificate.
    2. Legal guardians acting on behalf of the minor must include proof of legal guardianship (i.e., certified court order).
  1. Have your form signed by a licensed health care provider
    1. Your completed Request to Change Sex Designation on a Birth Certificate for a Minor form (DOH 422-144)(PDF) must be signed by a licensed health care provider or licensed mental health care provider, whose scope of practice allows them to determine that the requested change is consistent with the minor's identity.
    2. Examples of licensed health care and mental health care providers include, but are not limited to the following:
      • Licensed medical, osteopathic, and naturopathic physician
      • Psychiatrist
      • Psychologist
      • Advanced registered nurse practitioner
      • Licensed osteopathic physician assistant
      • Physician assistant
      • Advanced social worker
      • Independent clinical social worker
      • Marriage and family therapist
      • Mental health counselor
  1. If applicable, provide legal name change documentation
    1. If the minor has not legally changed their given first and middle names, you can change their first and middle names by submitting an Affidavit for Correction (DOH 422-034)(PDF) with the consent of all listed parents.
    2. If the minor’s name has been legally changed on their birth certificate, you must provide a certified legal name change court order with the Request to Change Sex Designation on a Birth Certificate for a Minor form (DOH 422-144)(PDF) 
    3. If you want the minor’s full current legal name amended on their birth certificate, indicate this by checking the appropriate box. Additional proof documentation might be requested.

Are there any other forms or fees for my request?

There is no fee to amend the birth certificate record. If you want a certified copy of the new birth certificate, complete a Birth Certificate Order Form (DOH 422-182)(PDF) (en español) and include $25 for each certified copy requested. Make the check or money order payable to “DOH”.

Will I automatically receive a new birth certificate in the mail?

No. To receive a new birth certificate that reflects this change, complete a Birth Certificate Order Form (DOH 422-182)(PDF) (en español) and include it in your submission to DOH. Include payment for all fees, your government issued photo ID, and all required documents referenced on the certificate application instruction page. If your government issued ID no longer matches the birth record, mail in the certificate order form and copy of your ID anyway.

Can I exchange my birth certificate with my correction request?

If you currently have a certified copy of a certificate that was issued less than one (1) year ago, send in the certified copy of the certificate with your correction request. We will exchange the certificate at no charge.

Can I mail in any other requests for vital records with this correction request?

If you have any other vital records requests, such as for a death certificate or marriage and divorce corrections, you can submit all completed forms with your correction request. Visit our Ordering a Vital Record page for more information.

How do I submit my sex designation change request to DOH?

By mail

Mail the correct completed form and any fees or additional required paperwork to:

Center for Health Statistics
Department of Health
PO Box 47814
Olympia, WA 98504-7814

In person

Schedule an appointment to submit your completed form in person.

What happens next?

Though turnaround times can fluctuate due to staffing availability, we aim to process your request in a timely manner. We are currently processing sex designation change requests in three (3) business days after they are received. Please allow up to two (2) weeks for delivery and mail time for ordered certificates.

If you submitted an application with a processing fee, the date your check or money order is cashed is the date we received your request. If your bank processed the check or money order, our office received your order. Checking this date can help you estimate how much time is left for processing your request.

If your order was processed more than two weeks ago, contact DOH Center for Health Statistics at (360) 236-4300. Provide the customer service representative with the check or money order number and date cashed.

Use by government agencies

At this time, we are unsure if other agencies and applications – such as the U.S. Department of State’s application for U.S. Passports – will accept these amended certificates. For records with amended sex designation, nothing on the certificate will indicate a change was made. This might create challenges when connecting the current record with the previous name on other documentation. In some cases, a court order might be needed for full use of the new name and sex designation.

All forms (in English)

Available forms (en español )

Contact Us

If you have any questions, contact us by email at SexDesignationChange@doh.wa.gov.