Map detailing the procedure each state uses to alter the sex on one's birth certificate in the United States. Source is Instructions For Changing Name And Sex On Birth Certificate by Dr. Becky Allison.
  New birth certificate is issued with correct sex designation	 
  Old birth certificate is amended to correct sex designation
  State does not alter sex on birth certificates for transsexuals
  Unknown/ambiguous
File:Blank US Map.svg
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