Since 4 April 2005, as per the "Gender Recognition Act 2004" (; ), it has been possible for transgender people to change their legal gender in the UK, allowing them to acquire a new birth certificate, affording them full recognition of their acquired sex in law for all purposes. Transgender people must present evidence to a Gender Recognition Panel, which considers their case and issues a Gender Recognition Certificate (GRC); they must have transitioned two years before a GRC is issued. It is not a requirement for sex reassignment surgery to have taken place, although such surgery will be accepted as part of the supporting evidence for a case where it has taken place. There is formal approval of medical gender reassignment available either on the National Health Service (NHS) or privately.