For some trans people, legal affirmation can include updating their birth certificate. Affirming gender isn’t about “changing” who someone is, “having a sex change,” or “becoming a man or a woman.” A trans or gender diverse person who hasn’t medically or legally affirmed their gender is no less the man, woman or non-binary person they’ve always been.
Acknowledgements
This page was created with input from trans writers across each state and territory, and developed in collaboration with Northern Territory AIDS and Hepatitis Council (NTAHC), SHINE SA, Transgender Victoria (TGV), A Gender Agenda, TransFolk of WA, Queensland Council for LGBTI Health (QC), and Working It Out Tasmania (WIC). All content was reviewed by the Inner City Legal Centre.
Role of Clinicians in Updating Gender Markers
Clinicians often play an essential role in the process of updating gender markers. The specific requirements and responsibilities vary depending on the state or territory. These roles may include:
- Writing a letter of support (see our template here).
- Confirming that the person has undertaken counselling prior to their decision.
As legislation continues to improve, the role of a GP in this process may begin to lessen. In any case, it is useful to know so that information can be passed on to anyone who inquires.
Your patient may also request your assistance in creating certified copies of their identity documents to go along with their application. Visit the ATO website for more information regarding certified copies of identity documents.
Note: This page is designed to help clinicians better support trans adults in updating their legal gender markers in Australia. It focuses on information relevant to people aged 18 and older. If you’re working with someone under 18, please refer to our page on Under 18’s rights.
Do All Trans People Update Their Gender Markers?
Not all trans people choose to update their gender markers. For some, the process may feel unnecessary, burdensome, or inaccessible. Non-binary people, in particular, face unique barriers: many cannot select a gender marker that reflects their identity. Additionally, X markers are not universally recognised, which can complicate international travel or unintentionally “out” someone when their documents are viewed.
For those who do want to update their gender markers, the experience can be quite euphoric and reduce stress in their daily lives. Having a supportive clinician throughout this process can make an enormous difference.
It’s also worth noting that some applicants may be both intersex and trans. Clinicians will need to work with the applicants to determine which criteria to select during the application process. Clinicians can find more information about providing care to trans and gender diverse patients throughout this page.
Passports, Licence, Medicare & other documents
There are many agencies that allow trans people to update their gender marker without an updated birth certificate, or gender affirming surgery.
Personal records kept by federal bodies like Medicare, Centrelink and the Australian Tax Office, can be updated with a statement from a registered medical practitioner or a psychologist that simply confirms their gender.
We’ve designed a statement template you can use to support your trans patients with this.
Updating the gender marker on an Australian passport requires a medical practitioner or psychologist to complete a B14 Form. This form does not necessarily require that you have provided any gender affirming treatment.
Updating Gender Marker State-By-State
Explore the requirements, options, and resources for legal gender affirmation in each state and territory in the tabs above.
You can also support patients by directing them to our pages on Updating Your Gender Marker and Updating Your Driver’s License, or having a read yourself so you can effectively outline the process.
For people over 14 years old, changing gender/sex marker with the ACT Births Deaths and Marriages Registry does not require a clinician’s involvement or any medical evidence.
If they are an adult (18 years or above) they can apply to change their own gender marker. The process is available through the Access Canberra website and is as follows:
- If they were born in the ACT, complete an ‘Application to alter birth register to record a change of sex’ or if they were born outside of the ACT complete ‘Application for recognised details’
- Provide proof of identity
- Provide proof of ACT residency if born outside ACT
- Submit application by:
a. email to bd*@*****ov.au, or
b. post to GPO Box 158, Canberra City ACT 2601, or
c. in person at an Access Canberra Service Centre.
They may, however, still approach you with questions or directions on the process. If they are looking for assistance with the process, your best resource will be to refer them to A Gender Agenda: Gender Pathways, a peer navigation service in the ACT that can support them through this process.
If your patient was born overseas or another state or territory, they may be able to apply for a Recognised Details Certificate with the ACT Registry.
Trans and gender diverse folk in the NT can update the gender marker on their birth certificate. In most cases, they will require a supporting statement by a medical practitioner or psychologist.
Your statement must affirm your patient’s updated gender marker (male, female, non-binary or unspecified), and confirm that your patient:
- is an intersex person, OR
- have received “appropriate clinical treatment related to their sex or gender”
“Appropriate clinical treatment” is not defined in the Act, and it is therefore at the discretion of the clinician to consider the appropriate standards of care.
This could include any or all of the following:
- Psychological support
- Voice therapy
- A diagnosis of gender incongruence
- Hormone therapy
- Affirming surgeries
The legislation does not specify that the doctor writing the statement must be the same doctor who provided the treatment.
You should use the section for doctors and psychologists on the Adult Change of Sex or Gender Birth Registered in the Northern Territory form available on the NT Registry website.
Steps for Clinicians to Support Gender Marker Updates
A patient may request a statement of appropriate clinical treatment to update their gender marker with the NT Births Deaths Marriages Registry.
The clinician completes the relevant section of the application form, confirming the treatment provided, and what gender marker the patient wants to use.
The completed form is given back to the patient for submission as part of their application.
Links
Register a change of sex or gender on a birth certificate | NT.GOV.AU
Births, Deaths and Marriages Registration Act 2019 – Northern Territory Legislation
Register change of sex of adult application PDF – Northen territory Government Website
Register change of sex of a child application.PDF – Northern Territory Government Website
Following the passing of the Equality Legislation Amendment (LGBTIQA+) Act 2024, the rules for changing gender/sex markers with the NSW Births Deaths and Marriages Registry are changing.
From July 2025 the process will become much easier, and no medical evidence will be required for adults wishing to update their gender/sex marker with the Registry. There will be no role for clinicians to play in an adults change of gender marker application unless they’d like to offer a statement of support if a patient requests one. Even though drivers’ licenses do not display gender, some people might want to change their gender marker with Transport for NSW. To do so, they will need to provide a support letter from a registered medical practitioner.
We’ve designed a statement template you can use to support your trans patients with this.
References
Births, Deaths and Marriages Registration Act 1995 – Australasian Legal Information Institute
2 Sex and gender diverse passport applicants – Department of Foreign Affairs and Trade
Downloads
Gender confirmation statement from medical practitioner – TransHub
10 trans questions to ask a doctor – TransHub [ Plaintext version ]
10 tips for clinicians working with trans & gender diverse people – TransHub [ Plaintext version ]
Gender affirming intake form for doctors – TransHub
Links
Pride in Health + Wellbeing – ACON
NSW Change of Sex Form (bottom of website) – NSW Births Deaths and Marriages
NSW Recognised Details Certificate Application (bottom of website) – NSW Births Deaths and Marriages
Public Statement on Gender Affirming Healthcare, including for Trans Youth – AusPATH
Queensland (QLD)
In Queensland, no medical evidence is required for a person 16 years or older to change their sex marker with the Queensland Births Deaths and Marriages Registry.
You are able to fill-in an application and pay online, via: www.qld.gov.au/AOSadult. An application to change the sex marker of a person under 16 years old will need to be include a supporting assessment by a ‘developmentally informed practitioner’ (see here for a list – it includes doctors, psychologists and registered nurses.)
Your written assessment must be about a child you have a relationship with (e.g. a patient) and must include:
- The change of gender marker application is supported
- The child understands the meaning and legal implications of the application
- Your name, address of practice, telephone number and email address
- Your professional registration/membership
- The dates you saw the child
- information about your relationship with the child
- a declaration that the contents of the assessment are true and correct.
The Queensland Registry may develop a template in the future.
If your patient was born overseas, they may be able to apply for a Recognised Details Certificate with the Queensland Registry.
South Australia (SA)
Trans and gender diverse folk in South Australia can update the gender marker on their birth certificate. They will require a supporting statement by a medical practitioner or psychologist registered under the Australian Health Practitioner Regulation National Law.
Your patient will need you to provide a statement certifying that they have “undertaken a sufficient amount of appropriate clinical treatment in relation to” their gender/sex (including intersex people or people whose sex ‘has now become determinate’).
The legislation clarifies that appropriate clinical treatment does not have to be invasive medical procedures. Counselling, hormone treatment, voice therapy, affirming therapies, etc. are likely to be considered appropriate.
If treatment consists only of counselling, this must be:
- at least 3 separate counselling sessions aggregating 135 minutes; or
- counselling sessions occurring over a period of at least 6 months.
The legislation does not specify that the doctor writing the statement must be the same doctor who provided the treatment.
The SA Births, Deaths, and Marriages Registry provides a suggested template for medical practitioners (it is annexed to the Change of Sex application form available on their website).
A trans person seeking to change their legal name at the same time as their gender marker can do so using this same form. Changing one’s legal name and gender marker at the same time can reduce the overall cost of legal affirmation. Changing one’s name and gender marker separately will result in a person paying two separate filing fees, instead of one.
Your patient may request your assistance in creating certified copies of their identity documents to go along with their application.
Tasmania (TAS)
Trans and gender diverse folk in Tasmania can update the gender marker on their birth certificate. For people over 18 years no medical evidence is needed. In fact, the Registry is not allowed to request medical documents for the application.
The Tasmanian Registry of Births, Deaths and Marriages provides guidance on changing someone’s gender on their birth certificate, including links to the relevant application forms.
For people between the ages of 16-18 years old, the registry may request evidence that they have undertaken counselling regarding the application. For more information, refer to our page on updating gender markers.
Trans and gender diverse people under 16 years old will require their parents/guardian to apply on their behalf. The registry is likely to request evidence that they have undertaken counselling regarding the application.
Your patients under the age of 18 may request a document from you (typically in the form of a letter or statement) that indicates:
- Your patient has undertaken counselling about:
– whether or not to make the application for change of gender on their birth certificate AND
– the implications of the registration of the gender in relation to the person
- You (the person who provided the counselling) has suitable qualifications, training or experience to provide such counselling.
The letter can be given to your patient to include in their application. There is no further detail in the legislation about what constitutes a suitable person to provide counselling, but the form itself suggests services like Legal Aid, Working It Out, etc . We would suggest a GP or psychologist, etc. would very likely be considered suitable. A school counsellor, nurse or social worker could also be suitable.
As this law applies only to those born in Tasmania, residents of Tasmania whose birth was registered in another State or Territory or overseas will not be able to change their gender marker with the Tasmanian Registry.
REFERENCES
Births, Deaths and Marriages Registration Act 1999 (Tasmania) – Tasmanian Legislation Online – Tasmanian Government
Sex and Gender Diverse Passport Applicants – Department of Foreign Affairs and Trade
LINKS
Australian Professional Association for Trans Health (AusPATH).
Tasmanian Registry of Births, Deaths and Marriages: Gender Registration (justice.tas.gov.au)
Pride in Health + Wellbeing – ACON
Public Statement on Gender Affirming Healthcare, including for Trans Youth – AusPATH
DOWNLOADABLE RESOURCES
Register Gender for 16 years and over Application Form
Gender confirmation statement from medical practitioner
10 tips for clinicians working with trans & gender diverse people
Gender affirming intake form for doctors
10 trans questions to ask a doctor
Victoria (VIC)
In Victoria, there is no requirement for any medical evidence or support for an adult to change their gender marker with the Victorian Births Deaths and Marriages Registry.
However, if you have been providing care for a trans person for more than 12 months, you can assist by writing a supporting statement. You must state that:
- You support their application
- You believe they are applying in good faith
If your patient was born overseas, they may be able to apply for a Recognised Details Certificate with the Victorian Registry.
If your patient was born in another state or territory of Australia, they should apply with that state or territories’ Registry. In some special cases, they can apply to the Victorian Registry instead.
LINKS
Victorian legislation | legislation.vic.gov.au
Homepage | Births Deaths and Marriages Victoria (bdm.vic.gov.au)
Supporting statement – change record of sex – adult born in Victoria | Births Deaths and Marriages Victoria (bdm.vic.gov.au)
VicRoads | Homepage
Sex and gender diverse passport applicants | Australian Passport Office (passports.gov.au)
Equaldex | Homepage
ID Change Support Fund | TGV
DOWNLOADABLE RESOURCE
Victorian Birth Certificate COID PDF .pdf (website-files.com)
Western Australia (WA)
Following the Births, Deaths and Marriages Registration Amendment (Sex or Gender Changes) Act 2024 (WA), creates a new streamlined process for individuals to update their gender marker. Now, adults who were born in WA are able to change their gender marker through the WA Registry of Births, Deaths and Marriages by filling out a BDM501 form.
This form requires a statement from a doctor or psychologist stating that their patient has “received appropriate clinical treatment” for their gender/sex.
Appropriate clinical treatment is not defined in the legislation as it will be different for each patient. For example, it may include discussions with a doctor or psychologist, hormone therapy, puberty blockers, chest binders, speech therapy and voice modification, facial hair removal, supportive therapy or other forms of gender affirming care.
However, there are no specific procedures or therapies required. This means that no clinical treatment can also be considered appropriate in some cases. Applicants will not need to provide details about any treatment they have undertaken in the application.
The legislation does not specify that the doctor writing the statement must be the same doctor who provided the treatment. Check out this fact sheet for further details regarding the process following recent reforms.
Your patient may also request your assistance in creating certified copies of their identity documents to go along with their application.
LINKS
Pride in Health https://www.prideinhealth.com.au/
Public Statement on Gender Affirming Healthcare-
AusPATH https://auspath.org.au/2021/06/26/auspath-public-statement-on-gender-affirming-healthcare-including-for-trans-youth/
DOWNLOADABLE RESOURCES
Gender confirmation statement from medical practitioner
10 tips for clinicians working with trans & gender diverse people
Gender affirming intake form for doctors
10 trans questions to ask a doctor
