Rhode Island has made it easier for transgender residents to change their gender designation on their birth certificates.
The state Health Department has removed the requirement that people have gender reassignment surgery before changing their gender on a birth certificate. Instead, a medical provider can certify that the person has gone through hormone therapy or another appropriate treatment.
The new regulations take effect Tuesday. Several other states have made similar changes.
Advocacy groups say surgical intervention is an outdated way to recognize one's gender, and that transgender people have been discriminated against and harassed for having identifying documents that did not match their gender identity.
Monique Paul, a transgender woman, says she will feel more complete once her paperwork is updated.