Direct replacement of ‘sex’ with ‘gender’ in U.S. passport and Social Security policies

At the federal level, it is possible to change the sex on both your Social Security card and United States passport documents. The policies currently in effect require only a physician or psychiatrist’s attestation of “appropriate clinical treatment” (Social Security Administration) or “gender-related care” (U.S. passports).

In both cases, gender is used in direct replacement of sex. There is no explanation offered in either policy for why the terms are used interchangeably, with gender given the power to change sex. This semantic sloppiness should be considered unacceptable in such important, legally binding policies about identification documents.

Here are the relevant details and legal sources, including links and my red text highlighting the conflation of the terms sex and gender:


Passport SEX

Passports (June 2010)

U.S. Department of State Foreign Affairs Manual Volume 7
Consular Affairs; 7 FAM 1300 APPENDIX M: GENDER CHANGE

b. Medical Certification Accepted for Gender Change/Transition.
(1) A full validity U.S. passport will be issued reflecting a new gender upon presentation of a signed original statement, on office letterhead, from a licensed physician who has treated the applicant for his/her gender-related care or reviewed and evaluated the gender-related medical history of the applicant.

NOTE: Such licensed physicians include Medical Doctors (M.D.) and Doctors of Osteopathy (D.O.). The physicians may specialize in various medical fields, including, but not limited to, internists, endocrinologists, gynecologists, urologists, surgeons, psychiatrists, pediatricians, and family practitioners.

Statements from persons who are not licensed physicians, such as psychologists, nurse practitioners, health practitioners, chiropractors, and pharmacists, are not acceptable.


Autumn Sandeen on the change: The Prep Work I’m Doing To Get A Passport Under New State Department Rules

Transgender Legal Defense and Education Fund, New State Department Policy on Passport Gender Change


Social Security SEX

Social Security (June 2013)

From the Program Operations Manual System (POMS), RM 10212.200 – Changing Numident Data for Reasons other than Name Change

For this update Obtain this supporting documentation and follow any additional instructions
Sex field Accept any of the following:

  • full-validity, 10-year U.S. passport with the new sex

NOTE: Do not accept passports with less than ten years of validity.;

  • State-issued amended BC with the new sex;
  • court order directing legal recognition of change of sex;
  • medical certification of appropriate clinical treatment for gender transition in the form of an original signed statement from a licensed physician (i.e., a Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.)). The statement must include the following:
    • physician’s full name;
    • medical license or certificate number;
    • issuing state, country, or other jurisdiction of medical license or certificate;
    • address and telephone number of the physician;
    • language stating that the individual has had appropriate clinical treatment for gender transition to the new gender (male or female);
    • language stating the physician has either treated the individual in relation to the individual’s change in gender or has reviewed and evaluated the medical history of the individual in relation to the individual’s change in gender and that the physician has a doctor/patient relationship with the individual;
    • language stating “I declare under penalty of perjury under the laws of the United States that the forgoing is true and correct.”

NOTE: See RM 10212.200C in this section for a sample letter from a licensed physician that includes all required information to certify to the individual’s gender change.

IMPORTANT: Surgery is no longer required to change the sex field on the Numident. However, if an individual presents an original or certified letter from a physician stating the individual has undergone sexual reassignment surgery, accept it as evidence to change the sex field when it meets the requirements in GN 00301.030 and contains sufficient biographical data (e.g., name, date of birth) to clearly identify the individual.

NOTE: In some cases an individual’s sex may impact eligibility for benefits dependent upon spousal relationships. To make title II entitlement or title XVI eligibility determinations dependent upon marriage, follow the instructions in GN 00305.005B. Do not use sex field data on SSA records to make marital status determinations.


The ACLU and the Transgender Law Center say: VICTORY! Social Security Administration Drops Surgery Requirement for Gender Change

Trans Equality Fact Sheet

Miami Herald, Revised policy a major milestone in Federal recognition of transgender people


  1. “Gender” is correct for these documents.

    “Sex” refers to bodily reproductive capabilities. “Gender” refers to ways in which a person interacts with the world. Reproductive capabilities are not relevant for a passport and social security, except as part of biometric information (like fingerprints or blood type). The documents relate to interaction with governments, a part of “the world”. Therefore, “gender” applies.

    The government is rectifying an error by removing an unrelated biological parameter, which is a part of medical history and should be treated as such, from non-confidential documents.

    I understand that gender abolitionists might want to campaign for removal of “gender”, but there is no valid reason to have “sex” there. Either have “gender” or have neither.

  2. I guess it depends on whether one’s definition of ‘gender’ is that it’s a STABLE and unchanging quality, like sex, or something that changes over time.

    Replacing an immutable category with a mutable one necessarily decreases the certainty of identification, which I believe is the actual purpose of the document.

  3. Certainty of identification can’t be achieved without biometric information. The person’s looks change, too. But biometric information – which, I posit, legitimately includes sex, as well as other biological details – carries significant privacy concerns. No one should be required to publish anything about their bodies or their chromosomes. This information belongs in databases with strict access control. I see no difference here between sex, fingerprints, DNA samples, medical history, etc.

    In the case of passports, an important motive for the change appears to be protection of citizens from violence and significant harassment in countries that permit such treatment of transgender people, by refusing to reveal to their government officials the sex of the traveling citizen. Unless one happens to agree with those governments, I see no reason for not supporting the measure for this reason alone.

    I had an idea that a compromise that could perhaps gather a broader coalition would be to use “gender”, but also provide a “None” option that – unlike the “other” gender – is simply a tick in the form. It could work for various people, from non-binary folks, to the wing of the trans movement that opposes “medicalization”, to members of communities like the Indian Hijra (who have just got this option approved by the Supreme Court of India), and also for principled gender abolitionists who have a conscientious objection to identifying officially with any gender, which they see as a harmful construct. A “none” gender in a passport could endanger a person in discriminating countries, but it would be someone’s own choice to have it there – a warning to this effect could be placed on the form; some people don’t even want to travel to places like this. This option actually exists in international passport standards.

  4. I would argue that removing the ‘sex’ field all together is preferred to adding a completely useless ‘gender’ field.

  5. Mary Sunshine · ·

    Reblogged this on Female Biology Matters and commented:
    Guess the boys have formally declared that female biology doesn’t matter anymore. Unless they want to punish the shit out of us for actually having it.

  6. Your solution might well work with social security, which appears, from what I could find, to have rules thta are the same for everybody.

    But it’s different with passports. The international machine-readable passport standard (this is an open text line, not to be confused with the newer “biometric chip” standard) has a “sex” field, see .

    As the government decides to stop publishing people’s medical information, it can either replace the field by a related public characteristic, or go the principled route and use “Unspecified” in all new passports. But passports are not ideological documents that state a principle; they are requests from a state to allow its citizens to pass. So going for principle might result in discriminating countries refusing Americans entry altogether or subjecting all Americans to harassment, while publishing biological data subjects a subset of Americans to harassment in such countries.

    Gender is the way that the citizen wishes to present to border officers who want to check. It can be read as “all that the government decides to publish that is related to a person’s sex”.

    I would consider stating gender the most beneficial way for all citizens – except, that is, those who object to being assigned an official gender, and see this objection as more important than uninhibited passage in discriminating countries. I would support catering for such objectors, whatever their reason, by offering a None option.

    (I am sad to note that my native Russia can well be a discriminating country in this regard. While border guards probably do get some training, in Russia any police officer can ask for your passport; and I would not advise an American in Russia to show a passport showing sex/gender that does not match their presentation).

    That’s the problem when you get this stuff onto the international scene – like passports, and in a previous story, like the UN. You have to consider more than just the US and Western Europe. You have to take very different governments into account.

  7. anonymous · ·

    Yeah, taking different world governments into account, they want to know if somebody is biologically male or female. They don’t give a shit about your delicate politics. Trans shouldn’t be able to “present” as two very different kinds of people for purposes of criminal and other identification. Confusing your birth name is another tactic that lets you get away with…a lot of disguising of real perpetrators.

    if those studies that say MtT people have the same rate of criminalism as men are true, we are looking at an attempt to erase that knowledge, among many other serious consequences.

  8. And just why would you want to provide these governments with this information, seeing as in what passes for laws in their jurisdiction, “presenting” wrongly may be a crime in itself?

  9. anonymous · ·

    I agree with using “unspecified”, and suggest that the US put plenty of accompanying pressure on countries that don’t want to accept that. “Unspecified” prevents scientists using SS or passport data for studies such as medical studies (epidemiology), from confusing biological men from women and coming to wrong conclusions.

    However, it looks like what is going to happen is that the binary will be maintained, so this element of complete confusion will arise if MtT and FtT people are counted as FAB or MAB people. respectively. Since that is happening, there needs to be a new scientific standard disallowing studies using men and women as separate categories, which rely on data from either of these two sources, hereafter.

    There may be other confusing impacts which I haven’t come across. Wonder if others have similar concerns and can set those out for discussion.

  10. I doubt any studies, except perhaps those about international travel, use passport data, as passports don’t have universal coverage. However I do see a practical issue with a changing gender marker, too. If a person is shown (for example, by a full body scan or patdown in the airport) as being of a sex different to the marked gender, foreign officials who are inclined to harass transgender people can claim the passport is stolen, detaining the person. A US consul will likely be summoned but that can take quite some time. So, it seems to be a judgement call whether using “unspecified” (for trans or even for *all* people) might be a better solution. In any event, the passport thing is a practical thing about international travel.

    I do agree about removing the sex/gender market from social security entirely. In fact there seem to be calls to that effect from trans activists. Proof: . Also in : “NCTE [National Center for Transgender Equality] continues to advocate removing gender from these matching systems altogether.”

    Have we stumbled across a cause where trans activists, queer theory supporters, and gender criticists/abolitionists can actually stand together?

  11. anonymous · ·

    @ramendik, I can’t answer that as I am no expert, merely one commenter. The main objection I personally have to trans women being considered as “women” in all cases is because women are born into a subservient sex caste, have not achieved liberation as such, must continue to struggle as such, and cannot include non-members in that caste, as the “caste” is then vitiated into non-existence.

    Also, the issues of trans women and FAB are different in many ways and sometimes clash in certain important ways, for instance, in medical, sociological, and psychological research, in feminist insistence on prioritizing reproductive rights for women, and in legal provisions protecting women from male violence and privacy invasion.

    Further, I personally am NOT in favor of the folding of women’s ancient history and the cultural manifestations of our specific biology into androgeny, or a complete abolition of “gender” (in its general sense of a set of social roles). I maintain that the sex caste “women” must be separated into two aspects: the fact that it is a subservient sex caste, which should be thrown out, and the fact that there are some precious differences expressed in women’s history and culture, which we should not throw out at the same time..

    Having said all that, I think it is a good idea to use “unspecified” for certain legal purposes. It is certainly preferable to including men who identify as women in the category “woman” when any sort of generalizations about women may followe, whether those are scientific or social.

    Both Social Security and passports seem to me, initially anyway, to be situations in which biological sex is irrelevant. I can’t think of any legal distinctions based on sex that need to remain. Perhaps other radfems can. Absent such situations, I don’t see any impact on the women’s liberation movement, in fact “unspecified” may be preferable to.using the traditional two-sex definition, and certainly is preferable including trans women in the category of “women”.

    Ramendik, I am sure there are some issues in common which could be collaborated on, such as presenting a joint face against male violence, which harms both groups. However I don’t think such collaborations can occur so long as trans women continue to insist that they join the subservient sex caste of FAB, with its distinct and ancient history and culture and distinct biology, when they change their gender presentation.

  12. Tobysgirl · ·

    I find all this concern about transgender people being harassed when they travel internationally most amusing. Apparently, Mikhail is not aware of the frequent harassment experienced by women going through security checkpoints, customs, walking down the street, etc. Perhaps this only happens in the United States, she said with her tongue in her cheek.

    The absurdity of classifying someone as female who has a penis is beyond belief. As my husband says, you can’t even write absurdist literature anymore because it can’t begin to keep up with real life. (I would dispute the real in that phrase; very few people seem to be able to grasp reality.

  13. @Tobysgirl: the very real fact of harassment of women does not mean a government should collude in harassment of transgender people by employees of other governments.

  14. Tobysgirl · ·

    Mikhail, this is pretty hard for a U.S. citizen with a conscience to stomach. Do you know how many countries the U.S. government “colludes” with in harassing people of various descriptions? I don’t want to see people who call themselves transgender harassed, but the few people who may have the funds to travel overseas absolutely pales when compared to the MURDER (on a daily basis) of women and African-Americans in the U.S.

    You must be rich to spend so much time concerning yourself with THEORETICAL harassment. Are you someone who stole from the Russian people, consequently living in comfort in the U.K.? I am far more interested in ACTUAL REALITY. If you’re so concerned about transgender people, why aren’t you speaking up loudly against MALE violence against transwomen? This is far more of a reality than a handful of people traveling outside the U.S.

  15. “Are you someone who stole from the Russian people, consequently living in comfort in the U.K.?”

    I do know what community you are talking about and understand the suspicion, but for all I know they don’t tend to concern themselves with this sort of politics. No, I’m just an IT engineer who went to Ireland, not the UK, for a better job, and ended up staying for good and getting naturalized.

    “If you’re so concerned about transgender people, why aren’t you speaking up loudly against MALE violence against transwomen? This is far more of a reality than a handful of people traveling outside the U.S.”

    I don’t see how these things are mutually exclusive. Last tine I checked, the POTUS was male, the Secretary of State is now also male, and the foreign government officials concerned are predominantly male. So this radfem cliche (“why are you protesting against female words not male violence”) does not make sense in this context. We are not discussing any female-specific actions, but documents that a male-led government issues and male foreign government employees examine. So, a subtype of predominantly male violence.

  16. …oh. and I fuly agree with your description of the US government collusion in violence in other countries. I just don’t see how this excludes this issue at all. In *something*, and something pretty small compared to these big things, the US makes a change that makes lives of some people easier. I don’t see why one would protest that change based on the fact that the same government makes the lives of a lot of other people harder (not by that particular action though).

    As for applying outright ideology and referring to ancient female history when discussing a practical travel document, as anonymous does… words fail me. Ideological running of daily lives is Soviet practice at its worst.

    (As an aside, I do know Ayn Rand wanted to apply strict political ideology in daily lives too, she was pretty much a reversed Soviet, but she was powerless to change real lives).

  17. Tobysgirl · ·

    But, Mikhail, I have NEVER heard you speak against male violence towards transwomen. And your being an IT engineer says it all, I guess, as it seems to be a world of gross misogyny and male entitlement.

    Mark Twain: It is by the goodness of God that in our country we have those three unspeakably precious things: freedom of speech, freedom of conscience, and the prudence never to practice either.

    Do you really think ideological running of daily lives was restricted to the Soviet Union? I can only speak for the United States, but there are many ways to pressure people to conform that are less obvious than the spoken ideology of Soviet Communism. People here are so brainwashed they don’t even know they are brainwashed. I can’t remember who said it, but it has been pointed out that Americans are the most propagandized people to ever exist.

  18. Actually much of what I write on the trans issue is about male violence towards trans women, specifically the kind done by male-dominated governments.

    For all I know, according to radfem theory government is an inherently male institution, so it should be obvious government violence is male violence. I do not agree with radfem theory but I observe that *most* governments are male-dominated – and are at least no less “a world of gross misogyny and male entitlement” than IT companies. Therefore, speaking out against government violence towards trans women *is* speaking out against male violence towards trans women.

    I mostly do not speak of the criminalized kind of male violence towards trans women, and the reason is mere lack of knowledge in the general area. I’ve been looking into public policy for the last 25 years but I know little about practical details of fighting crime. I did, however, repeatedly speak out against state collusion in such violence, namely the “gay panic/trans panic” defense. As far as I remember, in this very blog I opposed the idea of seeing “sex without revealing trans status” as sexual assault or rape, because it would give violent men an excuse that a trans woman was raping them (when they agreed to have oral sex without knowing what is between her legs, for example).

    Your statement got me thinking about the few governments which, contrary to radfem theory, I do NOT see as male-dominated institutions; governments with significant influence of females, and feminist ones at that. I actually find that these governments, like Sweden and Iceland, are quite decent towards transgender people.

    These governments are sometimes described as “radical feminist” because of other policies, like the Swedish model on the issue of sex work and quotas for women in company boards. They also implement wide-ranging feminist policies in child care, maternal/parental leave, prosecution of rape (ref: Julian Assange case) and other issues. Yet none of them seem to recognize a need to protect women against trans people. On the contrary, Janice Raymond was disinvited from a conference in Oslo for transphobia; in my view the decision was justified.

    So, actual (and unquestionably female) feminists in government don’t seem need this sort of poicy. In fact, then Prime Minister of Iceland Jóhanna Sigurðardóttir, an open lesbian, presided in 2012 over the unanimous passing of a law mandating research into sex reassignment and GID; the law also gives legal recognition of a new gender following diagnosis and a 18 month process, with no surgery requirement. (She also presided over banning strip tease, and as far as I know played an active role in that too, so no stereotypical “funfem” there).

    I conclude, therefore, that the strand of political activity providing allegedly feminist support to a backlash against trans rights has only one political meaning (note “political” as opposed to moral; I am not judging individual motives). It is not a part of real-life Western feminist political change. It is only a cheerleading club for male violence against trans women in its government form. A source of “feminist cred”. Many known actions support this political analysis – from Sheila Jeffrey’s adulation of Lord Tebbitt in her hack piece on the UK Gender Recognition Act, to signal-boosting of the apparent libel against Colleen Francis, which was created by a right-wing group.

    (And yes I think Colleen should sue for libel over the misrepresentation that she somehow disrobed in front of minors, which, apparently, was never the case: ).

  19. I can’t believe you posted a link to the Transadvocate here! Oh wait, yes I can.

    I am not convinced that the information posted by Williams, even assuming it is correct, resolves the problem. Fine, underage girls happened to wander into an area they were not supposed to go into. But you know what? I don’t want to see Colleeen’s dick EITHER. It’s called indecent exposure no matter how you slice it. #keepyourdickcovered

    From the TransAdvocate:

    “Here’s the nugget of truth to the story: two teens did claim to see Colleen Francis nude while in the Evergreen College sauna.
    Here’s what may not have not heard:

    The sauna area was off limits to the two teens.
    Unless one specifically tries to see inside the sauna, you can’t view the people inside the sauna.
    Colleen Francis AND her cisgender female friend were using the sauna together. They were sitting there talking.
    At no point did Francis act to expose herself to children.
    At no point was Francis walking around nude in the area where children were.

    So, the actual story is that two 17 year olds went into an area they weren’t allowed, attempted to view the people in the sauna and saw Francis. The rest of what you’ve probably heard about this incident is, at this point, an urban myth.”

  20. Tobysgirl · ·

    Just because an Icelandic lesbian prime minister signed off on a no-surgery requirement for sex reassignment does not make it legitimate. By this logic, Obama’s aggression toward Russia is okay because he had an African father. Many laws are not well thought through; their repercussions are not considered by most people. I have yet to hear one single feminist call for any violence against trans people; violence does not consist of women not wanting to share toilet/locker room facilities with males, not wanting people with penises to have identification that says they are female, etc. I really believe people need to get out of their cubicles and see some real life — we are so divorced from the actual world that we are destroying it (and ourselves, of course). Welcome to the Anthropocene Era: the garbage in our heads is real and the physical world does not exist.

  21. The immediate matter debated here was about passports. (The post is also about Social Security, but we apparently have a consensus that for Social Security it would be best to abolish the sex or gender designation altogether).

    My point was that divulging a transgender person’s sex in their passport is collusion with actual violence. To make it clear, collusion with actual male violence by a male-dominated government. I also posited that replacing sex with gender in the passport might help some citizens avoid this violence (again, male violence).

    However, some feminists campaign against this change on ideological grounds. Therefore they are, in my book. ready to collude with male violence against trans persons, because their ideology (“not wanting people with penises to have identification that says they are female”) is more important to them.

    The violence is still male. But certain female feminists are campaigning to collude in it. Why? In my view, because of overvaluing ideology and collectivist analysis – something that happens to all sexes and genders.

    (Overvaluing ideology does happen to transactivists too. Like those who so want “depathologization” they seem ready to throw all trans people of Western Europe under the bus. You see, this here old-EU – not so sure about new EU members – has pretty good socialized medicine, and the presence of a diagnosis and medical consensus means trans people can actually get help without waiting years to earn enough for it. And if these activists manage to destroy the diagnosis in the name of “not being stigmatized”, European trans people will lose a LOT… but then, with the recent Medicaid decision plus Obamacare, perhaps the “depathologizers” will get firmly shouted down in the US too).

    Oh, and “I have yet to hear one single feminist call for any violence against trans people” – actually Bev Jo did say “They expect we’ll be shocked to see statistics about them being killed, and don’t realize, some of us wish they would ALL be dead.” I do realize it’s an isolated case and all causes have their extremists. But now you know the “one single feminist”. (I did find a few other quotes calling for violence but they are attributed to nobodies with unfamiliar nicknames, so can very well be the work of trolls. Bev Jo seems to be real though).

  22. On a more philosophical note, perhaps you do have a point about the “actual world” or rather “natural world”. The most accepting country in Europe, and probably the world, for all sort of non-compliant people including gays and trans, as well as sex work and all sort of stuff? The “funfem” paradise? The Netherlands. (Disclaimer: I’m just back from a very good holiday there)

    You know what’s special about the Netherlands? Much of the country is “human-made”. The old saying goes “God created the world but the Dutch created Holland”. Much of the country’s territory was claimed from the sea and internal lakes. Water was pumped out and “polders”, artificial dry land, made. Even the largest national airport is on a polder! A huge flat 19th century polder, now crisscrossed by roads and railways. Not what was there naturally.

    The Netherlands threw down the gauntlet to the natural order of things ages ago. It did not always go well; notably the country turned out unfit to give a serious fight in World War II, and it makes sense, because collective violence, too, is a part of the natural order of things.

    There might be an interesting philosophical link here. Trans and queer; robotics and IT and loads of technological stuff before it, starting at least with the steam engine; Holland as an entire country (fittingly the home of a lot of fabulous artists too); transhumanism… All of these things are about the triumph of the artificial, the human-made, the transformation of everything by human action.

  23. Tobysgirl · ·

    This is not calling for violence against trans: “Bev Jo did say ‘They expect we’ll be shocked to see statistics about them being killed, and don’t realize, some of us wish they would ALL be dead.’ ” I wish a lot of people were dead, but I am not killing them. Every time some royal creep kicks the bucket, I open a bottle of cheap champagne; that is not killing them.

    Absurd, equating petitioning the government for redress — something all marginalized peoples have had to do — with the actual rape and killing of trans by MEN.

    And you don’t want to know what I think of Holland’s man-made environment and their participation in colonial violence and exploitation. You can visit a prostitute, smoke some dope, and stand on a polder as the world goes down just as it did at the end of the Permian.

  24. The thing is that there is no “redress” petitioned for in the case of passports, except on a purely ideological level. No single woman is ever harmed by the specific fact that a travel document classifies someone as female; the only alleged harm is about “making a class invisible” and other similar ideological stuff. But the fact that a transgender person’s sex is revealed to a hostile government enables actual physical violence against persons.

    So what is happening here is that some – though, on the feminist side, actually very few – activists want their government to collude in actual violence for ideological reasons.

    Now, to be fair, most people who oppose trans rights – and probably even most *females* opposing them – are not coming from this kind of allegedly feminist thought. For example, in this article an Irish trans woman complains, among other things: “One particular government agent, upon hearing the purpose of my phone call, laughed and told me, “You’ll never be a woman!” And then she hung up the phone on me.” I do not think such behaviour is acceptable from a *government official* but, frankly, she was far more likely to be a Catholic than a radfem.

  25. Tobysgirl · ·

    No single woman is ever harmed by the specific fact that a travel document classifies someone as female.

    It takes NO imagination to refute this. A sexual predator says he is female — as has already occurred — travels to another country and assaults any number of women. Ah, another instance of a “female” sex offender! This scenario makes at least as much sense as your fears for trans travelling in unsympathetic environments.

    Have you ever considered what might happen to a M2T who does not have surgery, travels with a female passport, and then is patted down? Or strip-searched? These actions occur quite frequently here. All those unsympathetic law enforcement types you mention might not be amused.

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