Our name and/or gender shows up on many different documents and pieces of identification: driver's licenses, passports, credit cards, social security cards, birth certificates, health insurance, etc. When it comes to updating your documents to reflect the correct name and gender, there are is no one stop shop. Everything must be updated individually since no agency communicates with each other if you were to update your information with them. Healthcare systems make it pretty hard to record our true gender identity. Some of this is because healthcare technology is imperfect, and some of this is because of laws and rules that we have to follow in healthcare. We wish it was more simple!

As you begin your process of updating your documents, it can be helpful to gather your current identity documents as you will likely need them as you are updating your documents. Some things to gather can include:

  • your current birth certificate
  • your current social security card
  • your current passport
  • your current state ID

For state IDs and driver licenses

As a transgender person, updating your documents varies from state-to-state. Some states have certain requirements that others do not. We recommend checking these resources for navigating the process for gender marker and name change in your state.


  • Search for "Name/gender marker clinics in [YOUR STATE]". Sometimes local non-profits, law schools, legal clinics, and other groups will host virtual or in-person events that assists anyone interested in updating their name and gender marker.  
  • Ask your local legal aid society for assistance in processing paperwork

For social security records

To update your social security records, you will first need to obtain an official court-ordered name and gender change. Under current U.S. policy, a transgender person can change their gender on their social security records by submitting proof of their gender marker change (either government-issued documentation reflecting a change, or a certification from a physician confirming that they have had appropriate clinical treatment for gender transition). To change your name on your card, you must show social security documents proving your legal name change and identity.

Acceptable forms of "proof" include:

  • A full-validity 10-year U.S. passport showing the correct gender and/or name
  • A state-issued birth certificate showing the correct gender and/or name
  • A court order recognizing the correct gender and/or name
  • A signed letter from a provider confirming you have had appropriate clinical treatment for gender transition

If you use a physician letter, it must come from a licensed physician with whom you have a patient relationship and who is familiar with your transition-related treatment. This may be your Plume provider or any physician who is familiar with your treatment, including a primary care physician or a specialist. Learn more about how to get a letter of support here. 

For passports

Medical documentation is no longer required to update your U.S. passport. You can select the gender marker you want printed on your passport, and your selection does NOT need to match the gender on your supporting documentation (birth certificate, previous passport, or state ID). Beginning in 2023, individuals will be able to select X as a gender marker on U.S. passports. For more information, click here.

For credit and debit cards

Contact your individual financial institution on how to update the information on your debit/credit card accounts. You will likely need a copy of your updated photo ID and any court documents related to your legal name/gender change. Once they have received proof of your updated information, they will send you new cards reflecting this change.

For health insurance

To update the name and gender on your health insurance, you will want to contact both your individual health insurance agency and your employer's Human Resources department if your insurance is sponsored through your job. It is important to have your health insurance information match your state ID information to ensure no delays in care. For example, if the gender marker a provider uses on a prescription order is different from the gender marker on your insurance card, it can cause a delay in getting your medication because your insurance company will not identify you as the correct person due to the mismatched information.

About gender markers in Plume patient records

When you sign up and create your profile at Plume, you tell us your “sex assigned at birth” and gender identity. We have a space in our system to make your gender clear, but it gets tough when we transmit an order to other places (like a pharmacy, lab, or insurance company). These outside systems only have a M or F “sex” field that pulls from our “sex assigned at birth” field. These outside partners require that this field (and this field only) gets sent, regardless of your legal gender or gender identity in our system. To try and make this better for our patients, we offer to send your pronouns and chosen name as an FYI when we send a pharmacy or lab order. But, we know it’s not perfect.

Another option is for us to change your “sex assigned at birth” in our records. Since this is the field that gets sent to an outside pharmacy, lab or insurance company, they would then see this updated change. But, this can create some challenges that we want you to know about. For example, if the gender marker we send is different from the gender marker on your insurance card, it can cause a delay in getting services covered. Right now, your visits and labs with Plume are covered by your cash membership fee, but some people do use their insurance at the pharmacy. Also, we hope to accept insurance for all Plume services in the future and are working to ensure our procedures align with the rules that can make this happen.

As you likely know, you are able to change your legal gender marker. This process depends on your state and on the place you’ll be changing your gender marker (bank vs. health insurance vs. pharmacy, etc). It’s always best to check with your state and the specific place where you’re trying to change the gender marker. The Transgender Law Center has some great resources to help understand this.  You can read more about your rights in changing your legal gender with your insurance here.

To change the gender that is sent to both the lab and pharmacy (the “sex” field), we do request a supporting document. This helps avoid confusion with other healthcare partners. If you would like for us to go ahead and make this change, please send your Care Team a picture of one of the following SSA (social security administration) approved documents:

  • Copy of gender marker change at social security office (gender is not included on the actual card, but you can ask for a printout of your profile which includes gender)
  • Medical certification of appropriate clinical treatment for gender transition in the form of an original letter from a licensed physician;
  • Full-validity, 10-year U.S. passport showing the new gender;
  • State-issued amended birth certificate showing the new gender; OR court order directing legal recognition of change of gender