Changing Gender or “Sex Designation”
If you were born in Iowa, first decide if you also want to change your legal name. If yes, you will want to update both your name and sex designation on your birth certificate at the same time, to save you both time and money.
To change the sex designation on your Iowa birth certificate, follow these steps:
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Get your doctor to provide a signed and notarized letter, known as an affidavit, explaining that your sex designation has changed permanently through surgery or other treatments
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This affidavit will also need to include a description of the medical procedures or treatment and the doctor’s full name, address, state of medical license, and medical license number
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Call the Iowa Bureau of Health Statistics at (515) 281-6263 and speak with a staff member to get a packet of materials that includes an “Amendment to Iowa Certificate of Birth” form
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Make a copy of your current, government-issued photo ID
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If you are also changing your name, include a certified copy of the court order that granted your name change request (see our page on “Changing an Adult’s Name” for more information)
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Submit the forms and supporting documents to the Iowa Department of Public Health at:
Iowa Department of Public Health
Bureau of Health Statistics
Lucas State Office Building, 1st Floor
321 E. 12th Street
Des Moines, Iowa 50319-0075
You should also get a certified copy of your birth certificate so that you can change other legal documents, such as Social Security records or driver’s licenses. Please see “Getting a Certified Copy of Your Birth Certificate” for details. 
You can find more information on changing your sex designation on your:
- Iowa birth certificate,
- Iowa driver’s license, and
- other forms of identification and legal documents
in the Iowa Guide to Changing Legal Identity Documents: A Handbook and Roadmap for Transgender Individuals Interested in Changing Their Legal Name and Gender on Government and Personal Records and Accounts, 2019 edition. This guide was prepared by the University of Iowa Law and Policy in Action Clinic and Len Sandler, Clinical Professor of Law.