The ACLU of Virginia strongly supports the proposed rule updates to 12 VAC 5-550. The existing regulation goes beyond the authority of the Board of Health and establishes a requirement that a person undergo gender reassignment surgery,  a standard not authorized by law. The proposed new regulation would be consistent with the governing statute which requires only a “medical procedure.” Additionally, the proposed rule will help facilitate the process for transgender people to change the gender marker on their Virginia birth certificates. Sadly, many transgender individuals are involuntarily outed as transgender or experience harassment due to inaccurate gender markers on identity documents. No one should have to face this type of humiliation and discrimination. The updates to 12 VAC 5-550 will help transgender people get accurate identity documents and prevent unwanted outing and discrimination.