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Medical providers may abide by  where a letter from a licensed therapist is required before proceeding with hormones or any surgical procedures. Insurance companies may ask for additional documentation (such as an additional letter from another licensed therapist).

Legally transitioning may include name, birth certificate, and/or gender marker change. Factors that may influence ease (or difficulty) in changing legal documents may depend on where your birth certificate was issued, financial resources, and/or where you are currently living. 

To legally change your name within the state of Michigan, individuals over the age of 22 must:

• Submit a name change petition to county court
• Publish a notice of the petition in a local newspaper
• Provide 2 sets of fingerprints for a criminal background check

To update your 'sex designation' on a Michigan state ID or driver's license, individuals must:

• Bring a physical copy to the office when applying for a Michigan ID

For more information, view our document changes page.

Medically transitioning can include hormones and/or surgical procedures in addition to routine medical wellness.

Hormone Replacement Therapy (HRT) can include topical, oral, or injection depending on dosage and type of hormone (such as estrogen versus testosterone). Prolonged use of hormones may also include scheduled visits with an endocrinologist to do regular blood work and to regulate any adverse health outcomes. Please speak with a trusted medical professional about what options might work best for you. 

Surgical procedures may include face, torso, and/or genitalia. Pursuing any surgical procedure is a personal decision that should be discussed with a trusted medical professional. Access and availability of reliable surgeons may be dependent on type of procedure, therapist letter requirements (if any), location, recovery time, minimum required consultation appointments, insurance and/or funding.

Transgender individuals may wish to speak in a range that is reflective of their identity.  may include speech, language, and pragmatic functioning as they relate to gender. For transgender voice services through 51¸£ÀûÉç, visit the Speech, Language, and Hearing Sciences page or call (269) 387-7000. All clients must get an evaluation before starting individual weekly voice therapy on a semester basis.  For more information about the availability of transgender voice therapy, .