DHHS Changing Your Gender in NV

Changing

Your

Gender

in Nevada

A Guide to Name and

Gender Marker

Changes and Gender

Reassignment Services

Table of Contents

Introduction............................................................................................1

Name Change in Nevada................................................................2-3

Birth Certicate Name and Gender Marker Change....................4-5

Social Security Card Name and Gender Marker Change...............6

Department of Motor Vehicles (DMV)

Name and Gender Marker Change...................................................7

Division of Welfare and Supportive Services (DWSS)

Name and Gender Marker Change...................................................8

Nevada Medicaid Coverage for Hormone Therapy

and Gender Reassignment Services (GRS)....................................9-10

Additional Resources...........................................................................11

Introduction

This informational booklet is meant to serve as a guide to the specic steps

involved in managing the process of changing your name and gender

marker on important documents like your birth certicate, social security

card, and driver’s license in Nevada.

This booklet also provides information related to changing your name and

gender marker with the State of Nevada Division of Welfare and

Supportive Services (DWSS), understanding Nevada Medicaid coverage

for hormone therapy and gender reassignment services, and Nevada law

regarding health care coverage related to your gender identity or

expression.

Nevada Revised Statute (NRS) 651.070 identies and prohibits

discrimination in any place of public accommodation in Nevada, includ-

ing insurance ofces, ofces of providers of health care, hospitals, or other

service establishments, based on race, color, religion, national origin,

disability, sexual orientation, sex, gender identity or expression. NRS

651.050(2) denes gender identity or expression as “a gender-related

identity, appearance, expression or behavior of a person, regardless of

the person’s assigned sex at birth.”

Nevada Administrative Code (NAC) 686A.110 through 686A.160 prohibits

denial of benets relating to coverage of medically necessary health care

services on the basis of sex. NAC 686A.140 prohibits restricting, reducing,

modifying, or excluding benets relating to coverage involving the genital

organs of only one sex when the restriction, reduction, modication or

exclusion is not required for both sexes.

NRS 651.070 and NAC 686A.140(7) prohibit the denial, exclusion, or limita-

tion of benets relating to coverage of medically necessary health care

services on the basis of sex as it relates to gender identity or expression.

An insurance carrier may not deny, exclude or limit benets for medically

necessary health care services if the medically necessary health care

services would be provided at current standards of care to another

covered person without regard to their gender identity or expression.

This guide was compiled using information from a number of different

agencies (state and local government agencies and non-prot

agencies).

Please see the nal page of this guide for a complete list of contributors.

Name Change in Nevada

Nevada Law (NRS 41.270-290) requires several steps for a name change

including ling with the district court, publication of notice and court

hearing. However, if a name change is for gender identity

purposes, a Notice of Publication of Petition does not need to be

completed.

Complete the following:

(1) Family Court Cover Sheet,

(2) Petition for Name Change, and

(3) Request for Summary Disposition & Declaration in Support may be

required in some counties.

File a veried petition with the clerk of the district court (the district in

which you reside). The petition is addressed to the court and states your

current name, the name you would like to have in the future, the reason

for desiring the name change, and whether you have been convicted

of a felony.

If you have been convicted of a felony, you must disclose this and

submit a copy of your ngerprints with your documents.

Forms for Nevada name changes can be found here:

http://selfhelp.nvcourts.gov/self-help/name-changes/name-changes-for-adults?enter=1

The forms for Washoe County can be found here:

https://www.washoecourts.com/Main/FormsAndPackets

The forms for Clark County can be found here:

http://www.familylawselfhelpcenter.org/self-help/name-changes/name-changes-for-adults

Note: If links do not work, try using a different browser like Google Chrome

Fees may vary by county. In Clark County, there is a $270.00 fee to open

the case. If you cannot afford this fee, you may also apply for a fee

waiver.

You can also le in person or by mail at the following addresses:

Family Courts and Services Center

Attn: Clerk of Court

601 North Pecos Road

Las Vegas, NV 89101

2nd Judicial District Court

District Court Filing Ofce

75 Court Street

Reno, NV 89501

Name Change in Nevada

After you le your documents with the Court, submit the Order of Name

Change for the judge to review and sign.

Staff will either mail the order to you or contact you to pick it up and

le it. If you are told to le the order yourself, le it at the Clerk’s

Ofce.

If you wish to change your child’s name, the same requirements apply;

however, both parents with legal rights to the child must consent.

*Note: Getting a name change with the Court does not automatically

change your name with government agencies, banks, the DMV, Social

Security.

After you get your court order, you will need to contact each ofce to

change your name.

Most agencies will need to see a certied copy of the name change

order before changing your name on their records.

You can get a certied copy of your order by visiting the Clerk’s Ofce.

The Transgender Allies Group developed a roadmap that outlines

each step for changing your name on your birth certicate, diplomas,

and professional certicates.

The step-by-step roadmap is available here:

http://transgenderalliesgroup.org/roadmap.html

For court locations outside Clark and Washoe County, visit:

http://selfhelp.nvcourts.gov/nd-my-court to nd a court in your area.

Birth Certicate - Name and

Gender Marker Change

If you were born outside of Nevada, check with the Ofce of Vital

Statistics in the state of your birth for requirements to change your

name and gender marker.

If you were born in Nevada, you may complete forms to change your

name and gender marker with Nevada Vital Records.

Forms found online at:

http://dpbh.nv.gov/Programs/BirthDeath/Birth_and_Death_Vital_Records_-_Home/

Click on the link titled: Sex (Gender) and Name Change Informational

Packet and Forms.

To amend or correct a birth certicate, you must be the person of

record (person listed on birth certicate), parent or guardian of the

person of record, or a legal representative of the person of record.

Complete the following documents:

(1) Afdavit for Corrections of a Record – Completed by you (the per-

son of record), parent, guardian, or legal representative and notarized.

AND, one of the following:

(2) Supplemental Afdavit (in Forms section at the end of this

brochure) – Completed by a person having personal knowledge that

you (the person of record) assumed, identies with, and intends to

maintain the gender marker corresponding to your request.

*Note: this cannot be completed by you or any other person that

completed the Afdavit for Corrections of a Record.

3) Other Veriable Evidence –

Examples include:

-A written statement from a licensed Healthcare Professional

on facility letterhead.

-A court order stating that a licensed Healthcare Professional

has treated, evaluated, or consulted with you (the person of

record) and your change request is consistent with the gender

that you identify with and intend to maintain.

Birth Certicate - Name and

Gender Marker Change

There is a $40.00 fee that includes one certied copy of the amended

birth certicate.

Additional copies are $20.00 each.

Submit your documents in person or by mail to:

Division of Public and Behavioral Health

Preparedness, Assurance, Inspections and Statistics

Ofce of Vital Records and Statistics

4150 Technology Way, Suite 104

Carson City, Nevada 89706

For specic questions about amending or correcting information on a

birth certicate, call 775-684-4242 and ask for an amendment clerk.

For all other questions, call the Ofce of Vital Records at 775-684-4242,

or you can e-mail questions to: [email protected].

Social Security Card - Name

and Gender Marker Change

IMPORTANT - Change your name with the Social Security Administration

(SSA) rst.

Wait at least two days after updating the change with SSA to

complete the change with DMV.

To make these changes, you must visit a Social Security ofce in

person. The Social Security ofces in Nevada are located in Reno

or Las Vegas.

In Reno:

1170 Harvard Way, Reno, NV 89502

In Las Vegas:

4340 Simmons St, North Las Vegas, NV 89032

1250 S. Buffalo Drive, Suite 100, Las Vegas, NV 89117

10416 S. Eastern Avenue, Henderson, NV 89052

If you are located in a rural area, you must arrive in person at a Social

Security Administration ofce in either Reno or Las Vegas.

For SSA Name Change:

Submit the following: (1) Application for a Social Security Card; (2)

proof of your identity; (3) proof of citizenship or immigration status;

and (4) acceptable proof of name change. Acceptable proof of

your name change may be: court order for name change (original

or certied copy); marriage, civil union, or domestic partnership

certicate (original or certied copy); divorce decree (original or

certied copy); or certicate of citizenship or naturalization (original

only).

For SSA Gender Marker Change:

Submit one of the following to change your gender marker:

(1) birth certicate showing the correct gender marker; (2) court

order recognizing the correct gender marker; or (3) signed letter

from a provider conrming you have had appropriate clinical

treatment for gender marker transition.

Transgender Allies Group recommends having your physician ll out the

letter template, which can be found here:

http://transgenderalliesgroup.org/transitionForms.php

Department of Motor

Vehicles - Name and

Gender Marker Change

DMV Name Change:

Bring an original or certied copy of your court order and your

current ID with you to the DMV to change your name. This must be

done in person at a DMV ofce.

DMV Gender Marker Change:

A physician must complete the form titled DMV Medical Certication

and the Gender Change Authorization form on your behalf. Once

completed by a physician, bring the form to the DMV to change

your gender marker.

The form is located here:

http://www.dmvnv.com/pdfforms/dld136.pdf

DMV Name Change on Vehicle Registration and Title:

It is important to change the name on your vehicle registration

and the title so that these documents match your ID card or

driver’s license.

To change these documents, you must provide the DMV with

your court order for name change, proof of insurance, and current

registration. The DMV will match the full legal name on your driver’s

license to your vehicle registration and title.

IMPORTANT - The insurance card that you present to the DMV must

already have your updated name on it when you change the name

on your vehicle’s registration and title.

Division of Welfare and

Supportive Services - Name

and Gender Change

DWSS determines eligibility for the Medicaid, SNAP, TANF, and Energy

Assistance Programs.

If your information has been updated with SSA or DMV, then DWSS

will verify the reported changes through electronic data sources

whenever possible.

To either apply for new benets or report changes to existing cases you

can do so online, on the phone, in person, or by mail.

Contact Online: https://dwss.nv.gov/TANF/Access_Nevada/

Call: Customer Call Team (CCT) 775-684-7200 or 702-486-1646.

Visit any District Ofce: District ofces are located in Las Vegas,

Henderson, Reno, Sparks, Carson City, Fallon, Yerington, Hawthorne,

Elko, Ely, and Pahrump.

Visit: https://dwss.nv.gov/Contact/Welfare/ to nd the ofce closest to you.

Mail information to:

State of Nevada

Division of Welfare & Supportive Services (DWSS)

P.O. Box 15400

Las Vegas, NV 89114-5400

Nevada Medicaid Coverage

for Gender Reassignment

As of January 1, 2018, Nevada Medicaid covers genital reconstruction

surgery (GRS) services.

Nevada Medicaid covers medically necessary services for the

diagnosis and treatment of gender identity disorder, also known

as gender dysphoria, among eligible recipients.

Currently, hormone therapy prescription drugs used in delaying the

onset of puberty and/or continued pubertal development, and

mental health services are covered.

Hormone Therapy

Medicaid recipients seeking hormone therapy or hormone suppression

prescription services schedule an appointment with a licensed family

physician (FP), endocrinologist, or obstetrician-gynecologist (OB/GYN)

that accepts Medicaid. Medicaid policy requires a diagnosis of

gender dysphoria to qualify for hormone suppression therapy drugs.

Hormone therapy and hormone suppression are different. Hormone

therapy for transgender individuals helps aid the transition from

male-to-female or female-to-male. Hormone suppression involves

continuous hormone suppression prescription drugs given to children

between ages 8 – 15 while in Tanner Stage 2, to halt the progression of

puberty including the development of secondary sex characteristics.

To be considered for genital reconstruction surgery (GRS) services,

Medicaid adheres to World Professional Association for Transgender

Health (WPATH) Standards of Care, requiring that gender hormones be

taken for 12 consecutive months with the recipient living in the

relatable gender role.

Mental Health

Medicaid recipients seeking mental health services must be

recommended by a physician or other licensed practitioner of the

healing arts, and schedule and maintain ongoing psychotherapy

with a licensed psychiatrist or psychologist.

Nevada Medicaid Coverage

for Gender Reassignment

Nevada Medicaid adheres to WPATH Standards of Care and covers

gender reconstruction services. To be eligible, the recipient must:

1. have a persistent and well-documented case of gender

dysphoria;

2. be 18 years of age or older;

3. be sufciently physically t and meet eligibility criteria

under Nevada and federal laws;

4. have the capacity to make a fully informed decision and

give consent for treatment;

5. have had comprehensive mental health evaluations;

6. have lived 12 months in a gender role congruent with

the recipient’s gender identity without reversion to the

original gender; and

7. have obtained authentic letters from two qualied

licensed health care professionals,

a. a licensed psychiatrist or psychologist with which

the recipient has an established and ongoing

relationship; and

b. a licensed psychiatrist, psychologist or physician

that has only had an evaluation role.

Male to Female Gender Reassignment

Male-to-Female (MTF) surgery may cover: breast or chest surgery

(mammoplasty) and genital surgery (orchiectomy, penectomy,

vaginoplasty, clitoroplasty, vulvoplasty, labiaplasty, urethroplasty,

prostatectomy).

Augmentation mammoplasty for MTF recipients is a covered benet

only when 12 continuous months of hormonal (estrogen) therapy has

failed to result in breast tissue growth of Tanner Stage 5 on the puberty

scale, as determined by the provider, or the recipient has a medical

contraindication to hormone therapy.

Female to Male Gender Reassignment

Female-to-Male (FTM) surgery may cover breast or chest surgery

(mastectomy) and genital surgery (hysterectomy,

salpingo-oophorectomy, phalloplasty, vaginectomy, vulvectomy,

scrotoplasty).

To nd an enrolled Medicaid physician, surgeon, and/or behavioral

health physician, please see the following link:

https://www.medicaid.nv.gov/hcp/provider/Resources/SearchProviders/tabid/220/Default.aspx

Additional Resources

The following links may be helpful for you and your physician to review

and understand the Medicaid requirements that pertain to covered

Transgender Services.

To review the policy related to Transgender Services, please see the

following link:

http://dhcfp.nv.gov/Resources/AdminSupport/Manuals/MSM/C600/Chapter600/

Select link under 2018 titled Current - Effective Jan 1, 2018:

http://dhcfp.nv.gov/uploadedFiles/dhcfpnvgov/content/Resources/AdminSupport/Manuals/MSM/C600/MSM_600_18_01_01.pdf

Scroll down to Section 607 for revisions to Transgender Services.

To review billing guidelines, please see the following link:

https://www.medicaid.nv.gov/providers/BillingInfo.aspx

Click on Provider Type 14 to see guidelines for Behavioral Health

(Psychotherapy) outpatient treatment services.

Click on Provider Type 26 to see guidelines for Psychologist

services.

Click on Provider Type 20 to see guidelines for Physician/Surgeon

services.

Please contact the State of Nevada Department of Health and Human

Services Primary Care Ofce if you have additional questions.

Phone: 775-684-4000

Email: [email protected]

We would like to acknowledge and thank our contributors to this guide:

State of Nevada Division of Health Care Financing and Policy

State of Nevada Division of Public and Behavioral Health

State of Nevada Division of Welfare and Supportive Services