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Lawsuit Looks to End N.C. Policy Requiring Surgery to Change Gender

Lillith Campos and the NC Capitol

The lawsuit argues that forcing a trans person to have surgery to change the gender on their birth certificate violates their constitutional rights. 


LGBTQ+ rights group Lambda Legal and several firms filed a federal lawsuit Tuesday that challenges North Carolina's requirement that forces trans people to undergo gender-affirmation surgery to have their birth certificate changed to reflect their proper gender identity.

"It's dehumanizing and demoralizing being denied a birth certificate that reflects who I am. I cannot afford surgery and do not have access to surgery through my health insurance," plaintiff Lillith Campos, 45, who is a transgender woman from Jacksonville, N.C., said in a press release.

"It is wrong for North Carolina to require that I obtain surgery in order for them to recognize me as the woman I am," Campos continued. "As a trans woman, having incorrect documentation makes me feel like a second-class citizen because I am denied the same rights as the rest of the population. It just makes me feel like I am 'less than' before the eyes of the state."

Lambda Legal, Baker Botts, and Brooks Pierce McLendon Humphrey & Leonard filed the lawsuit in the U.S. District Court for the Middle District of North Carolina on behalf of three plaintiffs. Besides Campos, two minors -- C.B., a 16-year-old boy from Chapel Hill, and M.D., a 14-year-old girl from Carrboro -- are part of the suit. The names of the two minors were changed due to privacy concerns.

"Birth certificates are essential and foundational identity documents critical for people navigating life. North Carolina's policy explicitly requiring transgender people have surgery to affirm their identity is not only discriminatory but arbitrary and inconsistent with standard medical practice," argued Omar Gonzalez-Pagan, senior attorney and health care strategist at Lambda Legal.

Gonzalez-Pagan said the requirement was a large barrier for many trans people, especially those who cannot afford gender-affirmation surgery and those who do not want it. He added that the state is "out of step" with the rest of the country for requiring the surgery.

The suit claims that denying transgender North Carolinians the ability to get an accurate birth certificate without such surgery violates their rights based on sex, invades their privacy, and goes against their rights to medical autonomy.

"My daughter is a 14-year-old girl and the state's requirement for surgery is unrealistic and creates a barrier for my child to have a normal childhood. Not having an accurate birth certificate has exposed my daughter to discriminatory treatment and exclusion in school, sports, and other places. No child should go through knowing the state doesn't recognize as who she is and that's why I am supporting my daughter in this lawsuit," said Katheryn Jenifer, mother of plaintiff M.D.

Lambda Legal notes that the requirement is also against the North Carolina policies of allowing trans people to correct their sex on other documents like their driver's license without surgery.

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