While inconsistent from state to state, most states allow for the correction or amending of the birth record.  Some states issue a new record changing all the data except the date of issue; some states will not change records. Indiana does not include 'sex' on their birth record and some states will amend rather than issue new records.  Some amended records like those from Florida will reflect only that the record is amended with no evidence of what was corrected.  Others like Mississippi require a court order and will issue an amended birth certificate with the gender typed in the margin, but the old gender remaining unchanged.

Most states rely on medical records dating back to birth and or affidavit from the attending birth physician.  This can be simple as was recently done in Ohio where the parents of a CAH female infant obtained her daughter's new birth certificate by submitting a statement from the attending physician indicating a mistake
had been made. 

For adults seeking to change the records because they were not changed during childhood by the parents, it can sometimes take years to acquire the old medical records; some are sealed, some take court orders to release and some are just no longer available.  Without these, one must rely on the documentation provided by current medical caregivers, submitting these to and working with the respective state Department of Health to request the record change.  With all the documents submitted, the new birth certificate received will have the correct designator in the 'SEX' box.

Here we have outlined the basic information regarding birth records. The states have come a long way, however it has taken years and we must continue to promote the advancement and diffusion of knowledge and understanding on these issues to ensure that those that follow us benefit from our work.