HI HB1231

Adds "X" as a third gender marker option on Hawaii birth certificates, allowing individuals to designate their sex as male, female, or X.

Permits adults (18 years or older, or emancipated minors) to apply for sex designation changes on their own birth certificates by submitting a completed application with required personal information and notarization.

Allows parents or legal guardians to apply for sex designation changes on minors' birth certificates with a signed statement from a licensed health care provider attesting the minor is under their care and the request is consistent with the minor's identity.

Removes the previous requirement for physician attestation regarding medical treatment and completion of gender transition, replacing it with a streamlined application process.

Takes effect January 1, 2022, with the provision for creating necessary application forms taking effect July 1, 2021.