HI HB257

Requires all new birth certificates issued by Hawaii to include a sex designation based on the genitalia of the person

Restricts birth certificate sex designation amendments to adults (18+) only, eliminating the previous allowance for minors to amend sex designations

Removes the requirement that applicants complete "clinical treatment for gender transition" before amending sex designation, replacing it with a requirement that a physician verify the registrant's genitalia does not align with the current birth certificate

Mandates that birth certificates amended for sex designation changes be marked as "amended with regard to sex designation," unlike other birth certificate amendments which remain unmarked

Requires original birth certificates amended for sex designation to be unsealed from medical archives, reversing the previous confidentiality protection that allowed registrants to request access to sealed records