Arizona requires transgender people to undergo surgery to obtain a birth certificate that matches who they are.  That surgery requirement is particularly harmful to transgender young people because it is not medically appropriate for them to undergo those surgeries at their age.  Having to use an inaccurate birth certificate prevents transgender people from treated consistent with their gender identity.

On November 4, 2020, NCLR, along with co-counsel Cooley LLP and Osborn Maledon, filed a lawsuit alleging that requiring surgery to correct the gender marker on a transgender person’s birth certificate violates the Equal Protection and Due Process Clauses of the Fourteenth Amendment to the United States Constitution.

Plaintiffs’ Motion for Class Certification was granted on August 10, 2023, allowing the outcome of the case to apply to all transgender individuals in the state of Arizona who wish to change the marker on their birth certificate but have not undergone surgery.

On August 20, 2024, Plaintiffs’ Motion for Summary Judgment was granted. A judge for the U.S. District Court for the District of Arizona found that the surgery requirement was unconstitutional and violated Equal Protection and Due Process rights. We then filed a motion for a permanent injunction which was granted on September 30, 2025. The injunction enjoined enforcement of the word “operation” from existing Arizona surgical requirement, allowing transgender Arizonans to demonstrate their sex change without being forced into surgery. The state appealed the permanent injunction to the Ninth Circuit where we are currently awaiting a decision. The Ninth Circuit granted the state’s request for a stay of the lower court order while the appeal continues, keeping the surgical requirement in place for now.