After looking through the records of my name change and noticing a spot where my local FAA office (read the history here, here, and here) had recommended I call Washington for more help on changing the “M” to an “F,” I decided to call that number. I spoke with a very helpful fellow named Bruce Lansford (who has a column in the AOPA magazine, by the way), who told me that no, surgery wasn’t necessary to change the gender marker. What I needed was a letter from my doctor saying I was in the process (or had completed the process) of changing gender, and that was about it. He said they do this all the time, and it shouldn’t be any trouble.

This was quite a pleasant surprise, so I wrote my local FAA office and said I would like to re-initiate contact with my local FAA officials so that I could proceed with a name and sex change.

Nothing is ever easy with bureaucrats, of course, and I received the following note from the FSDO, which pasted a copy from a manual into the email, explaining that I needed the following documents:

A complete FAA Form 8710-1 Airman Application for the name change and gender change. For the name change you will need appropriate documentation acceptable to the Administrator, which substantiates the validity of the requested change.

For a change of gender on an airman certificate, the original copies of two documents must be provided. After examining and verifying these documents, we will photocopy the documents and attach the photocopies to Form 8710-1. In Block I, under Other, we will note gender change reissue. The file is then forwarded to AFS-760 for processing. The required documents are:
1) A court order, issued by a court of the United States or its territories, stating that the individual has changed his/her gender to ___, or a court order stating that the individual’s gender is ___; and
2) A physician’s statement clearly indicating that the individual is physically the gender noted on the court order.

Surprised, I wrote back:

I’m a bit confused as to how to reconcile what you’re telling me with what Mr. Lansford told me, and I asked him quite directly about this when we spoke on the phone. I asked if I needed to be “physically” female, as your request of my physician suggests, or whether my process of becoming and my daily existence as female was sufficient, and he said very forcefully that it was the latter, not the former, that the FAA cares about. He said I needed to present a letter to the FAA from my physician stating that I have been undergoing treatment (psychological and medical) that has altered or will alter the gender and he specifically said that I did NOT have to undergo surgery in order to change my airman’s certificate.

The reason I ask is that only about 5% of all transgendered people choose to change their genitals, either because of preference or because of funding issues, so I suspect there must be hundreds of transsexual pilots out there who are living in their new sex roles, but who haven’t had surgery, and who really, really ought to have identification that matches their name and appearance.

Second, and this relates to the previous point, just what does “physically the gender noted on the court order” mean for the purposes of my physician’s letter? Does the FAA mean genitals? chromosomes? hormones? All three of these can be considered physical aspects of sex. My physician can write you a letter saying I’m hormonally female, but I’ll always have XY chromosomes and I have not had genital surgery. My psychologist can write you a letter saying that I am permanently female, physically, mentally, and socially, having transitioned about a year ago. But I just don’t know what the FAA means by “physically.”

I would like to change my name on the airman’s certificate in any case, but I would also like to change the gender marker from M to F if I can do this within the constraints outlined above. I’ve got all the paperwork necessary for the name change, and I really don’t feel comfortable flying around the country with all my ID saying Joyce and female, and my FAA license saying [oldname] and male.

My next email came from Gordon’s supervisor, Steve:

We have contacted Mr. Lansford of AFS-760 to determine if he had other guidance we should follow. Our discussion with Mr. Lansford revealed he had provided you with guidance from a superseded Inspector Handbook (FAA Order 8700.1) which was replaced by the 8900.1 in 2007. After further research with our regional Technical Support Branch, we were informed that the physician’s statement must be from a Designated Medical Examiner or a Regional Flight Surgeon’s office. If you have additional questions regarding the medical information and applicable documentation please contact Dr. G.J. Salazar, Regional Flight Surgeon, Southwest Region at (817) 222-5300.

We will be obligated [sic] to process your request once you can submit the required documentation.

OK, I thought. We’re going backwards. Now it’s not just my physician, but an FAA physician. I replied:

Thanks for your reply. I guess we’re getting somewhere, even if it feels like it’s going backwards. Can you point me to the AME or FAA manual that is going to give the FAA medical examiner guidance as to this statement: “A physician’s statement clearly indicating that the individual is physically the gender noted on the court order?” In other words, my previous questions as to what “physical” means are still unanswered, and I would hope that the FAA, which defines everything, right down to the arc-minutes below the horizon the center of the sun needs to be as a definition of “sunset,” would be able to clarify for me and for its AME’s.

Seeing as how this is clearly going to take a long time, I would like to set up an appointment ASAP to submit to you my name change documentation.

The regional FAA Flight Doctor, who had been cc’d on this exchange wrote me back:

Dear Joyce — I have been asked to address some of your questions with respect to medical information that may be required with individuals who have requested a reclassification of gender identity to the FAA. Although I prefer not to discuss specifics on anyone’s medical information over an email I will try to respond to your email queries. I also noticed you do not have a current medical application on file so my response will be very general and it will only apply to aeromedical certification and not to the pilot license issue being addressed by the Bedford Falls FSDO.

The Guide for Aviation Medical Examiners does not have every possible medical condition listed in the contents — that would be an impossible undertaking. The Guide is exactly that, a guide and not policy. An Aviation Medical Examiner is expected to defer these cases to Aerospace Medical Certification Division (AMCD) in Oklahoma City for issuance of the medical certificate, which in part explains why there is no specific guidance in that publication. I would suggest that no medical reports be provided to the AME at the time of the FAA physical — AMCD will send the applicant a letter making it very clear as to what medical information is needed.

AMCD has considerable experience with requests for medical certification of individuals involved in the gender identity change process. It is rare for the agency not to medically certify an applicant who has made that request. In general terms the process the agency follows varies for every applicant depending on the specifics of the case. When a new deferred medical application is received and the applicant has identified that they are in the gender change identity process AMCD will ask for additional medical information from their treating physician(s). This request is initially general in nature, i.e., stage in the process, medications and dosages, any underlying medical problems, is surgery anticipated, etc. They will likely ask for a current psychological assessment to make sure no stressors may be present that could preclude issuance. Depending on what information is received additional requests for information will be made. When the agency is satisfied medical standards are met, a medical certificate is granted most likely under the special issuance process, with follow up reports requested. Again this is a very general description and each case will vary.

If you are interested in obtaining medical certification, please visit your AME and start the application process. They will defer issuance and AMCD will notify you what is needed. I have taken the liberty in forwarding a letter today to you explaining the need to start the medical application process.

There were many good things in his email, including the statement that the FAA has lots of experience in gender-changes, and several troubling things, like his statement that there is no current medical certificate for me on file even though I did a new one last August, and the waffling answer that the medical guide can’t possibly answer everything. In other words, “physically the gender indicated on the certificate” can mean whatever the physician wants it to mean. Since I do have a current medical certificate, I wrote back thusly:

Thank you very much for your mail. I do, in fact, have a 2nd class medical, but you’ll need to look up my old name in the FAA records, as I was advised to wait by the Bedford Falls FSDO to do the gender/name change all at the same time: [oldname], private pilot, cert #99999999. I passed my 2nd class physical a year ago — as a woman — with flying colors, so what’s being requested at this point is not a new medical, but rather a change in my pilot’s airman’s certificate noting the sex is F, rather than M.

I am visiting our FSDO on Monday to initiate my name change, as it appears this sex-change request may take a while. I will show Gordon my 2nd Class medical certificate at that time and ask if that document is sufficient to get the ball rolling on changing the M to an F.

And he replied:

Joyce — now I am confused. I had been given the name [oldname] by the FSDO and looked you up in the system prior to emailing you. The date of the last exam I have on file is July 12, 2006, which would make that certificate expired for all classes. If you had a physical in 2008 (or 2007) and your AME did not transmit it as required that is worrisome — the agency would have no way of knowing you have a valid medical in your possession and that can cause a problem during a ramp check. Could you please identify your latest AME and the exact date on the certificate — the last AME on record for you is Dr. KF in Bedford Falls and he did your 2006 exam.

And I replied:

Yes, I’m looking at it right now, a white certificate, second class medical, signed by KF, examiner number 99999-1, and we did the exam in the late afternoon of August 7th, 2008. I do know that he had some traumatic medical events in his life shortly after my exam last August, and maybe it’s the case that some of his last bits of paperwork didn’t get filed? I don’t know.

And he ended the conversation thusly:

Thank you — please ask him to provide you or us a copy of the physical if he has it — but you would be better off to get a new physical when you decide you wish to pursue medical certification under a different name. That way there is no confusion with regards to the nature of the application. Simply for information, Dr. KF no longer is an AME.

In addition, it would be helpful if you could fax a copy of that certificate (and the physical if you obtain it) so we have it on file. Our fax is 817-222-5965.

OK, at least I’m still legal to fly because I’m in possession of a medical certificate. I think Dr. Salazar’s argument that I should get a new medical for the new name rings a bit false — I don’t recall anywhere that changing your name due to marriage, etc, requires a new medical examination. I don’t know if this is progress, but the dialog is productive and, more importantly, it’s moved beyond the local FSDO’s domain and includes the regional flight medical examiner.