Montana Gov. Gianforte signed SB 280, requiring surgery and a court order to amend a birth certificate's sex marker
On April 30, 2021, Montana Gov. Greg Gianforte signed Senate Bill 280, sponsored by Sen. Carl Glimm, reversing a 2017 Department of Public Health and Human Services rule that had let transgender Montanans update the sex designation on their birth certificate to match their gender identity. SB 280 instead required DPHHS to receive a court order confirming the person underwent gender-affirmation surgery before it would amend the sex marker, and took effect immediately upon signing.