Following an "emergency" measure, Montana is prohibiting changes to birth certificates. Health officials there described recorded sex as "immutable", even after gender-affirming surgery. The context: the courts and legislature there will be wrangling over this stuff presently, so this amounts to the current administration trying to force matters in advance.
Under the new rule, the state Department of Public Health and Human Services said it would no longer record the category of "gender" on people's birth certificates, replacing that category with a listing for "sex" — either male or female — that can be changed only in rare circumstances. … The new rule states that people's sex on their birth certificates can be changed only if someone's sex is misidentified when they're born or if the sex was wrongly recorded as a result of "a scrivener's error."
Trans people changing their birth certificates is an "emergency" in Montana? Must be an easy life out there.