The process of getting your legal gender marker changed in Pakistan is complicated. You can either get a different binary gender marker (M -> F or F -> M), or the X marker.

Binary gender markers (M/F)

The rules around this are derived from decisions made in past High Court cases, such as this example. This option is only available to those who have had their SRS or orchiectomy.

To get your binary marker, you must first go through an assessment by the medical board. You get the appointment after submitting your legal and medical documents to the provincial secretary of health. The medical board usually consists of a psychiatrist/psychologist, urologist/gynecologist, endocrinologist, and a medical health officer. After the assessment, you can go to NADRA with your documents and apply for your renewed ID.

University Students: If you are transitioning under the supervision of a medical professional, you can ask them to write a letter for you, allowing you to change your gender marker and name in internal university documents. This is to help prevent misgendering and make you feel safer.

X gender marker

This is governed by the Transgender Persons Act 2018, which established the right to choose the X marker. Although there is uncertainty as to the continued existence of this rule, as parts of the Act are still under review by the Federal Shariat Court, NADRA has resumed issuing ID cards with the X marker again.

The process involves going to a NADRA office with a witness (usually a guru) to get it changed.