Ontario
Under Section 36 of the Vital Statistics Act a certificate signed by both the surgeon performing the sex reassignment surgery and another doctor who has examined the person, as well as identification of the applicant was required to change sex designation on an Ontario Birth Certificate.
On 11 April 2012, the Human Rights Tribunal of Ontario ruled that genital surgery isn't required to recognize a change in sex designation. In its decision, the Tribunal ordered that the Ontario government "shall cease requiring transgendered persons to have 'transsexual surgery' in order to obtain a change in sex designation on their registration of birth" and has 180 days to "revise the criteria for changing sex designation on a birth registration". This makes Ontario the first jurisdiction in Canada to allow transgendered people to change the gender on their birth certificates without sex reassignment surgery.
Read more about this topic: Changing Legal Gender Assignment In Canada