New York state has adopted a policy change allowing transgender people to change the gender specified on their birth certificate without undergoing sex reassignment surgery. The shift follows a decade-long campaign by the Silvia Rivera Law Project and other groups, who say it will help transgender people access IDs which accurately reflect their gender and overcome barriers to jobs, housing and services. However, the change currently excludes prisoners, youth and people born in New York City. New York is the sixth state — along with Washington, D.C. — to lift the surgery requirement.