CS1 maint: ArgentinaBrazilBoliviaColombia and Ecuador allow individuals to change their name and gender without undergoing medical treatment, sterilization or judicial permission. For example, one was able to obtain the diagnosis certificate on their first visit to a psychiatrist,  while in other instances clinic staff and psychiatrists forced applicants to undergo a lengthy and humiliating procedure. It forecloses legal recognition to transgender people who are married, who have underage children or who have the capacity to reproduce. The adjective transgendered should not be used [
Archived from the original on 8 September
A letter is needed from a medical practitioner which certifies that the person has had or is receiving appropriate treatment. For example, an year-old trans man university student in Okinawa said:. Department of Social Protection.