Currently under Missouri state law a transgender person may only change their gender marker with a court order from a county judge or higher. The law also states that a transgender person must undergo gender confirming surgeries or apply for a waiver with a letter from a doctor stating it would put you at risk to have the surgeries.
 Currently surgeries for transitional purposes for a transgender person can cost more than $50,000 and a lot of private insurance companies that cover the transgender surgeries will require your gender marker changed first. 
  On top of cost the added mental health risk is high because a lot organizations such as hospitals, emergency services, or even your bank all see your gender on file and calls you a pronoun based off what they see no matter how many times you correct them. This puts transgender people at risk of mental health issues such as depression, anxiety, even a higher risk of suicide rates.  
 By changing this law to allow people who have been undergoing h.r.t. Treatment, has been living in their preferred gender openly for two years or longer and regularly sees medical professionals for transitional related treatments with a letter from a doctor as a statement of the ongoing treatment they have been receiving should be able to change their gender marker on their birth certificate, drivers license and other documents with a court order without a waiver or surgeries. 
  This will give many transgender people the ability to achieve their goal by opening up the ability to gain proper insurance that will help cover the cost of surgeries as well as relieve the stress and mental health strain, lower the rates of suicide in the transgender community as well as lower their risk from harm or danger from someone over hearing a bank or a nurse say sir or ma’am based off what they are reading on a piece of paper.