person may also qualify to change the sex designation if the person shows that such an amendment is not possible in the province or country in which the person is domiciled. They may make application to the Directeur de l'etat civil for a Certificate of Change of Mention of Sex (certificat de changement de la mention du sexe), regardless of their place of birth; however, this is solely limited to a male or female sex designation, forbidding the use of a non-binary gender designator. They may also apply for a combination Certificate of Change of Mention of Sex and Name (certificat de changement de la mention du sexe et de nom). After such a certificate is issued, one's gender may be amended on a Québec birth certificate. If one was born outside Québec, the birth certificate will be designated a semi-authentic act pursuant to Article 137 of the Civil Code. Previously, Québec required applicants to be Canadian citizens. A 2021 court ruling, Centre for Gender Advocacy et al. v. Attorney General of Québec, has struck down six legal provisions considered discriminatory towards trans and non-binary Québecois, including one forbidding the use of non-binary gender designations, and another one prohibiting non-citizens to obtain a change of name and sex designation. The Québec government has until the end of 2021 to amend these aforementioned legal provisions, except for the discriminatory citizenship requirement, which the Court declared invalid with immediate effect. The citizenship requirement has been removed in practice by the Directeur on application forms. In October 2021, Québec Minister of Justice Simon Jolin-Barrette introduced Bill 2, which among other things would partially reverse Québec's policy on birth certificate changes, creating a second category called "gender identity" on the certificate and allowing trans people to only change that while keeping the "sex" category fixed unless said trans people underwent a sex change. Bill 2 was quickly denounced by various civil society groups, and in November 2021, the Office of the Minister of Justice stated in an e-mail to MTLBlog that "[they were confirming] that the requirement for an operation to change the sex designation [would] be removed from the bill." Saskatchewan In February 2016, the provincial government changed the Saskatchewan Vital Statistics Act to eliminate gender confirmation surgery as a prerequisite for changing government documents. In May 2018, a judge ruled that the gender marker can be removed from a birth certificate. Saskatchewan