Act came into force the week of September 24, 2015. Therefore, a change of sex indicator is now available in Nova Scotia for persons born there or those who have been ordinarily resident at least three months in the province. Nova Scotia also offers the option of no gender being displayed on one's driver's licence and/or identification card. Nunavut Nunavut removed the surgery requirement for a legal gender change from the Vital Statistics Act in March 2015. A territorial legal change of gender is not accessible to residents who were not born in Nunavut. Ontario On 11 April 2012, the Human Rights Tribunal of Ontario ruled that gender confirmation surgery is no longer required for a change in registered gender on Ontario documents. In its decision, the Tribunal ordered that the Ontario government "shall cease requiring transgender 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". However, some medical certification is still required. It is also not accessible to residents who were not born in Ontario. In July 2021, an Ontario resident who was born abroad tried to obtain photo identification from ServiceOntario, only to be rejected as she could not obtain an amended birth certificate from her country of birth, nor an Ontario birth certificate. The alternative mentioned in the article was medical certification with prohibitive requirements. (However, the federal government does offer another alternative without medical gatekeeping requirements, as described in the Federal section of this article). Prince Edward Island In April 2016, the Prince Edward Island government amended the Vital Statistics Act to allow individuals to change their legal gender on ID without surgery. Individuals must present a letter from a doctor attesting to the applicant's gender identity. Islanders can also now choose to display no gender on their PEI-issued driver's licence/voluntary identification card. A provincial change of legal gender remains inaccessible for PEI residents born off-Island. Québec Since October 2015, adults have been able to change their legal gender on birth certificates in Québec. The process was simplified for minors in June 2016. To qualify to change legal gender, the person concerned by the application must be domiciled in Québec for at least one year. If the person concerned by the application was born in Québec but lives elsewhere, the