In the state of New York New York 
I understand both sides of this story. On one hand a person is born a certain sex and that should be reflected on a birth certificate. If a person changes their mind on their sex more than once I can see where there would be an issue but I don’t think that happens very often. When a person feels and decides to live their life as a transgender, I do not understand why the state is making it so difficult for a person to change their birth certificate. I am assuming from what I know, transgender people live a lot of their life being discriminated so when the state is discriminating as well, what does that show the rest of the citizens? Discrimination should not be tolerated and I am hoping the Health Department realizes this and finds an easier way for transgender people to live the life they deserve. 
Empowering everyone and erasing discrimination is something we can only achieve if we do something about it.
Check out the story Transgender Vs. New York
 
In my opinion, transgender individuals undergo unneccessary amounts of discrimination on a daily basis. For some it is easy to pass as the gender they have chosen, but for the majority it is a constant struggle. I took a trans and gender queer class last interim, and it was an extremely eye opening experience for me. After having the opportunity to talk with several transgender individuals, it was much easier to understand their frustration. I think that the state should allow these indivduals to change their birth certificate if they want to. It is true that many people cannot afford the expensive sex change surgeries, so that should not be a requirement to get doctors notes, etc. I do also agree with you that gender should only be allowed to change once, because that would guarantee that people are going to stick with their decision and not be flipping back and forth.
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