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STATE OFSOUTH DAKOTA —) IN CIRCUIT COURT SS COUNTY OF MINNIHAHA ) SECOND JUDICIAL CIRCUIT In the Matter of the Petition Regarding ee: A Minor Child 9-Aa IQ VERIFIED PETITION FOR NAME CIV: AND GENDER MARKER For a Change of Name and Gender Marker to CHANGEOF A MINOR CHILD Make (UNCONTESTED) COMES NOW, Petters, Jessta EEE titoeiat she CE os Aires EE edoptive mother of RB r«! hereby petition this Court for and Order changing the name of their or i, ES o a ond gender masker ffom female to male, and directing Vital Records to create a new certification of Ive bith for Petitioners’ minor chil to reflect a gender marker change and the name change, and in support of this petition, states as follows: 1, Petitioners are the biological and adopted parcnts of = 2 rninor chill. 2, Petitioner Jessica SIN has been a bom fide restfent citizen of Minnehaha County for in excess of six (6) months preceding the fiing of this Petition and resides at ER Sion Fes, SD 57150. 3. Petitioner Aunires EEE bes be a bona fide resident citicn of Minnehaha County in excess of six (6) mouths preceding the fling of tre Petiion und resides ot IIE Sioux Fall, SD 57104. 4, Petitioners’ minor chid, ME was bor on the 23" day of October, 2005 and has been a bona fide resident of Mimehala County for more than six (6) months. 5, I cinor child, is the natural child of Petitioner Jessica MENBINN and the adopted chiki of Petitioner Aundrea EE Othe: tn EE 20 onc has bad kya! custody of the child except Gregory [NE whose parcotal rights were terminated at the time of chid’s adoption by Mrs. 6. ‘The Pettioners are curently divorced and Petitioner Jessica II has primary physical custody of the minor chi, wie has resided ‘wih the Pettioner for over six (6) months. Petitioners have joint legal customer of the rrinor chill. 7. Petitioners request that the Court change the minor’s name tom [i SS 8. Petitioners move this Court for an Order changng (i > sone to EE pvrsiant t SDCL § 21-37-5, in good Sith Petitioners do not inlend to defraud anyone, and it & not done for the purpose of hiding the chid’s identity from any person, creditor, or governmental agency of any kind or as to avoid discovery by such person, ereditor, or governmental agency. 9. Petitioners farther move this Court for an Order directing Vital Records to create a ncw certiicate of ve bith, which is fled with the South Dakota Department of Vital Heath, Vital Records Offce, Pierre, South Dakota, to change i oe 10, Petitioners fither move the Court for an Order directing Vil Records to create a new certifcate of live bith for IIE. bith record, to change Is o-05ce rorker orn ferme to oe 11. Petitioners believe the name change and gender change will be in the best interest of their child, 12. Petitioner's. minor child, 's a transgender male who bas participated in mental beakh comseling fom Ame Diknschneide, PhD., DMin, QMHP, LPC-MH in order to obtain arecommendation to seen in the clic of Dr, Keith Hansen, and beyin gender contiming hormones 23. The minor child, III eter receiving the required mental heath assessment, was able to and is no receiving clical treatment for gender transition to the new gender of male. (Attached hereto and incorporated herein by reference as EXHIBIT 1 3s a ktter provided by Keith Hansen, MD, confirming the clinical treatment for the minor chid’s gender transition to the male gender.) 414, Petitoncrs belicve it i in the best interest of the chill to have the mame and gender change as the minor chid is referred to and known by fiends, family, health care providers, and others in the community. 415. Pettioners believe that the minor chik!’s andety and depression are made worse when ‘encountering new teachers, substitute teachers, and new medical providers who are unaware that minor child is transgender and use the mune [IEE or &male pronouns. 16. That the Petitioners request the name and gender marker change so that the minor chikl’s medal and school records, as well as fiture job applications and drivers’ license appropriately reflect a transgender male. 17. Petitioner’s further request, pursuant to SDCL § 21-37-5, that Court grant the Order changing the name of the parties’ minor child and the Order diecting Vital Records to creats anew bith certificate, without publication ofthe Notice ib Hearting, as Petiioner’s believe it is inthe best interest of the chill us the publication could bring unwanted attention to the minor child and: a, ‘The pleadings ivdicate the minor has been a resident of Minnehaha County, the county the Petition was filed, fbr at lesst six months; b. ‘The Petitioners are the minor chili’s parents and their parental rights have not been terminated and the Petitioners have given writen corsent for the name snd gender marker change; ¢. The minor child i 13, and therefore, twelve years of age or okler and has given, vwitten consent for the name and gender mark change; NOW THEREFORE, you Petitioners pray that the Court set this matter for hearing, ‘and that upon such hearing pray that an Order of this Court legally changing the rar: I SE : I 25 2 Order directing Via! Records to create a new certificate of birth to reflect the name change to [i PR 2"«: '0 resect the gender marker of male. Dated this Lathday of August _, 2019. VERIFICATION Dated this (I day of Dunusd 2019, STATE OF SOUTH DAKOTA ) 388 COUNTY OF MINNEHAHA ) 1, Jessica IIE being first duly sworn by oath, deposes and says that she is onc cf the Petitioners in the above-entitled matter, that she has tead the foregoing Verified Petition for Name and Gender Marker Change of Minor Child and knows the contents thereof, that the same is true to the best of Petitioner's knowledge and belief. Subscribed and sworn to before me this 12 dey of Bug gg, 2019 Notary Public Seal South Dakota Rian & Notary Public ~ South Dakota My commission expires: 12 fase (SBAL) lisneBaba Co x ‘Clerk Cireult Court VERIFICATION Dated this [y_ day of By gust +2019. STATE OF SOUTH DAKOTA, ) SS COUNTY OF MINNEHAHA ) |, Aundrea MEI cing frst duly swom by oath, deposes and says that she is one of the Petiioners in the above-ertiied matter, that she has read the foregoing Verified Petition for Name and Gender Marker Change of Minor Chidd and knows the contents thereof, that the same is true to the best of Petitioner's knowledge are belicf, A Subscribed and swom to before me this 12 day o figuct 2019. REINA PRARER Notary Publle Seal ‘South Dakota My commission expires: 5) \anx (SEAL) Notary Pibbe — South Dakota Minnobaba County, 8.0, Clerk Circult Cou SANFS3RD ME aL Le 04/04/2019 PE DOB: 10/23/2005 RECORD #: £573137 i Keith A. Hansen, M.D., South Dakota medical license 4446, am the physician of whe is changing his name a with whom | have a doctor-patient relationship and rom Tave treale has had appropriate dlnical treatment for gender transition to the new gender of male, | declare under penalty of perjury under the laws of the United States that the foregoing is true and correct with my signature. Sincerely, ‘ci HANSEN, M.D. 1500 W 22ND ST STE 102 SIOUX FALLS, SD 57105 Phone (605)326-8800 Fax (608)328-7775 This Fs al filad ft the Dopartment hasan chapter 24-25 of the GUTH OAROTA CODIHEDLA STATE OF SOUTH DAKOTA —) IN CIRCUIT COURT COUNTY OF MINNIHAHA ) SECOND JUDICIAL CIRCUIT In the Matter of the Petition Regarding civ: \9 209, ) ) en: ) A Minor }) CHILD'S CONSENT FOR NAME ) AND GENDER MARKER Nome and Gendet Markerto. -»«)),«»- CHANGEOF A MINOR CHILD Mae ) (UNCONTESTED) ) 1 Myce 2. 3. 4 My age is thiteen (13), Live ot I siowx Pals, South Dakota 57110, ‘The name and gender marker change is for me. ut 9 ne er Iwant my gender marker changed to male. ij | STATE OF SOUTH DAKOTA —) IN CIRCUIT COURT SS COUNTY OF MINNTHAHA ) SECOND JUDICIAL CIRCUIT In the Matter of the Petition Regarding ) ) civ: | ll — &: ) A Minor Chili ) ORDER FOR NAME A868 ) GEERER NEAR CHANGE Fora eof Name and Gender Marker to ) OF A MINOR CHILD aD |) “cxconresteD) ) “This matter came on for hearing on this 1f day of, FigusE ; 2019, upon ‘Verified Petition for the Name and Gender Marker Change of a Minor filed by Jessica IID Hod Aundrea I oo betulf of the minor chit tea HR *- Petitioners appeard pro se and no one appeared in opposition to said Veriieid Petition; now, upon the testimony, evidence, and entity record, tis hereby FOUND AND DETERMINED that the Court has full and complete jurisdiction of the ‘subject matter hereof pursuant to SDCL chapter 21-37, SDCL 34-23-51, and ARSD 44209:05102; and its frtber FOUND AND DETERMINED at the time of filing the Verified Petition herein, the Petitioners and the minor chid were residents of Mimehaha County, South Dakota and have been bons fide residems of Mimcbaha County, South Dakota tor more than six months prior to the fing of the Pettion; and iis finther FOUND AND DETERMINED Notte of the Hearing for Name andejonderctstacitor ‘Change of a Minor Child was not required to b¢ published pursuant to SDCL 21-37-4; and it is firther FOUND AND DETERMINED that: 1. The minor chidl’s fill mme on the minor chié's bith certificate is IM 2. The minor child's gender marker on the minor chi’s birth certificate is femake. 3. The minor child was bom in the State of South Dakota, Coumy of Minnehaka, and city of Sioux Falls, 4, The minor child’s bith mother's fall maiden name on the minor chik!’s birth certitcate is Jessica [I e06 5. ‘The minor chitl's adoptive mother’s fill name on the minor ehill’s bith corticate & Aucdcen and it frther FOUND AND DETERMINED that the name of the minor chil, as it appesrs on the chid's bith certicat:, III shal be changed is (en ir teeta tire venttete chet benhangsstaianen forsateteoic. ‘This Order shall be entered by the clerk; ane i is firther ORDERED, ADJUDGED, AND DECREED that the Petiioner provide the Department of Vital Records in the state where the chi was bor with a.certified copy of this “Order for ‘Name amdegemboesbdaxice Change of a Minor Chili” and pay the Department of Health Office of Vital Records the applicable fing fee for amending the chid’s birth certificate; that the Department of Health Office of Vital Records in the state where the child was bom locate the rminor child’s birth cerifoate using the Wentifying information above and verify that information within the state’s vital records registration system; that the Department of Health Office of Vital Records in the state where the child was born, within a reasonable time affer receiving both the certifed copy of this “Order for Name aggtssiowieraivecieet Change of a Minor Chil” and the applicable fee from the Petitioner, ervaterneynesi#icate—oblivexbetieationtenetcmmiccd smoezeled tomgoge the hich certificate ‘by changine the chit's mame of GER ccreesnty onto chitt’s bith canttcate, prhensive off Cpeetoceeec ote Dated this 1S" bay of August 42019, BY THE COURT: ‘rout Court Judge ATTEST: ANGELIA M. GRIES Che of Court By: Pp Hl Clerk Circuit aa STATE OF SOUTH DAKOTA) IN CIRCUIT COURT | 388 COUNTY OF MINNIHAHA ) SECOND JUDICIAL CIRCUIT Jn the Matter of the Petition Regarding civ; 12 TOA Female ) ) ) ‘A Minor Child. ) NOTICE OF HEARING FOR ) ) ) ) GENDER MARKER Le CHANGEOF A MINOR CHILD (UNCONTESTED) NOTICE IS HEREBY GIVEN that a Verified Petition for Gender Marker Change has been filed by JessicdIIE nd Aundres SII tue object and prayer of which isto change their minor child’s gender marker from female to male on the minor child's bieth records, Onthe 23 day of Sepamrtoee, 2019, atthe hour of 2 + SD gaasaid Verified Petition will be heard by this Court before the Honorable Lornen Genter Presiding, at the Court Room in the Minnehaha County Courthouse, City of Sioux Falls, Minnehaha County, South Dakota, or as soon thereafier as is convenient for the court. Any interested party may come and appear at that time and place and show reasons, if'eny, why said gender matker should not be changed as requested, Dated this [Q day of Aull, PA _, 2019 at Siowx Falis, South Dakota GELIA W.. GRE X A.