Background: In recent years. Massachusetts (MA) and Rhode Island (RI) joined a growing list of states allowing residents to easily change the gender marker and name on government-identification (ID) documents. This was an important change for transgender and gender diverse (trans) residents. who face frequent mistreatment and thus for whom legal gender affirmation is critical. https://missouriquiltcoes.shop/product-category/10-squares-layer-cakes/