If you want to legally change your gender in the UK, first a doctor has to diagnose you with a medical condition.
Gender dysphoria is when a person's biological sex and identity does not match.
Only then can they be considered for a new birth certificate - which gives their true gender.
But all that might be about to change, because since July 2018, people have been able to have their say on whether these rules should be updated.
Rory Darling is one of those campaigning for change.
"I want the government to recognise me for my gender identity," says the 19-year-old trans man.
"No-one should have to face such a dehumanising process just to be seen for who they truly are in the eyes of the law."
A 'gruelling and intrusive' process
Rory is in the early stages of applying for what's called a Gender Recognition Certificate (GRC) which recognises his transgender identity.
He needs to meet certain criteria, including that he's lived in his chosen gender for two years and has had a gender dysphoria diagnosis.
The application is then considered by a panel who judge whether a transgender person should be given a new birth certificate.
Rory believes it shouldn't be down to a "panel who don't know you, to decide if a person is trans enough to warrant legal recognition".
"It's severely outdated and the process itself is very gruelling and intrusive."
'Trans people should be treated with respect'
A statement from the government equalities office about the consultation says that "trans and non-binary people are members of our society and should be treated with respect".
"This consultation simply asks how best government might make the existing process under the Gender Recognition Act a better service for those trans and non-binary people who wish to use it."
Rory believes that gender, like sexuality, is something people should be able to determine for themselves.
"A group of people gaining equality doesn't take equality away from anyone else," he says. "We just want equal human rights."
There is opposition to reforming the act, with campaigners recently paying for a full-page advert in The Metro newspaper in an attempt to persuade people not to support proposed changes.
The advert claimed changes would pose "serious consequences to women and girls".
Why is this such a fiercely debated topic?
Transgender people say they just want equal rights, but some groups believe giving easier access to a gender recognition certificate will lessen women's rights.
Toilets, prisons and refuges are some of the safe-spaces they feel could be threatened by giving transgender people the opportunity to self-determine their gender.
You can read more about what some of the groups have said here.
Earlier this month, a transgender prisoner in a women's jail was ordered to serve nine-and-a-half years for sexually assaulting two inmates. Some campaigners believe situations like these will rise if there is easier access to a gender recognition certificate.
The Equality and Human Rights Commission says "the issues at stake are complex and personal" and it's important people "engage in a constructive and respectful way".
The consultation closes this week
The Gender Recognition Act was introduced in 2004 and - says author Juno Dawson - was a "world-leading" piece of legislation at the time.
"It just needs modernising. It's 14 years out of date now," says Juno, who recently released her book Clean.
Her driving licence, NHS records and passport all name her as Juno but what she calls the "dehumanising" process to get a new birth certificate means she hasn't applied to the Gender Recognition Council.
"It would mean the world to me," she says.
"It would be nice to just have it for me. Nobody else is interested in seeing my birth certificate, when was the last time anyone even got out their birth certificate?"
The British public can have their say on potential reforms to the GRA until Friday 19 October 2018.
Update 30 October 2018: This article has been updated to include some of the specific concerns of Fair Play for Women and other campaign groups, including their belief that giving easier access to a gender recognition certificate will lessen women's rights.