This paper explores an anomaly in gay, lesbian, bisexual and transgender (LGBT) rights policy, laws allowing transsexual individuals to amend their birth certificates. Unlike most other LGBT rights policies, these statutes are often found in conservative states. In fact, these laws are found in half of the Southern states and in Utah. The array of states with these laws does not conform to the pattern of traditional morality politics laws associated with LGBT rights. Using a Cox non-proportional hazards model, we find that the adoption of these laws was influenced by vertical diffusion of the Centers for Disease Control and Prevention's model vital records recommendations. States with more professionalized bureaucracies were more likely to implement these recommended best practices. However, as transgender rights have become more closely associated with the gay rights advocacy movement, this issue increasingly resembles morality policy.