The final effort was to amend her birth certificate and she had a letter from her endocrinologist saying she had medically transitioned.
But the Bureau of Vital Records didn't recognize her common-law name change and required a judicial name change, but Prinzivalli needed to provide a copy of her New York birth certificate. "It was circular reasoning," she said.
The 50 states have a collection of different laws on how transgender Americans can change their birth certificates.
Three states -- Idaho, Ohio and Tennessee -- ban any change to the birth certificate at all. Some require a court order, some, like New York, require proof of a surgical procedure.
In Washington state, which advocates say is a model, birth certificate changes require a doctor, under penalty of perjury, to validate the gender transition.
"Why would anyone who has not transitioned even think of doing this?" asked NCTE's Keisling. "You have a right to do this. It doesn't make sense. What possible fraud is there?"