How did certificate issue to Transgender for government purpose?

The question is a bit vague but there seem to be three ways it could go:

1) Asking about a certificate from a therapist/surgeon to prove they have had the surgery. These are most often just papers from the hospital denotating that GRS was done and completed.

2) About a birth certificate (change) some states (and countries) will not let you ever change your birth certificate, others do an amended (old and new info) and less allow you to get a new one. It all depends on the laws where you live.

3) The letters of recommendation you need from 2 therapists for a reputable GRS surgeon to perform the surgery: this is generally letterhead and typed letters from the therapists okaying the surgery (i.e. this person has gone through a year of living as the opposite sex, they understand the dangers and side effects of GRS and more)

Only #2 would be an actual certificate, the others would just be official paperwork.