Following on from the parliamentary hearings on 9 September 2003, the Sex Description and Sex Status Act, Act 49 of 2003 was altered, signed by the President of South Africa and circulated in the Government Gazette, on 15 March 2004.

The Act was amended in 2004 to address the concerns that arose after the Act was enacted in 2003.  The Act originally allowed individuals to apply to have the sex designation on their birth certificate changed if they had undergone gender reassignment surgery.  However, concerns were raised that this requirement was overly restrictive, as not all individuals who identify as a different gender undergo such surgery.

The 2004 amendment expanded the criteria for changing the sex designation on a birth certificate to include individuals who had undergone other medical treatments or procedures related to gender reassignment, as well as those who had received a diagnosis of gender dysphoria from a medical professional. The amendment was aimed at ensuring that the law reflected the experiences of trans individuals and provided them with greater access to legal recognition of their gender identity. 

Estian Smith, one of the individuals who made the oral presentation to Parliament in 2003, created a presentation to Gender DynamiX to explain a summary of the process of altering the Act including points about its history, parliamentarian lobbying, an explanation of the Act, oral presentations, parliament decisions, inadequacies, obstacles, impact, and a way forward.