Changes to the Vital Statistics Act took effect May 30. Those changes do two main things.
You no longer need to have any particular medical treatment to change the gender on your birth certificate.
You need only a letter from a doctor or a psychologist which says that the sex designation on your birth registration does not correspond with your gender identity, and a statement from you saying that you have assumed (whichever gender), identify with that gender identity and intend to maintain it.If you are a minor (under 19) you also need a consent from your guardians, or, if they won't give it, there is a process for the Registrar to decide it is in your best interest to have a change. (If you are in that situation, let me know through the contact form on this website). NOTE: you have to have been born in B.C.!
You are still stuck with only M or F as the choices.
At the same time, there have been changes to the procedure for getting gender markers on your BC i.d. (drivers licence, BC I.D. card, or health card). Details of the new procedure can be found here.