Right now, you’re able to select the appropriate gender marker on your passport without a note from a medical professional (and a passport can be used in the vast majority of situations you’d use a birth certificate) but because the self select gender marker was done by executive action, it’s extremely likely to be reversed when Trump takes office.
Also, having one might be a good idea in general.
I’m pretty sure Cuba is a bad choice for… other reasons
Cuba has the right idea with socialism. Cuba’s elections are a good sign they are moving in the right direction, but they still have a ways to go. For starters, they need more than one candidate per office and citizens need to be able to run without having to be nominated by the Communist Party controlled committees.