Same-sex couples in Ohio can hold their weddings in the Statehouse, file their state taxes jointly and list their spouses on death certificates.
Those are among the changes following the U.S. Supreme Court's decision last month that legalized gay marriage across the country.
The lead plaintiff in the case that led to the ruling was Jim Obergefell of Cincinnati. He sued Ohio's health director for refusing to list him as the surviving spouse on his husband's death certificate.
Now that gay marriages are allowed, the state is working to comply with the ruling.
State officials have sent funeral directors and hospitals new addendums to birth and death certificates with gender-neutral terms such as "parent" and "spouse." The state's Supreme Court has also ordered such neutral references in family court cases.