China's transgender people being deprived of vital medical care, Amnesty International says


Transgender people in China are going to extreme lengths to access medical care and gender-affirmation surgery in the face of widespread discrimination and social stigma, according to a new report by Amnesty International.

Many of the people interviewed by the human rights charity said they had resorted to buying hormone medication online and through other potentially unsafe channels as it was almost impossible to get them on prescription from a mainstream hospital.

Two transgender women said they became so desperate they attempted to perform surgery on themselves without the knowledge of their families.

"China has very stringent criteria for undergoing gender-affirming surgery, as trans people are required to obtain third-party authorisation to access (the) treatment," said Doriane Lau, Amnesty International's China researcher and author of the report, which was released on Friday. "It creates significant barriers for transgender people."

Under Chinese law anyone seeking gender-affirming surgery must be over 20 years old, single, have undergone at least a year of psychiatric or psychological therapy, and have obtained an official medical diagnosis of "transsexualism" as well as their family's consent.

Many of the people quoted in the report said they faced negative reactions including violence from their families when they attempted to come out, while others said they chose to remain in the closet.

"The majority of the interviewees said that having familial consent as a prerequisite for gender-affirming surgery makes it impossible for them to access the health services they need," Lau said.

Various global studies have shown that transgender individuals may experience severe emotional distress when their gender characteristics do not align with their sense of self.

Lau said that China provided no official guidance on other types of gender-affirming treatments, such as hormone treatment and counselling, which resulted in many trans people turning to online forums and messaging groups for advice instead of qualified medical professionals.

Estimates for the number of transgender people in China range from 100,000 to more than 4 million, but there is no official government data on those who identify as transgender or have undergone gender-affirming surgery.

"Public awareness on the diversity of gender identities is still very low," Lau said. "Trans people still face severe discrimination at work, in school and even at home."

Previous research suggests trans people are significantly more likely to experience mental health problems, family violence and bullying at school.

A 2017 study of more than 2,000 transgender Chinese by the Beijing LGBT Center and Peking University found that 73 per cent suffered from anxiety, more than 60 per cent had experienced depression, and 43 per cent had considered suicide.

The Amnesty report said that the only medical team in China that officially provides care for transgender people is based at Peking University Third Hospital, putting such treatment beyond the reach of those who cannot afford to travel.

In the 2017 survey, 71 per cent of respondents said they found accessing hormone therapy "difficult", "extremely difficult" or "nearly impossible".

"There are too few doctors specialised in transgender-specific medical treatment," a transgender woman named Yasi was quoted as saying in the report.

"At best, most of the doctors understand the concept of being transgender, but they do not have the knowledge to offer you help."

If you, or someone you know, are having suicidal thoughts, help is available. For Hong Kong, dial +852 2896 0000 for The Samaritans or +852 2382 0000 for Suicide Prevention Services. In the US, call The National Suicide Prevention Lifeline on +1 800 273 8255. For a list of other nations' helplines, see this page.

Copyright (c) 2019. South China Morning Post Publishers Ltd. All rights reserved.

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