Hey all, I got a question recently about trans rights in China. I wanna make sure I answer the question correctly so I came here. I would just look it up myself but it’s impossible given how filled to the brim the internet is with Sinophobic lies.

  • Tabitha ☢️[she/her]@hexbear.net
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    I guess I’m going to summarize what I’ve read in this thread than add an opinion on the general rhetoric.

    China does have some shit laws on the subject, but (perhaps mostly both the government and the average person) lacks a fascist-driven ideological framework that is very common in the US. You will assume everything is worse than Southern US States or Nazi Germany for no other reason than that reactionaries love making it sound that way, because there is almost no one on the English speaking internet loud enough to debunk them over their digital megaphones. Well meaning parrots will parrot the only thing they hear on the subject. Other comments on this thread go over how it is not as bad as the Southern US States.

    I think that future historians will note that some technology or element of an (post?-)industrial society, made faster by a socialized internet, leads most not-yet-LGBT-friendly societies into adoption of LGBT rights. The current rhetoric around the subject forgets that the US has had decades of modernization progress ahead of China on various subjects. China is caught up on manufacturing in general, China will most likely catch up on several specific technologies (CPUs) soon enough. There is no reason to believe that China will not catch up on LGBT rights in the same manor, in very short order.

    The 2022 Cuban Family Code referendum sets a favorable precedent that LGBT rights under AES is likely next on the natural cultural progressions of civilizations.

    China does pay attention to US politics and will notice things, such as anti-LGBT rhetoric being primarily rooted as a religious/fascist construct in modern US politics. I think they are much more likely to perceive it this way going forward than what others may have historically presumed, which was something like “LGBT rights is Capitalist decadence/influence”.

    • Tabitha ☢️[she/her]@hexbear.net
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      I’m predicting, that by 2030, most people megaphoning “China bad on LGBT” are going to be very embarrassed, both because of progress abroad and regression at home.

  • qwename@lemmygrad.ml
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    The Sex Reassignment Surgery (SRS) and Transgender Hormone Therapy (THT) articles on Baike wiki includes the current situation in China. From what I’ve read in these two articles, THT is less “standardized” than SRS, and the former cannot be used as a basis to change your legal sex.

    What I mean by “standardized” is that the National Health Commission has published standards for SRS in 2017 and updated them in 2022, the same cannot be said for THT. Here are the criteria in 2017 and 2022 for someone who wants to undergo SRS: (translated with DeepL)

    2017:

    性别重置技术管理规范(2017年版) – 三、技术管理基本要求 – (四)手术前手术对象应当满足以下条件:

    1. 对性别重置的要求至少持续5年以上,且无反复过程。
    2. 术前接受心理、精神治疗1年以上且无效。
    3. 未在婚姻状态。
    4. 年龄大于20岁,具备完全民事行为能力。
    5. 无手术禁忌证。

    Translation: Code of Technical Management for Gender Reset (2017 Edition) - III. Basic Requirements for Technical Management - (d) Pre-surgical surgical candidates should fulfill the following conditions:

    1. The [request/need] for gender reset has lasted for at least 5 years without a recurrent process.
    2. Received psychological and psychiatric treatment for at least 1 year prior to the surgery and is ineffective.
    3. Not in the state of marriage.
    4. Be older than 20 years old and have full capacity for civil behavior.
    5. No contraindications to surgery.

    2022:

    国家限制类技术临床应用管理规范(2022 年版) – G05 性别重置技术临床应用管理规范(2022 年版) – 三、技术管理基本要求 – (四)手术前手术对象应当满足以下条件:

    1. 对性别重置的要求至少持续 5 年以上,且无反复过程。
    2. 未在婚姻状态。
    3. 年龄满 18 岁,具备完全民事行为能力,有能力完成性别重置序列治疗。
    4. 无手术禁忌证。

    Translation: National Code of Practice for Clinical Application of Restricted Technologies (2022 Edition) - G05 Code of Practice for Clinical Application of Gender Reset Technologies (2022 Edition) - III. Basic Requirements for Technical Management - (d) Pre-surgical surgical objects should fulfill the following conditions:

    1. The request for gender reassignment has lasted for at least five years without a recurring process.
    2. Not in the state of marriage.
    3. Have reached the age of 18, have full capacity for civil behavior, and have the ability to complete the gender reassignment sequence treatment.
    4. No contraindications to surgery.

    Note that the updated criteria in 2022 removed the need for previous psychological and psychiatric treatment, and lowered the age requirement from 20 to 18.

    There were two nationwide studies on the transgender community, conducted in 2017 and 2021, and problems with medical support in China was mentioned in the published findings.

    Back to the question about access to estrogen, since there does not seem to be any national standard for THT, and 雌二醇 (Estradiol) is prescription medication, I would guess that it is indeed hard to get estrogen.

    The user also mentioned that this is the only thing stopping them from moving to China, I think they’re underestimating the challenges in emigrating to any foreign country in general, especially a country with a strong national identity like China.

    • ashinadash [she/her, comrade/them]@hexbear.net
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      Wow that update is a solid improvement in just five years, dang. The removal of the psychiatric requirement is huge to me. Why has the “Not in the state of marriage” bit stuck, though?? Is that just because of complications since same gender marriages aren’t acknowledged legally?

      • qwename@lemmygrad.ml
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        Yeah, I think there would be a very huge loophole in marriage laws if someone is able to change their legal sex while being married.

    • ComradeSalad@lemmygrad.ml
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      Not in the state of marriage.

      This is disappointing, especially since same-sex couples are not allowed to marry. They are essentially purposefully and cruelly soft locking a person out of marriage entirely.

      The requirement for sexual reassignment surgery to legally change genders is also disappointing, since that can possibly do more harm then good, as a significant portion of transgender individuals either do not want to complete a full course of reassignment surgery, such as only doing a mastectomy but not bottom surgery as a trans man; or do not want to undergo any surgery at all. So forcing the person to undergo surgery and become dysphoric with their body, or give up hope of legally changing their gender is disappointing.

      Hopefully the sex change surgery requirement is dropped soon, Japan dropped a similar law in the Fall of 2023. Same goes for the marriage requirement.

      Received psychological and psychiatric treatment for at least 1 year prior to the surgery and is ineffective.

      That is also a very gross requirement. Psychiatric analysis is vital, but trying to be “treated” by a psychologist for a year to even be considered transgender is backwards.

      • qwename@lemmygrad.ml
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        You mean as articles to describe part of the situation in China for the transgender community? The Baike articles are slightly outdated as the SRS page does not include the 2022 update I mentioned, but they were useful as leads to search on.

  • axont [she/her, comrade/them]@hexbear.net
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    This is just anecdotal, but I visited southern China in 2019. I don’t have broad knowledge of Chinese society, but I went to a bunch of DIY style punk shows around Shenzhen and there were tons of cool queer folk there. I ended up talking with a trans man for a while with my broken Mandarin and his broken English. Told him I’m an American who greatly admires China and he thought that was cool.

    Yeah, there are a bunch of very open trans and gay folk in China, but maybe that depends on where you go and what strata the people belong to, I guess? It’s not at all like what westerners claim, where they say it’s completely illegal to be trans and all trans media is censored. I didn’t see that at all. I met a bunch of trans people who seemed to have very ordinary, normal lives.

    There’s probably room for improvement, but that’s everywhere in the world. I don’t live in China though so I don’t fully know what struggles there are

    • loathesome dongeater@lemmygrad.ml
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      I’m gonna copy-paste it so that it lives forever (yes i am a juche necromancer)


      It’s similar to the USA but they don’t have a hate mob going after trans people cause they hunt fascists down for sport. There are many very positive interactions with trans people on national TV and they don’t stir shit about “the controversy” like in the West. Discriminatory remarks against any group, including gay and trans people (upheld explicitly for LGBT people by some law according to the Peoples Daily) isn’t allowed on national media and is strictly enforced. The media culture generally is very positive versus controversy seeking in comparison to the West.

      Also, no overt genocidal shit like Russia or Florida or something. Just general ignorance and knowing little about trans people. From what I’ve read from advocacy groups they think awareness has gone up a lot recently and they believe there will be a big shift in LGBT laws in China by 2030ish when the old cohort retires from the CPC

      And Cuba has the best LGBT laws on the books and they did it in short work after their old cohort died off, wouldn’t be surprised to see China do similar

      Really want to emphasize the hunting fascists down for sport part. There are online communists like us that, as a hobby, track down and report online fascists to the police, and there are tangible records of arrest from them doing that. I actually got in touch with one of these people and asked them about the LGBT situation among the youth and they seemed very positive about the progress.

      I’ve also talked with some rural trans chinese people and there is a very unfortunate and depressingly limited access to HRT outside of tier-1 cities. From what I understand, no one really becomes homeless like they do in the USA, housing is very cheap. Its also relatively easy to move to tier-1 cities, and there is a support network of trans people that help people do this and have lists of supportive doctors like they do in the USA. Self medicating is unfortunately very common outside of tier-1 cities, the black market, interestingly, is online and you must buy a potted plant that has HRT in a plastic baggie in the dirt (wild, there are lots of gardening jokes in trans spaces as a result). Phytoestrogen cocktails are also a common way of self medicating and there are guides online to make highly estrogenized teas. There are also menstruation products sold in pharmacies with high amounts of progesterone and estradiol and require no prescription, so they take these as well. Spironolactone and cypro are usually prescribed by dermatologists in China, so if you are sneaky you can get a dermatologist to prescribe them for acne and take over the counter birth control, though this option is still relegated to cities that do not have doctor shortages.

      Legal transition is a bit depressing, it has roughly the same laws as most southern states (re: you need surgery for gender marker change) and it also requires your family (!) to sign off on it and nullifies any marriage you currently have (like pre-gay marriage America). I do know there is a trick to get married to some trans person and then designate them as your family for the signature (and then the marriage will be nullified, so many friends do this), and you can ask your doctor to verify you had ‘the surgery’ (nebulous definition, like in America) and get your marker changed via that without surgery. This requires knowing a trans accepting doctor, which there are lists for.

  • ComradePlatypus [fae/faer]@hexbear.net
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    My understanding (but happy for more information if anyone has it) on the oestrogen thing, is China in the last few years increased restrictions on pharmaceutical medications across the board. Previously you could buy most non addictive (opiates, benzos et) online without any prescription. Antibiotics. Blood pressure medication, whatever. This is included oestrogen. They would also ship these overseas.

    Now it’s harder because you need a prescriptions and there’s other rules. So it wasn’t so much some officials saying “How do we make trans people’s lives harder” but more them bringing what had been a rather laissez-faire situation into regulations more in line with most other countries in the world (Europe, Asia etc). But it did materially affect trans people in China and globally.

    • ashinadash [she/her, comrade/them]@hexbear.net
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      Being able to buy anything nonaddictive online sounds rad though :/

      Idiot question: Would chinese citizens have any access to gray market chemist stuff online like we do here, or would international trade shenanigans/internet restrictions make that impossible?

  • 中国共产党万岁@lemmygrad.ml
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    Here’s a post of someone’s experience in China as of April 2024 “Record of transgender (MTF/MTX) experience in Sun Yat-sen University campus medical facilities”. The relevant translated passage:

    You must present a prescription (I used an electronic prescription for gender identity disorder from an internet hospital) to buy national supplements, (I’ve never asked about Sustanon), but it’s a bit expensive, 36 yuan a box, and student medical insurance can’t be used (because there’s no money in it). It’s recommended to buy only when your supplements are exhausted and the new ones haven’t arrived yet.

    Full translation under spoiler tag

    spoiler

    Record of transgender (MTF/MTX) experience in Sun Yat-sen University campus medical facilities

    I am located in the Zhuhai campus, and transgender individuals from other campuses can use this as a reference.

    1. Kangmeilai Pharmacy

    Address: Located on the second floor of De Yi Supermarket.

    Business Hours: 9:00-22:00

    You must present a prescription (I used an electronic prescription for gender identity disorder from an internet hospital) to buy national supplements, (I’ve never asked about Sustanon), but it’s a bit expensive, 36 yuan a box, and student medical insurance can’t be used (because there’s no money in it). It’s recommended to buy only when your supplements are exhausted and the new ones haven’t arrived yet.

    1. Zhuhai Campus Mental Health Counseling Center

    Address: Room 201, Liyuan 1

    QQ: 2315600589

    Reservation Phone Number: 0756-3668976

    Counseling Method: Online consultation or face-to-face, will be informed at the time of booking. (For online consultation, please maintain a good call environment, if there is no suitable place for online consultation, you can go to the campus to borrow the counseling room for consultation)

    Personal Experience: The counselor is very friendly, suitable for chatting, very friendly to transgender individuals, gentle and persuasive, guiding the inquirer to express their psychological state and will discuss the corresponding solution in detail according to the event that the individual is anxious about, with a good degree of confidentiality. The counselor has a certain professional level, good at looking at problems from multiple angles, and will guide the inquirer from the aspects of the inquirer’s life hobbies, etc. In short, the experience is good.

    By the way, I learned from the counselor that, speaking only for the counselor herself (there are at least 3 counselors in this campus’ counseling center, referring to one of the counselors), she has come into contact with 3 transgender individuals other than myself in this campus, all of whom have received good help. For example, mio (a transgender individual) used to frequently seek help from this counselor, which has greatly helped her mental state.

    Campus Clinic (Sun Yat-sen University Zhuhai Campus Health Service Center)

    Address: Walk about 100 meters in the direction of Huaxia Gate from Rongyuan Dormitory, you need to show your ID card or medical insurance electronic voucher (search for “medical insurance electronic voucher” on Alipay to use it) for consultation.

    Consultation Hours: Morning 8:00-12:00, Afternoon 14:30-17:30 Emergency: 12:00-14:30, 17:30-next day 8:00

    Notes: The reimbursement in the clinic is unlimited, and the referral to the Fifth Hospital of Zhongda is limited to 1500 per year (but for transgender individuals, only a small part of the examination needs to be referred to the clinic, and the corresponding cost is not high and difficult to reach the limit, so you don’t need to worry too much)

    1. Campus clinic for hormone six-items, liver and kidney function tests

    Go to the registration office on the right side of the lobby to register, give her your ID card or campus card or electronic campus card (Yixian card) according to the guide’s requirements, swipe the student medical insurance code (Zhuhai Medical Insurance mini program’s medical insurance electronic voucher) and WeChat collection code (other payment methods and cash are unclear) under the guidance of the guide, and then get the queue number given by the guide, enter the consultation room on the left side of the lobby for consultation. The following is the general content after I entered the consultation room:

    I explained to the doctor in the consulting room that I needed to see the six hormones and liver function, kidney function because of my long-term medication (this is very important, some doctors will think you are just a physical examination and will not let you go for medical insurance reimbursement, if necessary, throw out a medical record written by a third-class hospital with “gender identity disorder” or “transsexualism”), the doctor asked if these items had been tested before, I answered that I had been tested in other cities (Guangzhou) before, but due to the high cost, I wanted to try if I could use the school’s medical insurance.

    My answer made the doctor a little difficult, because although there are a certain number of transgender individuals in this campus (my observation), no one has ever checked such items in the clinic of this campus before (that is to say, I am the first one to do this in this campus, which is somewhat historical), so I don’t know if it can go for medical insurance. (In the end, it was proven possible)

    Then the doctor was puzzled and asked why I needed to check the six hormones and liver and kidney function and how often these items were checked. I answered truthfully, explaining that I needed to make a scientific judgment on whether the method and dosage of maintaining the female hormone level for a long time were appropriate for myself, and the impact of this long-term method and dosage on liver and kidney function.

    The doctor took over the outpatient medical record I handed in from Zhao Suhua, and opened the examination form according to the treatment suggestions on it. The prices before the six items of endocrine, liver function, and kidney function were reimbursed by medical insurance were 259.2, 45.92, and 42.48 yuan respectively.

    Then take this examination application form, pay the fee and stamp it at the registration office (student medical insurance reimburses 80%, only need to pay 69 yuan), and give the application form to the nurse in the blood collection room opposite. After the nurse looked at it, she clipped the relevant test strip with a paper clip and told me to come to draw blood on an empty stomach at eight o’clock the next day (if it’s Friday to open the examination application form, you have to come to draw blood next Monday). The report result can be found in the →medical service → report query in the public number of Zhongda Fifth Hospital. The report can come out quickly, the samples are sent for inspection at 10:00 in the morning, and they can all come out before 3:00 in the afternoon. About the six hormones, here when registering, it is called the six items of endocrine, if you say you want to test the six hormones, some doctors may think that the six hormones cannot be tested here and give you a referral form, the reimbursement rate of the referral form is only 50%.

    Campus clinic for bone density measurement

    The campus clinic is currently unable to check bone density and needs to be referred to Zhongda Fifth Hospital for examination.

    The specific process is probably: after registering and paying at the campus clinic, enter the consulting room and explain that you need to measure the long-term impact of this drug on bone density due to long-term medication, and then the doctor will issue a yellow (a few months later it turned white) referral form (valid for 30 days). Take it, stamp it first at the registration office of the clinic, then take bus No. 7 at the bus stop opposite Zhongda South Gate, go through about 10 stations (18 minutes) to arrive at the Fifth Affiliated Hospital of Sun Yat-sen University, and hand over the two-way referral form to the front desk consultation office in the outpatient hall, register for record, and self-pay registration in Zhongda Fifth Hospital public number or at the registration fee collection office in the outpatient hall (although this registration can enjoy the 50% reimbursement of referral, but it can only hang the same day’s number, and the same day’s queue is basically full, so this registration method is basically useless). Then explain the purpose of checking bone density in the corresponding consulting room (you can choose single photon bone density or dual photon and x-ray examination), the doctor will issue an examination form, take the examination form to the fee collection office in the outpatient hall, show the yellow referral form and the examination form, and swipe the medical insurance code (Zhuhai Medical Insurance mini program’s medical insurance electronic voucher) and WeChat collection code under the guidance of the guide (the original price of single photon is 60 yuan, the referral reimbursement is 50%, only need to pay 30 yuan, the original price of dual photon is 180 yuan, the referral reimbursement is 50%, only need to pay 90 yuan,)

    If you choose the single photon bone density test, you need to go to the 7th number of the Pediatric Health Department on the 2nd floor of the Beauty Medical Building opposite the outpatient hall (across a road with many taxis) to do the bone density test. This test does not have an electronic version. After the test is completed, a paper report will be printed, and its style is as follows:

    If you choose the dual photon bone density test, it cannot be detected on weekends, and you need to come to the Radiology Department of the Medical Technology Building (that is, continue straight from the corridor on the right side of the outpatient hall in the direction of turning your back to the outpatient hall door, then turn right and then turn left, walk along the long corrido

    • 中国共产党万岁@lemmygrad.ml
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      Looking at some comments they mentioned there’s an entire chinese wiki on MtF. Seems like parental consent is still a barrier among other things. But it’s worth mentioning that parental consent is a persistent feature of the entire Chinese society. I have heard of 27 year old international graduate students who wanted to do domestic travel in China and still needed parental signoff before they could buy the tickets, fwiw

    • 中国共产党万岁@lemmygrad.ml
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      spillover due to text length

      spoiler

      If you choose the dual photon bone density test, it cannot be detected on weekends, and you need to come to the Radiology Department of the Medical Technology Building (that is, continue straight from the corridor on the right side of the outpatient hall in the direction of turning your back to the outpatient hall door, then turn right and then turn left, walk along the long corridor and pay attention to the “Medical Technology Building” and “Radiology” signs on the left) during working days. After getting the number, come to the 6th examination room (the innermost part of the corridor on the right side of the entrance to the Radiology Department), take out the metal objects according to the doctor’s requirements and properly place the posture, after the test is completed, immediately get 3 reports, its detectable result style is as follows:

      Campus clinic uses diagnostic medical records to open prescription and purchase for domestic Bujiale (invalid)

      The school intends to remove Bujiale from the pharmacy in the clinic, and modify the prescription system, making it impossible for transgender women who have not changed their gender on their ID cards to open Kelingmeng in the pharmacy that is currently not removed, based on transsexualism or gender identity disorder diagnosis certificate or medical record.

      National supplements can be obtained in the campus clinic with the medical records or diagnosis certificates of gender identity disorder or transsexualism, and the specific process is the same as above ------ register (swipe the medical insurance code and collection code to get the queue number) → queue into the consulting room for inquiry → show the medical records or diagnosis certificates of gender identity disorder or transsexualism and simultaneously explain the intention to open domestic Bujiale → doctor opens the prescription → take over the prescription and pay and stamp at the registration office → submit the stamped prescription to the pharmacy. But you can only open a month’s worth at a time (I said I eat 3 tablets a day, one box a week, and the doctor opened a month’s worth of 4 boxes, I don’t know if other dosages will give more, the price after the box of medical insurance reimbursement is 7.6875 yuan, quite people-friendly)

      If the doctor in the clinic does not dare to open the prescription and refers you to the psychology department of Zhongda Fifth Hospital, and you are not a member of the parent party, please give up at this time, because the first consultation of the psychology department of Fifth Hospital not only requires 228 yuan for the first consultation test fee, but also after entering the consulting room and explaining the intention to open the national supplement, the doctor needs the parent’s phone knowledge and consent to open the prescription, (ignore if you are a member of the parent party)

      By the way, the pharmacy in the clinic is very likely not to have domestic Sustanon (because I asked the doctor when I was referred to the Fifth Hospital, she said no, so the clinic related to the Fifth Hospital is very likely not to have domestic Sustanon)

      This post is just so much for now, welcome to add!

  • GarbageShoot [he/him]@hexbear.net
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    3 days ago

    I think it depends heavily on where you are, since there is at least one dedicated transitioning institution and other institutions that support transitioning, but then there are other places with virtually no support. It’s definitely something Cuba is better about.