China Opens First Clinic To Support Transgender Youth In Shanghai

Above Photo: Brendan McDermid / Reuters

A new clinic has opened its doors in Shanghai, hoping to provide affirmative care for transgender children and adolescents. While several court cases have been ruled in favor of trans plaintiffs in recent years, trans visibility in Chinese society remains small.

The Children’s Hospital of Fudan University in the eastern city of Shanghai recently inaugurated a new multidisciplinary clinic to provide support for transgender children, including safely managing their transition needs, the Global Times, a newspaper operated by the Communist Party of China-owned People’s Daily, reported on Friday.

According to the paper, the clinic was formed in reaction to the hospital’s encounter with trans children, whose needs they had inadequate means to support.

For children whose psychological makeup doesn’t match their gender assigned at birth, the onset of puberty can become a rude wakeup call about their identity, bringing depression, anxiety, and thoughts of self-harm. Chinese children must undergo an examination by psychologists and endocrinologists to determine if medical intervention, such as hormone replacement therapy (HRT), is necessary to alleviate those symptoms.

The paper reports that trans youth might take intermediate steps in that process, including suppression of puberty effects like menstruation, to see if they are beneficial. Judging by the report, the clinic doesn’t seem to be dealing with surgeries of any kind, which are exceedingly rare for trans people under the age of 18.

Luo Feihong, director of the endocrine and genetic metabolic department of the Children’s Hospital, told the Global Times that their multidisciplinary approach is “of great help to reduce the negative emotions of these children and adolescents, improve their academic performance, improve their family relations and build a harmonious society,” as the paper put it.

Estimates of the trans population around the globe range from 0.1% to 1.1% of the population are transgender or third gender, which might be greater or lesser depending on various cultural factors affecting personal identification, such as cultural awareness and tolerance. The rise of internet subcultures over the last few decades has helped many trans people to understand their identities by finding out information about their condition, as well as connecting them to others like them.

Representation and Progress

In China, a 2013 census bureau report suggested there might be 4 million trans people. Awareness has been greatly helped by Jin Xing, a trans woman, former Red Army colonel and internationally acclaimed dancer once known as “China’s Oprah Winfrey” for her hugely popular television talk show, which was watched by some 100 million people daily before going off the air in 2017. Jin wasn’t the first Chinese trans woman to receive gender affirmation surgery, but in 1995, she became the first Chinese public figure to do so, although she doesn’t see herself as a standard-bearer for the LGBTQ community, just as a strong woman.

“I have always acted entirely according to my own wishes,” she told the New York Times in July. “If I indirectly became an idol to some young people, that’s fine, but I have never made myself into a leader. By living healthily and facing life positively, I’ve already positively impacted society. That’s enough.”

Homosexuality was decriminalized in China in 1997 and removed from the category of mental illnesses in 2001, but trans people must still be diagnosed with gender dysphoria before being allowed to legally access HRT or surgeries. There are few explicit legal protections afforded to LGBTQ people, but that is changing. Several court cases in recent years have defended trans plaintiffs from discrimination on the job if it’s related to their trans identity, such as refusing to respect one’s pronouns or regarding them as unreliable because they get or might later need to get surgeries.

The verdict in one 2020 case, which found that e-commerce giant Dangdang couldn’t fire a trans woman named Gao after she took a two-month medical leave to get gender affirmation surgery, spread like wildfire online. According to China Labor Bulletin, the powerfully-worded ruling was viewed 380 million times on Sina Weibo.

“The trend of modern society is towards increasingly rich diversity,” the verdict read. “We are accustomed to understanding society through our conception of biological sex, but there are some people who express their gender identity in accordance with their own life experience. This kind of social expression – the existence of which is sustained – often requires us to renew our understanding and how we look at things.”

The court also awarded Gao back pay for the time lost and recognized her legal right to equal treatment over the “discomfort” of her coworkers about her identity.

However, a 2017 report found that because of continued discrimination and social attitudes, trans Chinese can suffer as much as four times the unemployment rate, since about 14% of companies had anti-discrimination policies and even fewer had inclusion training and support groups for LGBTQ people.

Cuba’s Inclusive Revolution

While things seem to be moving slowly in the direction of tolerance and acceptance of trans people in China, in another socialist country halfway around the globe, LGBTQ people have become an open and proud part of the revolution.

Cuba’s National Center for Sexual Education (CENESEX), part of the country’s health ministry, advocates on behalf of LGBTQ inclusion, working to educate the population about the need to shed older, bigoted cultural attitudes about sexuality and gender identity. The center is headed by Mariela Castro Espin, the daughter of former Cuban President Raul Castro and Vilma Espin, who founded the Cuban Women’s Federation to fight for gender equality in the Cuban revolution.

Since 2008, HRT and gender affirmation surgeries have been made available free of charge to all trans Cubans as part of the country’s free national healthcare system, although the services were previously made available on a smaller scale for many years. It also provides anti-HIV pre-exposure prophylaxis (PrEP) medication free of charge. Trans people have become public officials and even religious leaders, and in 2013, workplace discrimination was banned under Cuban law.

US Rights Under Attack

Meanwhile, a record number of anti-LGBTQ bills were both introduced and passed in the United States in 2021, with the majority of them targeting trans people and children specifically.

One law passed in Arkansas in February was unexpectedly vetoed by Governor Asa Hutchinson, who had previously championed the bill, but later changed his mind after trans politicians in the state told him about the severe problems it would cause, including a statistic that nearly half of unsupported trans youth attempt suicide before they’re 18 years old.

Chinese research on trans youth has shown similar outcomes, the Global Times reported, noting the finding was one of the motivating factors to found the Shanghai clinic.

According to a count by the Human Rights Campaign national LGBTQ advocacy group, by May of 2021, more than 250 discriminatory bills had been introduced in state houses across the US, and the Williams Institute in Los Angeles reported that the bills endanger the healthcare of as many as 45,000 transgender youths.