# Transgender people in China

Transgender is an overarching term to describe persons whose gender identity/expression differs from what is typically associated with the gender they were assigned at birth. Since "transgender studies" was institutionalized as an academic discipline in the 1990s, it is difficult to apply transgender to Chinese culture in a historical context. There were no transgender groups or communities in Hong Kong until after the turn of the century. Today they are still known as a "sexual minority" in China.

## Terminology

Because Chinese transgender studies are so unfocused, a wide variety of terms are used in relation to transgender in the varieties of Chinese.
* Tongzhi (同志, pinyin tóngzhi) refers to all peoples with a non-normative sexuality or gender, including homosexual, bisexual, asexual, transgender, and queer peoples.
* Bianxing (變性, biànxìng) is the most common way to say "change one's sex", though not necessarily through sexual reassignment surgery—bianxing may also include hormonal changes and lifestyle changes.
* In Mandarin, the term kuaxingbie (跨性别, kùaxìngbié), literally "cutting across sex distinctions", has come into use as a literal translation of the English term "transgender", its use having proliferated from academic contexts.
* Offensive terms for trans women include "niang niang qiang" (娘娘腔, meaning sissy boy) or "jia ya tou" (假丫头, meaning fake girl).
* "Fanchuan" (反串, fǎnchùan) is the historical term for cross-dressing performing on stage, as in Beijing opera where males play women's parts, or in Taiwanese opera where females play men's parts.
In Hong Kong, there are specific derogatory terms used towards transgender people. The most common is jan-jiu (人妖) which translates to "human monster".
* Bin tai, or biantai (變態) in Putonghua, in Hong Kong refers to a non-normative person, deviating from the reproductive heterosexual family and the normative body, gender, and sexuality expectations. It is also a derogatory term for cross-dressers, pedophiles, polygamists, homosexuals, masculine women, sissy boys, and transgender people.
* Yan yiu, or renyao in Putonghua, translates into human ghost, human monster or freak. It is commonly used to target transgender people, but has historically been used for any kind of gender transgression.
* The second form is naa-jing referring to men who are considered sissy or effeminate. However, the politically correct term for a transgender person in Hong Kong is kwaa-sing-bit (跨性別). The media in Hong Kong might use the negative term jan-jiu or bin-sing-jan, referring to a sex or gender changed person.
* In the late 1990s, the performing group Red Top Arts (紅頂藝人, py Hǒngdǐng Yìrén) came to fame in Taipei, Taiwan as the island's first professional drag troupe. Since this time, "Red Top" and various homophones (紅鼎, 宏鼎, etc.) have come to be common combining-forms that indicates drag, cross-dressing, etc.
Terms for crossdressing are many and varied. 異裝癖 (py yìzhūangpǐ), literally "obsession with the opposite [sex's] attire", is commonly used. 扮裝 (py bànzhūang), literally "to put on attire", is commonly used to mean crossdressing. Related to this is an auxiliary term for drag queens: 扮裝皇后 (py bànzhūang húanghòu), or "crossdressing queen". There are several terms competing as translations of the English drag king, but none has reached currency yet. While research shows that China's younger population is much more accepting of transgender people, offensive terminology like "jan-jim" or "bin-sing-jan" is very common.

## History of transgender people in China

In the mid-1930s, after the father of Yao Jinping (姚錦屏) went missing during the war with Japan, the 19-year-old reported having lost all feminine traits and become a man, was said to have an Adam's apple and flattened breasts, and left to find him. Du He, who wrote an account of the event, insisted Yao had become a man, while doctors asserted Yao was female. The story was widely reported in the press, and Yao has been compared to Lili Elbe, who underwent sex reassignment in the same decade.

### Cross dressing in Peking Opera

Sinologists often look to theatrical arts when imaging China in a transgender frame because of the prominent presence of cross-gender behavior.
Peking Opera, also known as Beijing Opera, had male actors playing female dan characters. Men traditionally played women's roles due to women being excluded from performing in front of the public as a means of preventing carnal relations. Although, before 1978, male to female cross dressing was mostly for theatrical performances, used for comedic effect or to disguise a character in order to commit a crime or defeat enemies. Female to male characters were considered heroic in theatrical performances.
During the Ming and Qing Dynasties of China, cross dressing occurred both onstage and in everyday life. Within theater, some who were intrigued by it would roleplay, organize their own troupes, write, and perform theatrical pieces.
Many of early modern China's stories reflected cross-dressing and living the life of a different gender for a short period of time, mainly featuring the cross-dressers as virtuous, like Mulan.
Li Yu, a writer and entrepreneur, featured the gendering of bodies to be dependent upon men's desires and operated by a system of gender dimorphism, assumed by social boundaries of the time. When Li Yu created an acting troupe, as many elite males did, he had a concubine that played a male role as he believed she was "suited to male" or considered her more of the masculine gender.
In modern-day Peking Opera and film, there are male to female cross dressers and vice versa for characters, especially with certain time periods.

## Influence of religion, ideologies, and societal attitudes

Buddhism views all bodily concerns as entrapment in the Samsara, including those concerning LGBT+ identities.
Younger generations that have been less exposed to Maoist ideologies are more accepting towards members of the LGBTQ+ community.
According to some scholars, female infants were forced to dress up as males ("cross-dressing"). They claim that this, in turn, affected those children into living transgender lives.

## Legal aspects

After the World Health Organization dropped “gender identity disorder” from its International Classification of Diseases (ICD-11) in 2018, China promoted the new guidelines in medical institutions across the country.
In March 2019, China accepted recommendations by the UN Human Rights Council on banning discrimination against LGBTQ people.
In fact, as of now (2024 Q2), it is still recognized as a disease in medical practice.
On October 31, 2024, a Chinese transgender woman was approved by Changli county people’s court in Qinhuangdao to receive 60,000 yuan (£6,552) in compensation from a hospital that gave her electroshock conversion treatment against her will. This was the first time any transgender person in China won a legal challenge against the use of electroshock conversion treatment.

### Gender reassignment

Gender reassignment on official identification documents (Resident Identity Card and Hukou) is allowed in China only after the sex reassignment surgery. The following documents are required in order to apply for gender reassignment:
* A formal written request from the applicant;
* Household Registration Book (which may need to be retrieved from the applicant's family) and Resident Identity Card;
* A certificate of gender authentication issued by a domestic tertiary hospital, along with verification of the certificate from a notary public office or judicial accreditation body;
However, changing the ID card information will lead to an abnormal match with the academic qualifications, which often seriously impacts one's employment. (You cannot change your student status information after graduating from university.)
In China, trans women are required to notify family, prove they have no criminal record, and receive psychological treatment in order to be allowed a prescription for hormone replacement therapy (HRT). Familial disapproval had led many to seek alternative sources of their medication, including online sources.
As of 2024, transgender people first go to a transgender-friendly psychology outpatient clinic to obtain a medical record of Transsexuality/Gender identity disorder (depends on different doctors and hospitals), and then go to a transgender-friendly endocrinology outpatient clinic to prescribe medication based on the case.
Based on the Management Specification on Gender Reassignment Technology published by National Health Commission in 2022, the surgical patient has to be at least over 18 years old, have the desire of intending gender reassignment persistently for more than 5 years, be unmarried in order to undergo sex reassignment surgery; plus, proof of familial consent is required prior to any surgical practice regardless of surgical types.proof of diagnosis of gender identity disorder is also required for surgery.The vast majority of psychiatric clinics will require the parents not to object,sometimes even if that patient is already 25 years old.In some cases, a one-year observation period is required after the request is made.
In 2009 the Chinese government made it illegal for minors to change their officially-listed gender, stating that sexual reassignment surgery, available to only those over the age of twenty, was required in order to apply for a revision of their identification card and residence registration.
In early 2014 the Shanxi province started allowing minors to apply for the change with the additional information of their guardian's identification card. This shift in policy allows post-surgery marriages to be recognized as heterosexual and therefore legal.
In 2020, a transgender employee who was terminated by the e-commerce platform Dangdang for undergoing her reassignment surgery sued the company and won.
In 2022, the National Health Commission lowered the minimum age for surgery from 20 to 18 and removed a previous requirement of one-year psychological or psychiatric therapy before surgery.
In November 2022, Chinese government began preparations to restrict internet purchases of estradiol and cyproterone, and a draft had been reviewed. The ban was put in place in December so that even those with prescriptions cannot buy these drugs online. As of 2024 it can be purchased on Taobao but the review is very strict, much stricter than other prescription drugs.

## Social support

Prior to its closure in 2023, The Beijing LGBT Center (Chinese: 北京同志中心) was primarily composed of four organizations: Aizhixing AIDS Organization, Tongyu Lala Organization, Aibai Cultural and Education Center, and Les+. Tongyu Lala was an organization based in Beijing that combatted discrimination against and was an advocate for social inclusion of lesbians, bisexual women, and transgender people. The group also helped organize LGBT groups in China.
Events promoting LGBT rights and equality in China include or included the International Day Against Homophobia, Biphobia and Transphobia, the Beijing Queer Film Festival, and parades held in Beijing, Guangzhou, Hong Kong, and Shanghai).

## Challenges
### Youth

Transgender youth in China face many challenges. One study found that Chinese parents report 0.5% (1:200) of their 6 to 12-year boys and 0.6% (1:167) of girls often or always ‘state the wish to be the other gender’. 0.8% (1:125) of 18- to 24-year-old university students who are birth-assigned males (whose sex/gender as indicated on their ID card is male) report that the ‘sex/gender I feel in my heart’ is female, while another 0.4% indicating that their perceived gender was ‘other’. Among birth-assigned females, 2.9% (1:34) indicated they perceived their gender as male, while another 1.3% indicating ‘other’.
One transgender man recounts his childhood as one filled with confusion and peer bullying. In school he was mocked for being a tomboy and was regularly disciplined by teachers for displaying rowdy boy-like behavior. Some recommended to his parents that he be institutionalized.
These attitudes may be slowly changing and many Chinese youth are able to live happy and well-adjusted lives as members of the LGBT+ community in modern China. In July 2012 the BBC reported that the new open economy has led to more freedom of sexual expression in China.
In 2021, China's first clinic for transgender children and adolescents was set up at the Children's Hospital of Fudan University in Shanghai to safely and healthily manage transgender minors' transition.
According to a survey conducted by Peking University, Chinese trans female students face strong discrimination in many areas of education. Sex segregation is found everywhere in Chinese schools and universities: student enrollment (for some special schools, universities and majors), appearance standards (hairstyles and uniforms included), private spaces (bathrooms, toilets and dormitories included), physical examinations, military trainings, conscription, PE classes, PE exams and physical health tests. Chinese students are required to attend all the activities according to their legal gender marker. Otherwise they will be punished. It is also difficult to change the gender information of educational attainments and academic degrees in China, even after sex reassignment surgery, which results in discrimination against well-educated trans women.

### Workplace discrimination

A 2021 survey in Beijing showed that half of the transgender respondents do not express their gender identity at work and 34% said they had experienced workplace discrimination. The unemployment rate in the transgender community was much higher than China's urban unemployment rate.

### Gender-affirming treatments

In 2019, Amnesty International reported that transgender people in China resorted to unregulated used of medication and self-surgery due to inadequate access to information, legal and administrative barriers to gender-affirming surgeries. Many were afraid to come out to their parents. Some purchased hormone drugs through unregulated channels online, overseas, or on the black market. Specialized gender-affirming health care facilities are not common in China, although a multi-disciplinary medical team for gender-affirming treatments, the first of its kind, opened in 2018 at Peking University Third Hospital.
In 2021, China's first clinic for transgender children and adolescents was set up at the Children's Hospital of Fudan University in Shanghai to safely and healthily manage transgender minors' transition.

## Transgender culture
### Literature

Literature and plays in the 17th century featured cross-dressing, like Ming dramatist Xu Wei who wrote Female Mulan Takes Her Father’s Place in the Army and The Female Top Candidate Rejects a Wife and Receives a Husband. Despite the female to male cross dressing, the woman would eventually return to her socially gendered roles of wearing women's clothes and would marry a man.

### Social media and technology

Technological advancements help to promote greater awareness among youth of LGBT+ issues. Access to Western media such as trans-themed web sites and featuring of trans-identifying characters in Western movies are broadening the knowledge and sense of community that many trans youth seek.

### Transgender people in media

Entertainers:
* Jin Xing
Models:
* Liu Shihan
Citizens:
* Liu Ting [zh]
The following Chinese films portray transgender characters:
* Swordsman II (1992)
* The East is Red (1993)
* Whispers and Moans (2007)
* Splendid Float (2004)
* Drifting Flowers (2008)
In addition, in the 2019 documentary film, The Two Lives of Li Ermao, a trans migrant worker "transitions from male to female, then back to male," which some promoted as part of "Love Queer Cinema Week."

## Policy

Policies for transgender are always erratic, Some of the content in the text may quickly become outdated. To some extent, this is also characteristic of China, and in 2020, China's policies towards various subcultural groups have fluctuated violently (e.g., Airsoft)