Although there are no outright legal penalties for being a transgender person in China,
the absence of non-discrimination laws, lack of professional medical services for
transitioning, and a lack of targeted HIV programming and services, mean there is no
effective protection. In China, transgender people are classified as suffering from a
mental illness, and the pre-requisite of extremely expensive sex reassignment surgery
(SRS), not covered by national health insurance plans, prevents many from being able
to change the gender marker on their ID cards, household registration, or academic
records.
The alteration, examination and approval of gender on documents also come under the
jurisdiction of local public security organs. For those who do request SRS, petitioners
have to provide a series of certificates, including a permit from a public security
bureau showing no criminal record, a certificate from a psychiatrist, a notarized report
requesting SRS, and a certificate showing that next of kin have been notified of the
SRS. The patient must be unmarried, must have wanted to change genders for at
least five years, and must have undergone psychiatric treatment for at least one year
without being dissuaded. These requirements are not only extremely bureaucratic but
violate international human rights standard ̰