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跨性別人士與愛滋病的關系

有跨性別人士認為不需注意愛滋病的預防，因為自己並不是同性戀，也有拒絕與同性戀及愛滋病等看似負面的詞語扯上任何關系。但事實上，近年很多國際研究中，發現愛滋病的感染率中，「跨性別性行為要比男男性行為高出4倍以上」。

當然這情況不可一概而論，但有些重點我們是需要了解的： 

  • 預防勝於萬一，就算暫時沒有不安全性行為，也應了解其預防之方法。
  • 異性戀人士亦有感染愛滋病的存在風險。
  • 跨性別無論MTF、FTM、手術與否，進行高危性行為風險並不會較其他人士低。
  • MTF如未進性別重置手術，性行為風險與男男性接觸相近，更可能因議價能力偏低而存在更高風險。
  • MTF手術後的人工陰道因構造問題，會更容易感染愛滋病及其他經性接觸傳染的疾病。
  • 跨性別中無論男跨女、女跨男、手術與否，與任何性別發生性行為，也需要注意如愛滋病、梅毒、乙型及丙型肝炎及其他通過性接觸感染的病毒風險情度及預防守則。請參閱有關網站： https://www.21171069.com/tc/bye_bye_stis/stis_hiv.html
  • 不同的性病有不同的空窗期，意思是在感染後一定的時間後才能被檢測出來，愛滋病的空窗期為3個月。測試應於高危性行為3個月後進行。
  • 愛滋病毒的傳染途徑有以下3種：血液接觸/性接觸/母嬰傳染
  • 愛滋病毒的傳染原則：透過傷口或黏膜、接觸被愛滋病毒染污體液(血液/精液或陰道分泌/母乳)、有足夠病毒份量及濃度的體液
  • 愛滋病毒不能傳染的方法：例如握手/擁抱/社交接吻/同檯進食/一同洗滌的衣服/座廁/蚊蟲
  • 男跨女人士無論是已接受性別重置手術與否，與男性進行性行為，由於身體實際狀況，在性接觸時屬高風險。而手術後的男跨女，以重建後之陰道進行的性行為，由於結構上跟原生女性的陰道有別，所以也屬高風險。
  • 女跨男已接受性別重置手術人士，與任何性別人士性交，需注意保護重建後的男性性器官。
  • 無論任何類別的跨性別人士，其高風險性行為也包括以下各項：
    • 沒有配戴安全套進行肛交
    • 沒有配戴安全套進行陰道性交
    • 於沒有配戴安全套的情況下，在未射精前抽出陽具
    • 共用未經清洗或未換上新安全套的性玩具
  • 低風險性行為：
    • 與男性進行口交，而含或吞其精液
    • 沒有使用障礙物(如:牙套)與女性進行口交
    • 有配戴安全套進行肛交
    • 有配戴安全套進行陰道性交
  • 沒有風險之性行為：
    • 單方進行的性行為
    • 任何沒有體液交換的性行為 ( 互相手淫 / 摩擦身體 / 按摩 / 吻皮膚 / 偷窺 / 顯露性器官等 )

 

* 資料由跨性別資源中心提供

 

一般愛滋病資訊網站

愛滋熱線網站 27802211
．https://www.27802211.com

愛滋寧養服務協會 The Society for AIDS Care
．https://aidscare.com.hk/ 

HIV/AIDS愛滋病小常識
．http://www2.nsysu.edu.tw/valkyrie/AIDS.htm

紅絲帶中心
．http://www.rrc.gov.hk/chinese/e1.3.htm 

衞生署衞生防護中心關於跨性別愛滋病資訊

衞生署於2015年2月發表了「HARiS -愛滋病預防項目指標調查2014-男跨女跨性別人士」報告，顯示出以下結論：

  • TG的愛滋病感染率高 (18.6%)，較男男性接觸者的5.85%更高;
  • TG定期做HIV測試比率偏低 ;
  • 使用安全套比率可以再多D。

整份資料單張 -> 下載

 

世界衛生組織資訊

世界衛生組織於剛發表於2014年7月11日題為 "People most at risk of HIV are not getting the health services they need" 一文中表示，女性性工作者比一般女性有高出14倍感染愛滋病之機會，有男男性行為人士比一般大眾有高出19倍感染愛滋病之機會，而跨性別女性比一般成人有高出50倍之感染愛滋病機會。

"Studies indicate that women sex workers are 14 times more likely to have HIV than other women, men who have sex with men are 19 times more likely to have HIV than the general population, and transgender women are almost 50 times more likely to have HIV than other adults."

 

跨性別安全性行為動畫

以下是一套泰國組織Mplus+製作的動畫，帶出跨性別女性於結識伴侶時，應注意感染HIV/AIDS的危機，期望大家學懂保護自己。

Animation for Transgender HIV/AIDS Outreach and Prevention (Eng Subtitles) Mplus Thailand

 

台灣資訊

以下是來自台灣方面關於愛滋病的資料，我希望大家了解及保護自己，也應關懷這方面的人群，而不是拒絕、排斥及歧視。跨性別運動在全世界也是與同志運動緊密結連的，雖然歷史上有過群體間的對立，但若我們也互相排斥，運動就沒辦法進展。

香港的跨性別運動一直都有幾乎全港的同志團體在背後支持，沒有了他們，我們不會走得這麼快、這麼遠！我們都是同一家人！妨且跨性別的性傾向到底是同性戀或異性戀，就算是您怎樣分都大有人在，我們不可能只接納自己的性別認同，而將性傾向避而不談。

男變女性別重置手術 Male to Female SRS

 

女變男性別重置手術 Female to Male SRS

請點擊以下連結觀看視訊 Please click the link below to watch the video
https://www.youtube.com/watch?v=GdZhOZh71zw 

 

男變女言語治療及聲帶手術 Male to Female Speech Therapy

 Speech therapy and Voice surgery: presentation and animation from Geerten Gerritsen on Vimeo.

 

Information provided here are not always updated. For doctor visit, please call for enquiry and booking.

Outline and details of arranging Sex Reassignment Surgery (SRS) in Hong Kong

If you have a valid Hong Kong Identity Card (Public Charges – Eligible Persons), you will be subsidized by the government on GID assessment as well as SRS in the Public Hospital System and the overall cost is very low. The only problem is the period of time is much longer. It might take 1 to 4 years from beginning to SRS depends on your situation. Yet we do not recommend you should rush for the surgery as during the period of assessment, doctors will help you in the preparation and let you have time to understand your needs on the transitioning. That's very important for your future life. If you have enough preparation already and can bear a high private clinic cost, you can use the information below to connect to some of the private psychiatrists to move on the transitioning process.

1. A summary on Public GID Clinic vs Private Clinic

Public GID Clinic Private Clinic
Required a referral letter for booking of the first appointment Book directly
A one-stop service until all follow up after SRS. No need to arrange each of the clinics by yourself Not to arrange each of the clinics like psychiatrist, psychologist, endocrinology (hormonal treatment), etc
Slow scheduling (including first and future appointments) Fast scheduling (almost immediately)
The fee is usually low (for example, the first consultation in the psychiatric department is HK$135, and the subsequent consultation is HK$80) High fees (ranging from $1000-2000 each time)
Temporarily only serve Hong Kong residents Service for all people
After receiving the SRS letters from Psychiatrist and Psychologist, you can still choose to go abroad for surgery. After receiving the SRS letter from Psychiatrist and Psychologist, if you choose to go to the government hospital for SRS, you need to schedule from the beginning with the surgical department.
The SRS fee is under HK$2,000 (Breast implant will be paid by the patient. Usually under HK$10,000) SRS costs range from HK$80,000 to HK$2xx,000
The assessment process may take from 1 to 4 years Can be very fast (but not recommended to skip)
There are not many choices on hormone There may be better medicines to choose from
Follow up after SRS Follow-up after SRS needs to be re-scheduled with the GID clinic

 

2. The process of Sex Reassignment

*the information provided below only attended to the procedures relevant to the Surgery itself. If you do have a need for sex reassignment and are confident and prepared to face the new challenges of a new life, these are roughly the steps you have to walk through

  1. Acquire a letter of referral from a general practitioner or a family doctor for the referral to GID Clinic. (Check with 3. Detail Description)
  2. Submit the letter to Gender Identity Disorder Clinic, Department of Psychiatry in Prince of Wales Hospital for an appointment. (On the left of the entrance, 3/F Li Ka Shing Specialist Outpatient Clinics North Wing)
    or recognized psychiatrists and psychologists (contact us for more info)
  3. Informed by the Psychiatric Unit/Sex Clinic of the first appointment (may take 6-18 months *).
  4. Referred by the psychiatric unit to the psychologist and other specialties including the endocrinologist, speech therapist and social worker, etc.
  5. For a certain time of period, the doctor will discuss with the client of undergoing the “Real Life Experience” (RLE). The client will receive a supporting letter from the doctor for him/her to live more easy as another gender.
  6. Receive “Hormone Replacement Therapy” (HRT) prescribed by the psychiatric unit or endocrinology.
  7. Confirmation of client’s need and applicability for Sex Reassignment Surgery from the psychiatric unit and psychological unit separately.
  8. With the 2 referral letters of surgery from the two units mentioned above, head for Prince of Wales Hospital to book an appointment in the surgical out-patient unit.
  9. Informed by the surgical unit of the first appointment.
  10. Client makes pre-operative preparation upon doctor’s request.
  11. One or more Sex Reassignment Surgeries are commenced.
  12. The client will receive a testimonial letter of SRS from the hospital after he/she has completed the full SRS procedures according to the government administrative guideline.
  13. A deed poll should be drafted by a legally qualified person to change the name if there is a need.
  14. Go to the Immigration Department to apply for the change of sex and/or name with the testimonial letter of SRS.
  15. Amend the relevant entry/entries in other credentials and service accounts upon the reception of the updated identity documents. In general, the patient’s record kept by the Hospital Authority will be updated automatically after the surgery.
  16. Prescription of after-surgery hormone supplements from the doctor according to client’s need.
  17. Further consultations by the psychiatric unit and surgical unit until satisfactory.

* Note:

  1. The sequence of steps varies slightly according to the client’s condition and the hospital’s arrangement.
  2. To amend the gender marker on ID card in Hong Kong, one should complete the SRS procedure described in the administrative guideline of Immigration Departure. For more information, please check with Q22 of the link here http://www.gov.hk/en/residents/immigration/idcard/hkic/faq_hkic.htm
  3. Service charges for medical services provided by HA hospitals/clinics:
    https://www.ha.org.hk/visitor/ha_visitor_text_index.asp?Content_ID=10045&Lang=ENG&Dimension=100&Parent_ID=10044&Ver=TEXT
  4. GID Clinic provides one-stop cross-specialized assessments and medical services for patients across the territory, with no territory restrictions.
  5. GID respect the privacy of their patients in which all letters can be collected from the clinic on request. The clinic will contact each patient when there is letter ready for collection.

Waiting Time for New Case Booking at GID Clinic: 4-6 months

For information such as the arrangements under the epidemic situation and new case booking wait time, please contact the Prince of Wales Hospital (Psychiatric Unit) directly as it will be updated from time to time. Below is the contact information:

Location: 3/F, Block B, Staff Quarters, Prince of Wales Hospital, No. 30-32 Ngan Shing Street, Sha Tin, N.T.
Phone number: 3505-3415
Service Hours: Monday to Friday 8:45am to 5:30pm

 

The following diagram is reproduced with permission from "Quarks". For details of the post, please click the original post link: https://www.instagram.com/p/CdDHpucP-nk/

3. Detail Description

If you seek to arrange a sexual reassignment surgery in Hong Kong or are experiencing severe anxiety of gender identity, you can book an appointment with the GID clinic under the psychiatric unit of Prince Wales Hospital. The client needs to acquire a letter of referral from a registered doctor in Hong Kong by stating during the consultation, his will to be referred to a particular psychiatric specialty due to gender identity disorder. The ID card no. and the name of the client must be indicated in the letter. If there is any occasion of discourtesy of discrimination from the practitioner of doctor, you hold the right to declare the service unprofessional and request suspension of service. In general, it is very unlikely to happen in the government general out-patient clinic.

As the letter of referral is valid for 3 months only, please accompany a relative or go by yourself within three months, to the GID clinic of Prince Wales Hospital to book for an appointment with the letter of referral, identity documents and address proof (such as water, electric bill). The waiting time for a new case is around 6 to 18 months. 

Prince of Wales Hospital Psychiatric Unit- Gender Identity Disorder Clinic
Address: Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories.

* If the patient is under age of 18, his parents must approve and accompany him on the first appointment in a sex clinic.
* The Government GID Clinic and SRS service now only provided to Hong Kong permanent citizens. Non-citizens should go to a private psychiatrist and private hospital.

 

Fees: (Please refer to Public Hospital Website for the exact fee)

Referral Letter for GID Clinic: A general practitioner or family doctor will not charge an extra fee for referral letter and we are not able to provide information of different doctor's fee. 
GID Clinic Assessment Fee：Including the psychiatric department, the first visit charge is HK$135, followed by HK$80 each time. Each drug charges HK$15.
Surgery (SRS) Fee: Hospital Admission fee HK$75. Daily charge HK$120 with a small amount of misc. charges. Variant Surgery Selective materials such as breast implants are required to pay, depending on the price chosen, ranging from about HK$8000.

 

* TGR does not benefit from disseminating the medical practitioners' information. It is for user's reference only. Please call before visiting doctor to confirm the cost, service time, address and the kind of treatment and hormone they can provide.

4. Gender Assessment and SRS Private Clinic

Psychiatrist

Doctor Mak Kai Lok, Gregory (Psychiatrist)
Tel: 26876777 / 98028680
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Address: Room 1201A, Hing Wai Building, 36 Queen's Road Central, Central, Hong Kong

Doctor Au Yeung Kwok Leung (Psychiatrist)
Tel: 35763576
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Address: Room 1119, 11/F, One Grand Tower, 639 Nathan Road, Mong Kok, Kowloon (Mong Kok Exit E1)

Doctor Gordon Wong
Tel: 57265860
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Address: Unit 1807, East Point Centre, 555 Hennessy Road, Causeway Bay, Hong Kong

Doctor Cheung Ngo
813 Medical Centre
Tel: 28133700
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Website: https://www.hkpsychiatry.com/
Address: Room 813, 8/F., H Zentre, 15 Middle Road, TST, Kowloon
FB Page: https://www.facebook.com/druccello

Dr. Wong Chung Hin, Willy
Specialist in Psychiatry/Certified Sex Therapist 
Tel: 37096034
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Hong Kong Psychiatry And Integrated Medical Centre
Unit A, 18/F, Lokville Commercial Building, 27 Lock Road, Tsim Sha Tsui, Kowloon, Hong Kong

Certified Sex Therapist at centre

Dr. Wong Chung Hin Willy 
Tang Wing Kam Cannis 
Ho Ming Hei Hugo
Chang Yuen Wai Virginia 
Leung Kai Man

 

Sex Reassignment Surgeon

Dr. Yuen Wai Cheung, Albert
Ethics First Medical Practice (Central)
Suite 2804, 28/F, Bank of America Tower, 12 Harcourt Road, Central, Hong Kong (Central MTR Exit L)
Tel: 2110 2151/2110 2152
Info on FindDoc: https://www.finddoc.com/en/doctors/yuen-wai-cheung-albert-2528

 

Dr. Pauline Wong Shiu Yuen
Hong Kong Baptist Hospital - Plastic Surgery & Skin Centre
2/F., Block B, 222 Waterloo Road, Kowloon, Hong Kong
Tel: 2339 8666
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Family Doctor who can issue GID referral letter for transgender people

Dr. Ng Wing Ying Angela
Family Doctor & Sex Therapist
https://www.neohealth.com.hk/ch/team/item/546-dr-angela-ng.html
Tel: ‭31677040
Address: Room 1106, 11/F, No. 19 Des Voeux Road Central, Central, HK

 

5. Precaution on Hormone Replacement Therapy

So transgender people wish to purchase and apply self-medication of hormone to alter their body condition towards the opposite sex. TGR do not encourage self-medication of hormone without doctor’s prescription or follow-up, but please have a regular body check if this is the only way. Hormone supplement affects the function of liver and kidney, and due to physique or other problems, unnatural obesity, headache, fatigue, emotional fluctuation or other serious effects may happen after dosage. Therefore, take great care of the changes of your body.

The hormone applied on FTM and MTF is entirely different, FTM uses injected testosterone in most cases, which has the least effect on liver and kidney, with the highest absorption rate. MTF in most cases takes oral Estrogen and Anti-Androgen simultaneously, while some choose injection, adhesives or rub on cream on skin. There are also some people who prefer natural foods or Chinese medicines to adjust their bodies, of which the effect is not strong, yet safe.

* TGR does not benefit from disseminating the medical practitioners' information. It is for user's reference only. Please call before visiting doctor to confirm the cost, service time, address and the kind of treatment and hormone they can provide.

List of Private Endocrinologists (Prescribe Hormonal Treatment)

Dr. Annie Kung
Tel: 2525 3331 / 2525 3335
Address: Suite 709, 7/F, Central Building, 1-3 Pedder Street, Central, Hong Kong
Web: https://www.edr.hk/doctor/info/kung-wai-chee-annie

Dr. Ting Zhao Wei Rose
Tel: 2997 6328
Mobile+WhatsApp: 9317 1882
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Address: Room 1408, 14/F, Argyle Centre Phase 1, 688 Nathan Road, Mongkok, Kowloon
By Appointment

Dr. Lau Wing Yan
Tel: 25364368 (Consultation By Appointment)
Email：This email address is being protected from spambots. You need JavaScript enabled to view it.
Address: Suite1428, 14/F, Ocean Centre, Harbour City, 5 Canton Road, Tsim Sha Tsui Hong Kong
Web: https://www.edr.hk/doctor/info/lau-wing-yan
Reference Charge (excluding prescription):
First appointment HK$800-1200
After that HK$500-800

 

6. MTF Voice Surgery

Dr. Su Voice Beauty Clinic（Business closed）

http://www.voicebeautycenter.com/en

 

Far Eastern Voice Clinic

http://www.voicedoctor.tw/english

 

Kamol Cosmetic Hospital

Open Feminization Laryngoplasty: https://www.kamolhospital.com/en/Voice-Feminization.php

MTF Voice Feminization Training: https://www.kamolhospital.com/en/Voice-Feminization-Training.php

 


 7. Thailand SRS Information

Kamol Cosmetic Hospital

Website：https://www.kamolhospital.com/en

WIH International Hospital (Chettawut Plastic Surgery Center)

Website：https://www.wihhospital.com

Website：http://www.chet-plasticsurgery.com

Dr. Suporn's Clinic

Website：https://supornclinic.com

Dr. Pichet Rodchareon M.D.

Website：http://www.bangkokplasticsurgery.com

 

8. Useful Information

(The following information is provided by others and edited by TGR. Only for reference.)

 

Gossip Boys and Girls

 

Gossip Boys and Girls Book 1 – Domestic Transgender Reading Manual
(Chinese published on 11Feb2012)

 

Gossip Boys and Girls Book 2 – A Handbook for Parents of Trans People 
(Chinese published on 12Jan2015)

 

Gossip Boys and Girls Book 3 – A Handbook for Trans Ally 
(Chinese published on 8Mar2016)

 

Gossip Boys and Girls Book 4 – The Book of Transgender in Hong Kong
(English published on 8Feb2017)

 - An English version and summary of the previous 3 transgender booklets 

 

Gossip Boys and Girls Book 5 – TranStory 
(Chinese published on 31Jan2019; English published on 29Jul2019)

 

Please call 8203-2100 or email to This email address is being protected from spambots. You need JavaScript enabled to view it.  for copyright use.

 

The Genderbread Person Diagram

Information Source Website. TGR has been authorized by the author to use and translate the design and information of The Genderbread Person.
http://itspronouncedmetrosexual.com/

The Genderbread Person Diagram

 

Robyn Emerton, Faculty of Law, University of Hong Kong

Copyright Robyn Emerton to whom requests for reproduction and dissemination falling under copyright laws must be made

first uploaded 6/12/2002, minor revisions 21/2/03, 29/1/07 and 27/10/10

 

Note

This report discusses some of the main legal issues affecting Hong Kong based transsexuals (TSs) who have undergone sex reassignment or are in the process of doing so. It is a preliminary note, which will be expanded as I obtain more information about the issues which concern TSs in Hong Kong, further responses from the authorities about policies affecting Transgender people (TGs), and as I myself learn more about the law in this area (which is largely unchartered territory (1) ).

 

Introduction

Although transsexualism is recognised in Hong Kong and the government provides funding for sex reassignments through the Gender Reassignment Programme, the law still treats a TS who has completed sex reassignment according to his or her biological sex. This leaves TSs in a precarious position and causes them a whole host of problems in their daily lives.

TSs have won a number of legal cases around the world in recent years: for example, key cases have been won before the European Court of Human Rights and the courts in New Zealand and Australia, granting TSs legal recognition of their post-operative sex, including for the purpose of civil status, marriage, discrimination in employment and pension rights.

 

Identity

During the "real life" test, TSs in the Gender Reassignment Programme are given a letter to carry from their doctor/ psychiatrist explaining their position. After sex reassignment surgery, TSs usually wish to change their personal documentation to reflect their new identity. This is easier in some cases than in others:

Name: anyone wanting to change their name can do this by deed poll at a District Administration Office. However, the name on one’s birth certificate stays the same (and cannot be altered). 

Identity Card: TSs who have had sex reassignment may apply to the Immigration Department to have their identity card changed (2) . (In fact, the Immigration Department advised us that TSs have a legal duty to inform the office if they have had sex reassignment) (3) . Usually, a medical certificate and a sworn statement by the TS will be required to confirm the change of sex. A new identity card will be issued, showing the TS’s new first name, sex (which is represented by the symbol "M" or "F") and photograph. 

According to the Director for Immigration, 27 applications were received from TSs wishing to amend the details on their identity cards between January 1994 and June 2002. 12 of these applications were from MtF TSs, and 15 from FtM TSs. All applications were approved, and replacement identity cards issued (4) . One TS told us that the staff at the Immigration Department were very professional in handling her change of ID card, and that she felt little awkwardness during the procedure.

Birth certificate: under Hong Kong law, TSs cannot have their birth certificates amended after sex reassignment, unless it can be shown that there was a clerical error or error of fact when their sex was recorded at birth (5) (this might perhaps be possible if a TS could prove that his/her anatomical sex was determined incorrectly at birth, although we do not know of any cases where this has been shown). This has very serious consequences for TSs – despite having a sex reassignment, TSs will continue to be treated as their original biological sex for all purposes in law, as will become clear below.

Other personal documentation: on receipt of their new ID card, TSs can change other personal documentation, such as their driving licence, credit cards and bank accounts.

 

Freedom to pursue careers in cross gender role

Many Hong Kong TSs speak of discrimination and harassment in the workplace.

Hong Kong law provides special protection against discrimination and harassment in employment (as well as education, access to public premises and the provision of goods, services and facilities), where the discrimination is on the grounds of sex or disability (6) . This is under the Sex Discrimination Ordinance and Disability Discrimination Ordinance, which both apply to discrimination by private bodies as well as discrimination by the government and public authorities. Additional protection against discrimination by the government and public authorities is also afforded under the Bill of Rights Ordinance', which covers "discrimination on any ground, such as ... sex ... or other status" (7) . However, there have been no cases testing whether the courts would interpret these laws to apply to discrimination against TSs. The key issues which would be likely to arise are discussed below. 

SDO: the main test of discrimination in the Sex Discrimination Ordinance (SDO) is whether a woman is treated less favourably than a man on the ground of her sex (and vice-versa) (8) ; which is obviously not the pertinent issue when a TS is discriminated against simply for being a transsexual. It would be hard for the courts to stretch the current wording in the Ordinance to cover discrimination against TSs. 

BORO: the Bill of Rights Ordinance (which binds the government and public authorities, but not private bodies) refers to discrimination more broadly, including on the grounds of "sex … or other status". There are cases from other jurisdictions which have given a broad interpretation to discrimination on the grounds of sex, so as to include discrimination against transsexuals (9) . These cases might be persuasive if the Hong Kong courts were ever asked to determine this issue, however they would not be binding. 

DDO: it is also possible that discrimination against a TS could amount to discrimination on the grounds of disability for the purposes of the Disability Discrimination Ordinance (DDO). This defines "disability" very broadly, to include "disorders that affect a person's thought processes and emotions" (10) . If "gender identity disorder" was found to come within this definition, then discrimination – and harassment – against TSs in the workplace would be unlawful. This would cover discrimination in the recruitment process as well as during employment, for example in relation to training opportunities, promotions and dismissals. A recent case, which involved a TS who was excommunicated from the church which she had worshipped at for many years after she underwent sex reassignment (11) , was due to test this issue in the courts. However, the case settled before it reached the courts, so the question of whether discrimination against TSs would fall within the DDO remains unanswered. I am not aware of any precedents from any other countries on this point and whilst the DDO could provide some important legal protection for TSs, this line of argument does raise a dilemma, since it would involve arguing that transsexualism is a "disorder" and a "disability", with all the negative connotations that that brings with it.

 

Freedom to travel in cross gender role

Once a TG has received a new identity card, he or she can apply for a replacement Hong Kong SAR passport.

 

Freedom to marry according to gender identity

Under Hong Kong law, a marriage must be between a man and a woman (12). According to the Registrar of Births, Deaths and Marriages, this is determined by reference to a person’s original biological sex, as recorded in their birth certificate (13) . This means that TSs cannot legally marry according to their post-operative sex (14) , although, ironically (since same sex marriages are not permitted under Hong Kong law), a lesbian FtM or a gay MtF transsexual could marry someone of the same sex as their post-operative sex. 

It would in fact be possible for a marriage ceremony to take place in Hong Kong between a Hong Kong resident post-operative TS and his/her opposite sex partner. This is because Hong Kong residents need only show their identity cards, and not their birth certificates, in order to marry (and, as mentioned above, a post-operative TS can change the sex on his/her identity card). However, the marriage would be "null and void" in law (15) , that is, it would be treated as invalid from the start. In addition, a TS who marries someone in the full knowledge that the marriage is invalid under Hong Kong law commits an offence, which is punishable with up to 2 years’ imprisonment (16) .

 

Recognition of overseas marriages

Even where a Hong Kong citizen (whether the TS or non-TS partner) has contracted a valid marriage overseas, it seems that this marriage would not be legally recognised in Hong Kong. The courts have jurisdiction to hear cases regarding divorce, judicial separation etc. only in respect of "monogamous marriages" (17) , which are defined (if they took place outside Hong Kong) as marriages involving the "voluntary union for life of one man and one woman to the exclusion of all others" (18) . Given the discussion above, it can be expected that the words "man" and "woman" would be interpreted to refer to a TS’s original biological sex, with the effect that the Hong Kong courts would not have jurisdiction to hear cases concerning overseas marriages involving TSs. 

I am awaiting a response from the Registrar of Births, Deaths and Marriages to confirm the position, as well as from the Director of Immigration as to whether an overseas marriage involving TSs would be recognised for immigration purposes, where one of the parties to the marriage is not a Hong Kong citizen.

 

Freedom to raise children (either by previous relationship or by adoption)

There is no change in the legal status of TSs towards their children following sex reassignment. However, where the TS is separated or divorced from the other parent, it cannot be ruled out that their ex-partner might use the sex change as a reason for changing a custody or access order in relation to the children. 

It seems that a TS cannot adopt children in Hong Kong, whether those children have been put up for adoption, or are the children of his/her partner, unless he/she is married (19) . As discussed above, it is not possible for a TS to marry in their post-operative sex in Hong Kong, so that severely limits the opportunity for TSs to adopt after sex reassigment. I hope to confirm this with the Director of Social Welfare. 

I haven’t found out yet what the policy (if any) is towards artificial insemination of a woman married to a FtM transsexual, and would be grateful if anyone has any experience on this issue.

 

Other Legal Issues

There are a whole host of other legal issues which arise, some perhaps of more concern than others to the daily lives of TSs in Hong Kong. These include the following: 

  • On entering into a new insurance contract (e.g. life insurance, third party insurance) after sex reassignment, a TS must disclose his/her previous sex, otherwise the contract (which is classified as a contract of "utmost faith") will be invalid. 
  • Following sex reassignment, a TS may also need to notify the other party to any existing financial agreements (such as life insurance contracts, third party insurance contracts, mortgages, loans, guarantees etc.) of their change in sex, if the contract is worded in such a way that it will become invalid through non-disclosure of a change in personal circumstances. 
  • There are certain offences in the Crimes Ordinance which are defined by reference to the sex of the parties, for example, the offence of rape comprises a man having unlawful intercourse with a woman (20) . Although this has not been tested by the courts in Hong Kong, it is likely that a TS’s original biological sex would be used for the purposes of the criminal law, regardless of a sex reassignment (as has been the case in England) (21) . This would lead to a number of anomalies, whether the TS is the perpetrator or the victim of the crime.

 

Conclusion

There is obviously a long way to go in order to obtain legal recognition of the new sexual identity of post-operative TSs in Hong Kong, and with it, respect for TSs’ dignity, freedom and privacy. With the growing international trend towards improving TSs’ legal status, the time may now be ripe to raise the issue in Hong Kong.

 

Endnotes

(1) A brief summary of legal problems facing TSs is included in Ng, Wong, Chow et al "Transsexualism: Service and Problems in Hong Kong", Hong Kong Practitioner 11:12 (1989) 591, 599-600. This is the only published work I have been able to identify which deals with legal issues facing TSs in Hong Kong. 

(2) This is under the Registration of Persons Regulations (Cap 177A Laws of Hong Kong), Regulation 14(1)(a). 

(3) Registration of Persons Regulations, Regulation 18. 

(4) Letter to the author from the Director of Immigration, 7 August 2002. 

(5) Births and Deaths Registration Ordinance (Cap 184), section 27. 

(6) As well as family status, under the Family Status Discrimination Ordinance, although this is not relevant in the current context. 

(7) Article 22. 

(8) Sections 5 and 6. 

(9) For example, in the case of P v S and Cornwall County Council Case C-13/94 [1996] IRLR 347, which came before the European Court of Justice in 1996, it was held that the EC Equal Treatment Directive, which prohibits discrimination in employment "on the grounds of sex", should be interpreted broadly to include discrimination against transsexuals who are undergoing or have undergone sex reassignment surgery. 

(10) Section 2 of the Disability Discrimination Ordinance, Cap 487 Laws of Hong Kong. 

(11) "Sex-change Mormon sues church", South China Morning Post, 16 March 2001, p.3. 

(12) Marriage Ordinance (Cap 181), section 40. 

(13) Letter to the author, dated 7 August 2002. 

(14) This follows the UK case of Corbett v Corbett [1970] 2 All ER 33, which is technically binding on the Hong Kong courts, notwithstanding the fact that it has effectively been overruled by the landmark decision of the European Court of Human Rights in Christine Goodwin and I v the United Kingdom Government, No 28957/95 (1995) ECHR, which was handed down on 11 July 2002. In that case, the European Court held that the UK government’s failure to recognise the legal status of Ms Goodwin’s post-operative sex – including for the purposes of marriage – was a violation of the European Convention on Human Rights. 

(15) Section 20(1)(d) of the Matrimonial Causes Ordinance (Cap 179) states that a marriage will be void "if at the time of marriage, the parties are not respectively male and female". The Hong Kong courts would also be bound to follow the UK case of Corbett v Corbett [1970] 2 All ER 33, which held that a marriage between a TG who had undergone surgery before going through a ceremony of marriage with a male petitioner, was invalid, since the parties were biologically not of the opposite sex. The position was confirmed in the more recent UK case of Bellinger v Bellinger [2001] EWCA Civ 1140. 

(16) Marriage Ordinance, section 33. This covers circumstances in which a person "knowingly and wilfully" celebrates a marriage, knowing that he/she is not legally competent to marry. 

(17) Matrimonial Causes Ordinance (Cap 179), section 9. 

(18) Matrimonial Causes Ordinance, section 2. 

(19) See Adoption Ordinance (Cap 290), section 4. 

(20) Crimes Ordinance (Cap 200), section 118. 

(21) R v Tan and others (1983) 1 QB 1053.

 

2015 WHO: Sexual health, human rights and the law

Gender identity and expression

Being able to determine and express one’s gender identity without stigma, discrimination, exclusion and violence is an important dimension of health and well-being and the enjoyment of human rights. The possibility for people to live in accordance with their self-identified gender, in law and in fact, has a beneficial effect on their overall well-being, including being able to access health, social and other services. The respect, protection and fulfilment of human rights require that no one should be forced to undergo medical procedures, including gender-affirming surgery, sterilization or hormone therapy, or be forced to divorce, as a requirement for legal recognition of their gender identity and expression. A number of national laws that previously required such procedures for a change of identity have been challenged and modified, or new laws have been promulgated, to be in line with human rights standards.

Download Link

 

Hong Kong's Marriage Registration Procedures

According to the final judgement of the judicial review case of transsexual marriages, although Legco denies the second reading of the amendment of marriage bill, the government has made a communication, indicating that the immigration department has already amended certain administrative policies. For more information please read Q17:

http://www.immd.gov.hk/tc/faq/marriage-registration.html

 

Bills Committee on Marriage (Amendment) Bill 2014

Introduction: At the meeting of the Executive Council on 18 February 2014, the Council ADVISED and the Chief Executive ORDERED that the Marriage (Amendment) Bill 2014 (the Bill), at Annex A, should be introduced into the Legislative Council (LegCo) to implement the Court of Final Appeal (CFA)’s order in the case of W v the Registrar of Marriages (FACV 4/2012) (the W Case).

For more information about the meeting
http://www.legco.gov.hk/yr13-14/english/bc/bc52/general/bc52.htm

 

2012 UNDP: Lost in Transition: Transgender People, Rights and HIV Vulnerability in the Asia-Pacific Region

The ‘Lost in Transition: Transgender People, Rights and HIV Vulnerability in the Asia-Pacific Region’ report aims to provide a research and strategic information framework. It will guide governments, civil society, donors and key stakeholders to design and produce relevant research as part of collective effort to reduce the extreme vulnerability of transgender people to HIV, while protecting their rights in the Asia-Pacific Region.

Download Link

 

2012 WPATH: Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People

The World Professional Association for Transgender Health promotes the highest standards of health care for individuals through the articulation of Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People. The SOC are based on the best available science and expert professional consensus.

Download Link

 

2012 UN OHCHR: Born Free and Equal: Sexual Orientation and Gender Identity in International Human Rights Law

"Born Free and Equal" sets out the source and scope of some of the core legal obligations that States have to protect the human rights of lesbian, gay, bisexual and transgender (LGBT) people. The 60-page booklet is designed as a tool for States, to help them better understand the nature of their obligations and the steps required to meet them, as well as for civil society activists, human rights defenders and others seeking to hold Governments to account for breaches of international human rights law.

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2003 'Country report': Hong Kong, legal issues

English Content