I disagree with this article, but not for the reason you might think.
The right of people to marry should not be restricted for anatomical reasons, so let’s get that out of the way.
Had this article used the term transgender, rather than transsexual, I’d have had no problem with it. But when the title, “Sex-change surgery requirements for transsexuals constitute torture”, it is doing real harm to those who need SRS/GRS. What is the harm? In the mind of the general public, it makes such surgery seem less desirable and therefore reduces support for its inclusion in healthcare plans.
The problem exists for several reasons. The first is that the medical community has only designated an overly broad broad definition, gender dysphoria syndrome. The same definition is applied to those whose dysphoria produces a need to rectify their anatomical appearance and functionality, as well as those who don’t have such a need.
The second major reason is that as what had been strictly a medical issue, became, more and more, a social/political issue, the term transsexual was heard less and less and was supplanted by the broader umbrella term, transgender. Within that larger group, the proportion of those who need reassignment surgery, was reduced. Umbrella groups are notoriously poor multitaskers. They are, however great at prioritizing and the highest priorities always go to the needs of the largest segment of those under the umbrella.
Want examples? Why, under the LGBT umbrella, were no transgender issues (including healthcare) addressed until after marriage equality gained traction? Having the government officially recognize relationships that were already legal, was more important that potentially life saving transgender healthcare? Really? Under the transgender umbrella, issues of public accommodation and documentation have been aggressively pursued. Have you heard anyone voice the idea that exclusion of reassignment surgery from national healthcare plans is no more constitutional than refusing treatment for Sickle Cell or Tay-Sachs? No? I didn’t think so.
I realize that in all social/political movements, the objective is to satisfy the greatest number of those included in the group, so I am speaking out for those I most closely identify with and will continue to do so, anytime I see an article, that makes obtaining reassignment surgery more difficult for those who need it, by reducing its importance to those who need it, in the public’s mind.
The failure of the government last month to push the Marriage (Amendment) Bill through the Legislative Council hardly counts as a victory for those opposing it. After all, the bill is due to be tabled at the next legislative session. It is not clear that, when the votes are cast, it will be rejected.
Hong Kong could soon enact legislation requiring that transsexual persons wanting to marry their loved ones must first of all undergo sterilisation and genital reconstructive surgery.
Meanwhile, pending legislation, from last month the government has started allowing transsexual people who have undergone such surgery to marry in their chosen sex. This follows a Court of Final Appeal decision last year allowing “W”, who has undergone a sex-change operation, to marry her boyfriend.
For years transsexual people have had to undergo this surgery to get an identity card that matches their experienced gender. The new ID card safeguards their privacy, dignity and equal treatment in their daily affairs, whether they are applying for a job, opening a bank account, signing a lease, or even picking up a parcel from a post office.
The top court’s judgment has secured for transsexual people the right to marry. That is a step forward. But the same onerous surgical requirements are being imposed there too.
Driven by a conservative Christian lobby, the government continues to ignore expert evidence that surgery is medically unnecessary for some transsexual people, and medically inadvisable for others. Instead it continues to require that transsexual people (even those who simply seek a new ID card) to have their insides ripped out and their body parts rearranged, and that they show a medical certificate to prove it. We hear a lot nowadays about small government. But this is government so small it gets inside your underwear to check what you’ve got.
For transsexual men (those identifying as male) the surgical requirements imposed (and envisaged in the bill) are particularly onerous. The surgery demands several operations, and is beset with complications. The results are often unsatisfactory in appearance and/or function. Many people just can’t spare the time they will need for recovery and convalescence.
The government knows the problems, and, in a cynical effort at flexibility, says it is willing to accept anything counting as “some form of penis”.
Authoritative voices in health, including the American Psychological Association and the World Professional Association for Transgender Health, have spoken out against requirements such as those currently imposed by the Hong Kong government, and which would become law if the bill is passed.
In June, as the bills committee was wrapping up its work, two of the world’s most influential health organisations spoke out too. The World Health Organisation (and six other United Nations agencies) issued a 28 page inter-agency statement rejecting the practice of forced, coercive and otherwise involuntary sterilisation, including when perpetrated upon transsexual people.
The statement calls on all member states to “ensure that sterilisation, or procedures resulting in infertility, is not a prerequisite for legal recognition of preferred sex/gender”. It points out that such requirements “run counter to respect for bodily integrity, self-determination and human dignity, and can cause and perpetuate discrimination”.
The American Medical Association went even further, opposing the imposition of any kind of surgical requirements (not just sterilisation) as preconditions for gender recognition.
A system that withholds rights from people until they have undergone a medical treatment (one for which they may have no medical need, or for which they may be unsuited) is a system that is coercive. It makes the medical treatment involved coercive too.
In a system like that, it is nonsense to suggest people can consent freely to their medical treatment. As the UN special rapporteur on torture, Juan Méndez, recently said: “Medical treatments of an intrusive and irreversible nature, when lacking a therapeutic purpose, may constitute torture or ill-treatment when enforced or administered without the free and informed consent of the person concerned.”
The Secretary for Security tells us his legal advisers have assured him that his marriage amendment bill does not violate the rights of transsexual people. Doubtless they are the same advisers who gave him a thumbs up on his refusal to allow “W” to marry. And we all know how that ended.
There is an urgent need for a judicial review of those practices. As for the bill due to revisit Legco in October, it could reasonably be named the Transsexual Torture Bill. Let’s hope Legco members see it for what it is.
Sam Winter is a member of the board of directors of the World Professional Association for Transgender Health, and an associate professor at the University of Hong Kong
via Sex-change surgery requirements for transsexuals constitute torture | South China Morning Post.