Hong Kong medical profession remains in denial on coercive surgery for transgender people

It is now just over a year since the Legislative Council voted down the Marriage (Amendment) Bill, a bill that would have made sterilisation and genital construction a legal requirement for any transgender person intending to marry their loved one. The bill may have been defeated, but the policy is in place. The Immigration Department continues to demand such surgery as a precondition for issuing an identity card to a trans woman that will enable her to marry her fiancé, or to a trans man so that he can marry his fiancée.

The department website is very clear on what this surgery involves. For a trans woman, it is removal of the penis and testes, and construction of a vagina. For a trans man it is removal of the uterus and ovaries, and construction of a penis or "some form of penis". In effect, the government says to trans people: "You want the right to marry? You must give up rights over your own body, and your right to bear children".

Let me be clear on this. I am not arguing against genital surgery. Some trans people experience great distress about their genital anatomy; an anatomy that fails to match their deeply experienced sense of their gender. For them, genital surgery can be a medical necessity. But this is not the case for all trans people. 

Some are relatively comfortable with their genital anatomy. For them, genital surgery may be, in Hong Kong, more of a legal necessity; a way of getting an ID card that will enable them to lead a reasonably regular life. A way of being able to open a bank account without endless complications, of getting a job and a home without encountering prejudice, and of being able to marry the one they love.

As time passes, more authorities in the world of health and rights add their voices to the chorus calling for an end to gender recognition policies, like Hong Kong's, that impose medical preconditions. They include the Office of the High Commissioner for Human Rights, World Health Organisation, UN Development Programme, Amnesty International, Open Societies Foundation, World Professional Association for Transgender Health, World Association for Sexual Health and the American Medical Association.

And now, the World Medical Association (WMA), representing 10 million physicians and 102 national medical associations - including the Hong Kong Medical Association (HKMA) - has added its voice. Through a policy statement issued at its general assembly in Moscow on October 18, it has spoken in favour of the right of all transgender people to self-identification - without coercive treatment of any kind, including forced and coerced sterilisation.

Every organisation I have listed says it clearly: surgical requirements for legal gender recognition are in violation of basic rights (including to health) and may constitute coerced medical practices.