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China has one of the largest populations of transgender people in the world, it is estimated that over 400,000 people consider themselves to be trapped in the body of the wrong gender. However many of these individuals face an uphill struggle if they wish to undertake surgery for sexual reassignment.

And here she is, Zhang Kesha, who changed sex all those years ago in 1983.

The first sex change in China was carried out in 1983, so the technology has been available for a long time. The problem is that gender dysphoria is considered first and foremost to be a mental illness and unlike homosexuality it is unlikely that this stance will change soon.

This means that in the last 30 years, only 2,000 Chinese people have been able to become fully transsexual. In 2009, the government published fairly stringent regulations for anyone hoping to have surgery – some of these conditions seem reasonable given the severity of the surgery (it has to be noted that surgery does not seem to have a major impact on the long-term happiness of many transgender people, and the post-operative period is often one of depression and occasionally can lead to suicide) and others are seemingly arbitrary.

The main requirements of the policy are as follows:

  • The candidate must be over 20 years of age
  • The candidate must be unmarried
  • The candidate must be able to prove a long-term desire for sex change surgery
  • They must live as member of the opposite sex for five years before such surgery can be considered
  • They must undertake one year of therapy before they can undergo surgery
  • They must never have committed any criminal offence
  • They must receive permission from their local police bureau confirming that they have no objections to the candidate’s reassignment surgery and guaranteeing that the police will issue an ID card (Hukou) to the individual for their new gender

So China isn’t Thailand, and despite the fact that the country imports enormous numbers of Thai transsexuals to work as show girls – Chinese transsexuals have a much harder time being accepted into society.

There probably aren't enough transsexuals who've had surgery in China to hold a beauty pageant just yet - however this pageant in Thailand almost certainly has girls working in China by now.

However legislation is not all about barriers, unlike many countries in the West it is possible for a transsexual who has been through surgery to have new ID that matches their new gender. The first report of this actually happening was in 2008, according to the China Daily, when Ying Ning a male to female transsexual (who completed surgery in 2006) was awarded her hukou in Tianjin Province.

The final barrier to many of China’s transsexuals is that of money, gender reassignment is expensive (estimates are around 200,000 RMB) and many Chinese people simply cannot afford to have an operation of this nature. In a country where the average wage is 1,500 RMB a month, the average worker would need to go without food, clothes, a place to live, etc. for 11 years to be able to afford a sex change.