Transsexuals should not get new ID card until after surgery
As a medical doctor, I am perturbed by the recent controversy on the Marriage (Amendment) Bill and transsexualism.
I think that many people are bewildered by the different terms involved.
Gender identity disorder, also known as transsexualism, is a distinct clinical entity and should be distinguished from intersex (hermathroditism), male and female homosexuality as the etiologies, clinical presentations and management of these conditions are totally different.
Transgender is an umbrella term that describes people who identify as, or present themselves as, other than the gender they were assigned at birth and can be due to different causes.
The local incidence of gender identity disorder is estimated to be 200 to 400. The diagnosis can be difficult and requires a long period of follow-up, including at least one year of opposite gender role play.
The patients have to be treated by a psychiatrist, clinical psychologist, endocrinologist, gender reassignment surgeon, speech therapist, counsellor and specialised nurse. The facilities for the management of such a patient are grossly inadequate in Hong Kong and more resources should be allocated to address the needs of these patients. It is estimated that at least 10 to 60 per cent of them suffer from personality disorders, suicidal tendencies, drug abuse and depression.
I strongly disagree with the idea that the Marriage(Amendment) Bill is a gross violation of the human rights of such patients. Because of their psychological desire to change to the opposite sex, these patients often long for gender reassignment surgery but the waiting time for such surgery is long.
In many Western countries, such patients do not have to undergo surgery before they can obtain legal documents of the opposite sex but such a practice has given rise to social disruption. There is a famous case in the US where a "so-called" female entered a female dressing room and exposed his male genitalia to other users there and this led to a court case. The verdict of the court was that this transsexual "female" had the right to use the female dressing room and this created widespread public criticism.
I think that gender reassignment surgery is a definite prerequisite for patients with proven gender identity disorders before they can obtain a new identity card of the opposite sex. The public should be widely consulted before the Legislative Council and the government pass the bill and decide how to help these patients.
Dr Robert Yuen, Yau Yat Chuen