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'MTF' Alarm, Life Is Crueler Than Ever For Trans Women In China

Cast out by family, discriminated against by the state, shut off from the medication, China's "male-to-female" trans community is under immense pressure, as suicide rates rise and incomprehension continues to spread.

'MTF' Alarm, Life Is Crueler Than Ever For Trans Women In China

Shanghai Pride under the rain

shanghaipride via Instagram
Liang Yutong

BEIJING — Another MTF has committed suicide in China: born in June 2009, she was not yet 14. MTF is an acronym for "male-to-female," a term used by transgender women in China to identify themselves on online platforms.

Although the World Health Organisation announced in 2019 that "transgender" would be removed from the International Classification of Diseases, the transgender community in mainland China has had to continue to endure pressure and abuse from the state, society and families. Transgender women have a disproportionately high rate of suicide in China.

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One of the dangers that MTFs face is their medication being cut off. The drugs, including those containing oestrogen and anti-androgens, are the only way for the MTF community to maintain their femininity before undergoing gender affirming surgery. A number of trans women have openly shared their experiences of being deprived their medication, and being in constant fear of returning to a gender they do not belong to. This can lead to serious depression and other mental problems, that sometimes winds up with suicide.

Under the harsh restrictions on purchasing drugs in mainland China, MTFs often have to contact underground drug dealers, and that too often means being sold fake drugs. There was even a case reported of a transphobic man who deliberately sold high-priced fake drugs to MTFs, which caused dangerous side effects.

The Initium spoke with a transgender woman "Y," who preferred to remain anonymous. She buys medication from "authorized channels." Last year, she relied on her acquaintances to obtain a certified diagnosis of "transsexualism" from a hospital, and was able to buy oestrogen. Yet when she went back months later to renew her prescription, the doctor on duty refused.

Medications could be no longer prescribed

Y went to five other hospitals to try to get her medication. In talking to hospital staff, she learned that parents often report to authorities hospitals that prescribe hormones after finding out that their children are taking medication that has led to feminine features.

Hormonal drugs can no longer be sold across the internet.

Y can relate to this. After she went public with her desire to become a girl, her father broke all contact with her, and refused any financial support. After she attempted suicide, her mother joined a transgender family support group, and came to accept her daughter's choice.

Experts have drawn a link between suicide rates inside the MTF community and the release in November of "Prohibited List of Online Sales of Medicines" issued by the State Drug Administration of China. It states that some hormonal drugs can no longer be sold across the internet. At least 58 MTFs have committed suicide since the ban, a notable rise over the same period in previous years.

People attending Taipei Pride walk a giant rainbow flag up the stairs

Taipei Pride parade 2020


"Gender-correction" center

The main pressure that trans women face still comes within their own families.

There is a tragic but also typical story of a trans woman and her family: her parents tricked her to come home when she ran away from school, "promising" her to accept her as she is. But as soon as she arrived, she was sent to a "gender correction center" which uses methods such as electric shock, physical violence and even rape to "cure" people. Though criticized by state media, they are still not banned in China.

The story of Gelalei also reveals the difficulty for young trans who come from Chinese patriarchal families. She grew up in a military community dominated by macho rhetoric and discipline. After 20 years in the People's Liberation Army, her father had instilled in his "only son" the "masculinity" that the military requires.

But Gelalei always could not resist the feminine instincts. Confused, she once tried to search information about her situation in an outdated sex education book, which defined what she was feeling as "sexual perversion."

Only with the arrival of the internet in China did Gelalei finally discover there were other people like her in China, and began to seek gender affirming treatment. Still, abuse from her family led to a suicide attempt at the end of university. In the end, she started taking hormones after breaking off relations with her family and ultimately moving to Northern Europe to start a new chapter of her life: finally a life of who she is.

Why society exists

Even if she has the approval of her mother, Y finds that the plight of trans women is an endless struggle. She can finally exist as a woman, but the occasions in which she can be seen are constantly being reduced.

They have to communicate discreetly, or use codes.

Chinese universities have been growing ever more conservative in their attitudes towards sexual minorities, and Y read on social media platforms that many universities instituted official bans on sexual minority societies on campus in 2021. The prestigious Tsinghua University even punished students for putting up rainbow flags.

Y decided it was wise to continue to dress as a male.

Although Y is already a "woman" in terms of physical appearances, she would never consider going to a women's bathroom: as she she would want to cause panic among women, and give the trans community a 'bad' reputation.

It's not just the real world that is being squeezed, it's also the virtual spaces on the internet. Since 2014 with the "Clean Internet campaign," many online groups that serves as a gathering place for MTFs were blocked or shut down. Now they have to communicate discreetly, or use codes to replace "sensitive words," making it difficult of new generations of trans women to obtain useful information.

But the community is standing together. In a website that commemorates MTFs who have committed suicide, it wrote, "First of all we wish to live biologically, with food, clothing, shelter, and secondly we wish to live in dignity with our medication. There is the reason why society exists: for all people to live without fear."

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