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New rules on safety of sex-change operations

SHANGHAI hospitals that perform sex-change operations said yesterday they are happy with draft guidelines from the Ministry of Health that are designed to provide oversight of the procedures.

Hospital officials said the new rules would help protect patients and doctors by providing formal regulation of the procedure for the first time.

The draft rule, which was released on Tuesday for public comment, requires surgery applicants to be single, at least 20 years old and to receive approval from a local police station, with a showing that the applicant has no criminal record.

The rules also require a psychiatrist's diagnosis that the applicant has a gender identity disorder and is free of mental illness. He or she must have wanted the surgery for at least five years and lived under the new gender role for at least two years.

Hospital vetting

The draft also imposes a threshold for hospitals performing the surgeries, allowing only those considered to be top-tier medical centers with plastic surgery departments operating for more than 10 years to offer the service. Qualifying hospitals also must have a medical ethics panel and show they have experienced surgeons and staff.

At least three local hospitals are now performing sex change operations. The No. 411 Hospital under the Chinese Navy does at least 100 every year, far more than the others: Changhai and Changzheng hospitals.

Local doctors practicing sex-change surgery welcomed the guidelines.

Proof of concern

"It means the government is concerned about the needs of these people and is regulating the practice to ensure their safety and to supervise medical practice," said Dr Zhao Yede, director of No. 411 hospital.

He said the draft is similar to recommendations published in the 1990s by Dr He Qinglian, considered the father of transgender surgery in China. Big domestic hospitals usually follow He's rules.

The No. 411 Hospital performed 166 sex-change surgeries last year, mostly on people in their 30s.

"We turn down thousands of people every year because they can't provide the proper documents or their personal situation is not suitable," said Zhao, one of He's students.

Zhao said that while big-city hospitals are usually strict with patient selection, "it is true that some small hospitals or clinics may carry out the surgery without strictly checking applicants in order to make money."

"There are doctors and clinics who overcharge patients who were refused by the big hospitals," Zhao said. "The new guideline can help prevent that."


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