In the US they usually have you undergo a year of hair removal on the scrotum before the surgery. Did you have to go through that in China, if so I wonder what that process was like?

It is recommended but not necessary. It wasn’t even a year between my appointment for the surgery and the actual procedure, and because I was extremely anxious at the time and lacked the motivation to do anything, I didn’t get any hair removal treatments. Therefore, I have no experience with hair removal.

However, the doctor will manipulate the skin flap during the surgery to remove as much hair as possible and prevent hair growth inside the vagina. To my knowledge, no one who had surgery at the same hospital in the past year has reported vaginal hair growth, so I haven’t had any hair removal procedures.

I think my surgery was over $140,000 (but insurance paid for most of it

OH MY GOD

I had heard before that healthcare in the United States was very expensive (before insurance). This figure greatly shocked me.

The media in the West has publicized this deterioration, so I am somewhat aware of it from those headlines, for example there was a major LGBT+ center in China that was shut down by the government, and they arrested women for writing lesbian erotica and publishing it on the internet.

Yes, this is real. In fact, even earlier, in 2018, “MTF” and “药娘” (slang, literally meaning “girl by drugs”.) was blocked from searching on major Chinese platforms, and transgender forums in China were shut down. This prompted transgender people in China to flee to Twitter. (However, they don’t seem to like Reddit. btw I’ve never used Reddit before!)

However, I am deeply curious of what doctors in China think of gender dysphoria and gender transition - why do they think individuals seek this, on what basis is medicine so open to providing these surgeries to patients?

Honestly, I don’t know why either; perhaps only God knows.

Transgender healthcare in China relies so heavily on a handful of doctors. You can even find the list here. Millions of transgender people in China rely on these few individuals to obtain certificates proving their suitability for surgery, and on fewer than five doctors capable of performing SRS procedures. To my knowledge, most Chinese MtFs go to Thailand. Therefore, I would say that SRS in China is essentially a very privileged procedure.

In my personal opinion, the level of transgender healthcare in China is terrible. If you go through the formal channels, after a long and arduous observation period and confirmation of your parents’ opinions, the hospital will prescribe medication based on medical consensus from over a decade ago, with alarmingly low dosages. Almost everyone is a DIY HRT advocate, including myself. I have nearly six years of HRT experience and have never obtained a prescription, nor even considered going to the hospital to get one. My other SRS-ed friends also continue with DIY HRT.

However, paradoxically, because China has a well-developed black market for HRT, it’s actually quite easy for people to obtain hormone, as long as you don’t have an obsession with “obtaining a proper prescription.” At the same time, everyone is well aware of this, and SRS doesn’t require an HRT prescription (or even HRT experience).

I seem to have gone a bit off-topic. In short, doctors who are still willing to serve transgender people under these circumstances are generally compassionate towards transgender people, although there aren’t many such doctors in all of China. We transgenders in China also rely heavily on the community to determine HRT dosage, SRS preparation and recovery, and so on. Doctors actually play a relatively small role for us.

Therefore, I think that China’s transgender medical system is mostly learned by some trans-friendly doctors from Europe and the US, while the actual medical process is mostly completed by transgender people themselves.