Trans people are among the most vulnerable populations throughout Asia and the Pacific and face significant barriers in exercising their human rights, including their right to health.
Trans populations experience disproportionately high level of violence, discrimination, criminalisation and suicidality. Systematic social stigma limits trans people’s access to appropriate and sensitive mental health care. The lack of legal gender recognition of trans identities is a major contributing factor to the marginalisation and social exclusions of trans people – when you consider all the evidence together – it is clear we face an urgent health and human rights issue.
The Asia and Pacific region is vast and diverse and includes many different countries, cultures, traditions, languages, and policies and identities. A report published in 2012 estimates that there are at least 9 million trans people in Asia and the Pacific. Trans people throughout this region experience compounded discrimination that extends to many areas of their lives including employment, housing, and healthcare as well as persecution through laws that target trans populations, exposing them to increased discrimination and violence. The various policies regulating gender identity and society’s rigid conception of gender lead to impediments to changing identification cards, dress code laws, and so-called “impersonation” laws.
“There continues to be a great need to amend the policies and laws to be more inclusive of trans and gender nonconforming people”
In 2006, international organisations and human rights experts released the Yogyakarta Principles, international precepts describing the relationship between international jurisprudence and sexual orientation, gender identity, and sex characteristics (SOGISC). Principle 3 includes that the state shall “fully respect and legally recognise each person’s self-defined gender identity” and emphasises that legal recognition should be granted based on self-identity and not determined by medical procedures, official documents, or status. Although a decade has passed since the Yogyakarta Principles were released, many countries throughout Asia and the Pacific have policies that are extremely restrictive regarding legal gender recognition.
Among the countries that do have policies to amend gender markers, the vast majority require significant documentation, time commitment, money, and services that are difficult for the trans community to access. In Malaysia, the only way to gain access to legal gender recognition is through the courts, who in recent years have stated that there must be testimony on surgery and hormonal changes, among other things, requiring expensive expert testimonies and lawyers fees. Another such policy occurs in China, where family authorisation is required before gender-affirming surgeries can take place, which is itself a requirement for change of gender marker in China. Furthermore, accessing these services nearly always requires the intervention of a doctor of mental health provider and a diagnosis of “gender identity disorder”, “gender dysphoria”, or another disease or disorder.
Due to these, and similar, restrictions and obstacles throughout Asia and the Pacific the gender marker is difficult to amend. Trans rights advocates maintain that one’s gender marker should be based on self-determination rather than documentation. There continues to be a great need to amend the policies and laws to be more inclusive of trans and gender nonconforming people to ensure the state’s protection and human rights to all citizens regardless of their gender identity. Legal gender recognition is important in order to provide more equitable, socially conscious, and comprehensive care.
The Asia Pacific Transgender Network (APTN) works towards the inclusion, human rights, and protection of trans and gender nonconforming individuals. APTN works throughout Asia and the Pacific to advocate for trans-competent research, trans-led programming, comprehensive trans healthcare provision, and accessible, appropriate and equitable health services for the trans community. In 2015, APTN published the Blueprint for the Provision of Comprehensive Care for Trans People and Trans Communities in Asia and the Pacific (Trans Health Blueprint), designed to improve access to competent primary and specialised care for trans people.
This blog was published originally on the Study at SOAS website as part of a series on LGBTQI+ issues in Asia.