China's first medical guidelines on sex change surgery could require patients to gain police approval before the procedure, according to a posting on the Health Ministry's Web site.
The proposed guidelines, posted Tuesday, say candidates for surgery must show an agreement from police to change their sex on their identification cards once the procedure is complete.
The ministry posted the draft guidelines to invite public and professional opinions before July 10. China has no laws against sex change surgery, and the ministry says the guidelines are necessary to regulate the procedure.
One bioethicist at the Chinese Academy of Social Sciences, in an interview with state media, criticized the proposed requirements for police agreement and for patients to live openly in their desired gender for at least two years before surgery.
"As long as a person meets the physical and mental requirements, she or he should be granted the permit to have the surgery ... The police should change the sex of the receiver on the identity card accordingly," Qiu Renzhong told the official English-language China Daily newspaper in its report Wednesday.
Although attitudes about sex in China have become increasingly relaxed, especially in the big cities, the country remains a conservative society where sexual identity issues are not freely discussed.
Sex change surgery is one treatment available for gender identity disorder, a condition defined by strong feelings of discomfort with a person's sex at birth and identification with the opposite gender.
Experts estimate that nearly 2,000 Chinese have undergone sex change surgery while between 100,000 to 400,000 people are "considering it," the China Daily report said. It said no official statistics on transsexuals in China are available.
The World Professional Association for Transgender Health recommends that sex change surgery candidates undergo hormone therapy and counseling and live in their desired gender roles for at least a year before the procedure.
China's proposed guidelines also say candidates must show they have no record of criminal offenses and have told their immediate family that they are undergoing the operation. Patients also must be over 20, single, and have undergone psychological therapy for at least a year.