Replies to LegCo questions

LCQ22: Medical services provided for Gender Identity Disorders patients

Following is a question by the Hon Chan Chi-chuen and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (October 9):

Question:

Some overseas studies show that transgender people generally account for about 0.3 per cent of the adult population, and on the basis of this, the transgender community in Hong Kong estimates that there are about 18 700 transgender people in the city. At present transgender medical diagnosis services are provided only by two sex clinics in Hong Kong, located respectively in the Prince of Wales Hospital in Sha Tin and Castle Peak Hospital in Tuen Mun (the clinics). Some transgender people have pointed out that these clinics do not provide comprehensive diagnosis services, and it takes time to wait for consultation appointments. Moreover, as qualified doctors with relevant diagnosis experience will retire one after another in the next few years, some transgender people are worried about the succession problem. In this connection, will the Government inform this Council:

(a) of the number of attendances for medical services of transgender people at the aforesaid clinics in the past five years, and the average waiting time for new cases at present;

(b) of the current number of healthcare personnel (including plastic surgeons, psychiatrists and clinical psychologists) working at the aforesaid clinics who possess the experience or qualifications in transgender diagnosis and those who will retire in the coming five years;

(c) whether there is any plan to increase the resource input for training healthcare personnel with qualifications in transgender diagnosis; if so, of the number of healthcare personnel of various professions (including plastic surgeons, psychiatrists and clinical psychologists) who will receive training in the coming five years; if not, whether the Government will undertake to draw up contingency plans in the coming year to address the manpower shortage;

(d) whether no less than two clinics in public hospitals will be established to provide comprehensive transgender diagnosis services by healthcare personnel with relevant qualifications; and

(e) given the judgment handed down earlier by the Court of Final Appeal on the civil appeal filed by a transsexual regarding marriage registration and the court's recommendation that the legislature introduce legislation similar to the United Kingdom's Gender Recognition Act 2004 to set up a machinery for an expert panel to vet gender recognition claims and grant gender recognition certificates which recognise successful applicants in his/her new sex, whether the Government has worked out a roadmap and a timetable for setting up the machinery?

Reply:

President,

At present, the Hospital Authority (HA) provides medical services for people with Gender Identity Disorders (GID) through its psychiatric specialist outpatient (SOP) clinics in various clusters. In general, counselling services and treatment will be arranged for GID patients according to their individual conditions, and a small number of them may need to receive sex reassignment surgery (commonly known as "transsexual operation").

My reply to the various parts of the question is as follows:

(a) and (b) The psychiatric SOP clinics in various HA clusters provided medical services for a total of 95 persons with GID in 2012-13. The psychiatric SOP clinics will arrange medical appointments for new patients based on the urgency of their clinical conditions, which is determined with regard to the patients' clinical history and presenting symptoms. The date of medical appointment for different new patients therefore varies depending on the patient's actual clinical conditions. The psychiatric departments of the HA do not have a breakdown of the average waiting time of new cases of specific diseases. In 2012-13, the median waiting time for new cases of the psychiatric departments of the HA is seven weeks.

Since the number of cases of sex reassignment surgery is very small each year (around four to five cases per year in the past three years), at present, sex reassignment surgery is mainly performed at the Department of Surgery of Ruttonjee Hospital (RH). The only consultant surgeon responsible for sex reassignment surgery in the hospital will retire in 2015. Since the psychiatric SOP clinics in various HA clusters provide medical services not only to GID patients, but also patients suffering from other psychiatric diseases, HA does not maintain statistics on the number of healthcare personnel who provide treatment specifically for GID patients.

(c) and (d) To cater for the needs of GID patients for medical services, the HA has reviewed the existing service arrangements and is planning to rationalise its future services.

As the treatment of GID patients requires the involvement of a multi-disciplinary team which comprises professionals including psychiatrists, surgeons, endocrinologists, clinical psychologists and other allied health professionals, the HA plans to adopt the mode of a multi-disciplinary service centre in rationalising the relevant services. A service centre (the Centre) will be set up in Prince of Wales Hospital (PWH) under the New Territories East (NTE) cluster to co-ordinate various specialised services for GID patients.

Under this approach, whilst all other services will be provided by the Centre, surgery services will be provided at both the Centre and RH. PWH will provide surgery service for conversion between two sexes and RH will continue to provide sex re-assignment surgery for male to female conversion. The arrangement is to build on the expertise and experience already developed at RH over the years as well as to help share the volume of male to female re-assignment surgery in the NTE cluster.

HA has formed a Task Force with members from the management, concerned clinical and allied health disciplines in September 2013 to look into the service re-organisation. HA is identifying potential candidates of the multi-disciplinary team to provide the services and will bid for the necessary additional resources for service re-organisation through the annual planning exercise in 2015-16.

(e) The Hong Kong Government respects the judgment handed down by the Court of Final Appeal (CFA) in the case of "W" and the Security Bureau (SB) plans to follow up with the CFA's orders in this legislative year. Given the complex policy and legal issues involved in the recommendations mentioned in the judgment, the SB is working with relevant policy bureaux, departments and the Department of Justice on how best to follow up the matters.

Ends/Wednesday, October 9, 2013
Issued at HKT 16:36

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