Replies to LegCo questions
LCQ7: Gender identity disorder-related services provided by public hospitals
Following is a question by the Hon Chan Chi-chuen and a written reply by the
Acting Secretary for Food and Health, Professor Sophia Chan, in the Legislative
Council today (December 9):
Question:
At present, transgender people who wish to receive partial or full sex
reassignment surgery must first be assessed by the specialists and experts of
the various specialties concerned (including plastic surgery, psychiatry,
endocrinology, clinical psychology, etc.) to ascertain if they are suitable for
undergoing the surgery. The New Territories East Cluster under the Hospital
Authority (HA) announced earlier that from the current fiscal year onwards, the
Prince of Wales Hospital (PWH) under the cluster would provide one-stop medical
services for people with Gender Identity Disorder and those with Gender
Dysphoria (collectively known as "transgender medical services"). Starting from
October this year, PWH would reserve three operating theatre sessions for sex
reassignment surgery each month and would provide the relevant psychiatric and
endocrinology services later on. It is learnt that in the past, sex reassignment
surgery used to be performed mainly by a surgeon at the Ruttonjee Hospital, but
the surgeon retired in October this year. PWH has therefore arranged overseas
training for the doctors who will be responsible for performing this type of
surgery. Some transgender people have relayed to me that as there is a lack of
doctors with experience and qualifications in the relevant diagnoses in public
hospitals at present, and such medical services provided by PWH are still at
their early stage, they are worried that the waiting time for transgender
medical services will be rather long. In this connection, will the Government
inform this Council:
(1) whether it knows the number of attendances for transgender medical services
in public hospitals as well as the respective numbers of people who underwent
partial and full sex reassignment surgeries, in each of the past five years,
together with a tabular breakdown of the figures by hospital cluster and type of
sex reassignment (i.e. male to female conversion or vice versa);
(2) whether it knows the longest, shortest and average waiting times of new
cases for the various transgender medical services provided in public hospitals
at present (set out in a table);
(3) whether it knows the estimated number of patients to whom PWH can provide
transgender medical services in each of the coming five years; whether PWH will
provide medical services to the transgender people referred by public hospitals
in clusters other than the New Territories East;
(4) whether it knows the current number of healthcare personnel (with a
breakdown by specialty such as plastic surgery, psychiatry, endocrinology and
clinical psychology) in public hospitals with experience or qualifications in
transgender diagnoses; among such healthcare personnel, the number of doctors
working at PWH, and the number of those who will reach retirement age in the
coming five years;
(5) whether it knows the current number of healthcare personnel (with a
breakdown by specialty such as plastic surgery, psychiatry, endocrinology and
clinical psychology) in public hospitals who have received overseas training in
transgender medical services, and among them, the number of doctors working at
PWH; the number of healthcare personnel whom HA plans to send overseas to
receive training in this respect in the coming five years;
(6) given that pre-sex reassignment surgery psychiatric assessment services are
separately provided in various hospital clusters at present, whether it knows if
HA has any plans to centralise resources by designating PWH as the sole provider
of psychiatric assessment services for such type of cases across the territory;
if HA does, of the projected implementation time; if not, whether HA will
undertake to rationalise the assessment services in the coming year and put
forward feasible proposals; and
(7) as some transgender people have relayed to me that since they have given up
receiving sex reassignment surgery due to heath, family and personal reasons,
they are not permitted to change the sex entries on their identity cards, and
such situation has caused inconvenience to their lives, of the measures to be
formulated to help these people by the Inter-departmental Working Group on
Gender Recognition set up by the Government; the work progress of the Working
Group so far and its next course of action?
Reply:
President,
At present, the Hospital Authority (HA) provides preliminary assessment and
medical services for people with Gender Identity Disorder (GID) through its
psychiatric specialist out-patient (SOP) clinics in various clusters. In
general, psychological counselling services and drug treatment will be arranged
for GID patients according to their individual conditions, and some of these
patients may need to receive sex reassignment surgery (SRS) (commonly known as
"transsexual operation"). The Prince of Wales Hospital (PWH) started to receive
SRS (including male-to-female and female-to-male conversion) cases upon referral
in 2015/16, while the Ruttonjee Hospital (RH) continues to provide
male-to-female SRS service. The HA is planning to centralise the provision of
GID-related services at the PWH, and expects to commence the services in
2016/17.
My reply to the Hon Chan Chi-chuen's question is as follows:
(1) The breakdowns of the number of GID patients being followed up by
psychiatric specialist services and the respective number of persons who
underwent partial or full SRS in each of the past five years are at Annex 1 and
Annex 2 respectively.
(2) The HA has put in place an established triage system for new cases at the
psychiatric SOP clinics to ensure that patients with urgent healthcare needs are
given medical attention within a reasonable time. New cases received at the
psychiatric SOP clinics will be triaged into priority 1 (urgent), priority 2
(semi-urgent) and routine (stable) cases according to their severity and urgency
to ensure that more urgent and severe cases are followed up promptly.
The HA seeks to keep the median waiting time for first appointment at the
psychiatric SOP clinics for priority 1 and priority 2 cases within two and eight
weeks respectively. This performance pledge has been fulfilled. The waiting time
for new cases in non-urgent and stable condition is relatively longer as more
patients are under this category. The psychiatric SOP clinics under the HA do
not maintain a breakdown of the average waiting time of new cases of specific
diseases. In 2014/15, the median waiting time for first appointment at the
psychiatric SOP clinics for cases in stable condition was 22 weeks. If a
patient's mental condition changes before the appointment, he or she may request
the psychiatric SOP clinic concerned for re-assessment to determine whether
his/her original appointment should be advanced. Patients whose condition
drastically deteriorates or who require urgent medical attention may consider
seeking medical treatment from the accident and emergency department, and the HA
will provide suitable services for them according to their needs.
(3) As mentioned above, preliminary assessment and medical services are provided
for GID patients by the psychiatric SOP clinics in various HA clusters, while
SRSs are conducted at the PWH and the RH. The HA is planning to centralise the
provision of such services at the PWH, and expects to commence the services in
2016/17. In line with the service planning, the HA will ensure that sufficient
manpower is available at the PWH to cater for the needs of GID patients.
Appropriate adjustments will also be considered in the future taking into
account the changes in service needs.
(4) 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. Since the healthcare personnel of the multi-disciplinary team
provide medical services not only for GID patients, but also for patients
suffering from other diseases, the HA does not maintain statistics on the number
of healthcare personnel who provide treatment specifically for GID patients.
(5) The HA regularly arranges for the healthcare personnel to receive local and
overseas training in respect of the medical services they provide. With
commencement of the SRS service at the PWH in 2015/16, the HA also arranged
relevant local and overseas training for the healthcare personnel. For example,
arrangement was made for three surgeons of the PWH to receive overseas training
in SRS in 2015/16. The HA will continue to arrange such training in the light of
service development.
(6) As mentioned above, the HA is planning to centralise the provision of
GID-related services at the PWH, and expects to commence the services in
2016/17.
(7) The Government set up an Inter-departmental Working Group on Gender
Recognition (IWG), chaired by the Secretary for Justice, in mid-January 2014 to
consider legislation and incidental administrative measures that may be required
to protect the rights of transsexual persons in Hong Kong in all legal contexts,
and to make recommendations for reform as appropriate.
The IWG's remit covers a consideration of both recognition and post-recognition
issues. As regards recognition issues, the IWG is reviewing issues such as
various options for a gender recognition scheme, the qualification criteria and
the application procedure. As for post-recognition issues, the IWG is reviewing
all the existing legislative provisions and administrative measures in Hong Kong
which may be affected by legal gender recognition, so that any required
legislative or procedural reform can be followed-up by the Government.
The IWG has been meeting on a regular basis and is currently focusing on the
completion of a first-stage consultation paper to seek the views of the Hong
Kong public on recognition issues. This work includes a comparative study of
relevant laws in over 100 jurisdictions.
Ends/Wednesday, December 9, 2015
Issued at HKT 12:25
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