Replies to LegCo questions

LCQ16: Intersex people

Following is a question by the Hon Emily Lau and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (March 2):

Question:

Some people who are concerned about the rights and interests of intersex persons (i.e. persons born with ambiguous external genitalia) have relayed to me that intersex persons have all along met with misunderstanding and discrimination because the public generally have very little knowledge about issues concerning intersex persons. In addition, intersex persons are unprotected in aspects such as law, healthcare, etc. For example, quite a number of intersex persons have undergone genital reconstructive surgery arranged by their parents to assign a sex to them when they were still in their childhood and unable to make an informed choice. In this connection, will the Executive Authorities inform this Council:

(1) whether they have established a database on intersex persons in Hong Kong, which includes the number of such persons as well as the number of cases in which such persons have undergone medical treatment and surgery, to facilitate a better understanding about their situations; if not, of the reasons for that;

(2) whether they have made regular contacts with intersex groups to listen to the problems they have encountered and the requests they make; if so, of the details; if not, the reasons for that; whether the authorities have drawn up plans to comprehensively protect the rights and interests of intersex persons; if so, of the details; if not, the reasons for that;

(3) whether they will introduce legislation to prohibit acts of discrimination against intersex persons, and prohibit unnecessary genital reconstructive surgery on intersex persons in their childhood; if so, of the details; if not, the reasons for that;

(4) whether intersex adults who have not undergone related sex reassignment surgery may apply for changing the sex stated on their identity documents under the existing legislation; if not, whether the authorities will help those intersex adults (irrespective of whether they have undergone genital reconstructive surgery in their childhood) who wish to change the sex stated on their identity documents to make their wish come true; if so, of the details; and

(5) whether intersex adults who wish to undergo sex reassignment surgery at public hospitals are required to first go through psychological assessments for a long period of time?

Reply:

President,

My reply to the question raised by the Hon Emily Lau is as follows:

(1) Intersex people generally refer to people with ambiguous genitalia, which are caused by many different underlying conditions, such as genetic or metabolic diseases. As it is not a specific disease, the Hospital Authority (HA) does not have relevant statistics.

According to the information provided by the Security Bureau (SB), the Immigration Department (ImmD) does not maintain statistics on intersex persons in Hong Kong.

(2) and (3) Under the coordination of the Constitutional and Mainland Affairs Bureau, the Advisory Group on Eliminating Discrimination against Sexual Minorities comprised members from the academic and business sectors, the sexual minority community and the Legislative Council. The advisory group submitted its report to the Government at the end of 2015. The work of the advisory group included a qualitative study with focus group discussions or one-to-one interviews with sexual minority participants conducted by a consultant to help ascertain whether sexual minorities are discriminated against in Hong Kong and, if so, their experience of discrimination in different domains; a desktop research on the experience in tackling discrimination on grounds of sexual orientation and gender identity in six selected jurisdictions; and listening to the views of stakeholder groups. In its report, the advisory group recommended strategies and measures in five areas including, inter alia, further study on the experience of legislative and non-legislative measures of other jurisdictions to inform future consultation regarding both legislative proposals and administrative measures to eliminate discrimination on grounds of sexual orientation and gender identity. In addition, the Equal Opportunities Commission also published a study report concerning the sexual minorities in January this year, which contained a recommendation to legislate against discrimination on the grounds of sexual orientation, gender identity and intersex status. The Government will study the two reports carefully and listen to the views of stakeholders in considering the way forward.

At present, the healthcare professionals of HA will discuss with the parents of the baby with ambiguous genitalia and assess the sex and the sexual function which the baby may develop in the future. The decision will be made with the agreement of the parents of the concerned baby. The factors to be taken into consideration include diagnostic results, masculinisation of external genitalia secondary to prenatal androgen exposure, response to exogenous androgen stimulation and sexual function and fertility potential.

(4) According to the information provided by SB, ImmD issued administrative guidelines for considering applications to change the sex entry on Hong Kong Identity Cards (HKICs) in April 2012. The guidelines were formulated according to the advice of relevant experts in HA and in consultation with the medical sector in Hong Kong. The guidelines provide that persons who have completed sex re-assignment surgery (SRS) may submit relevant supporting documents (including medical proof indicating the completion of SRS) following established procedures to support their applications for change of sex on their HKICs.

(5) HA adopts a multi-disciplinary approach in providing service to patients with Gender Identity Disorder (GID), with a team comprising psychiatrists, clinical psychologists, surgeons, gynaecologists, physicians, endocrinologists, occupational therapists and medical social workers. Psychiatrists and clinical psychologists establish the diagnosis of GID (including for intersex people with gender identity problems), assess the degree of severity and work together with the professional team to provide appropriate service according to patients' specific conditions, including psychotherapy, hormonal treatment and surgery.

Ends/Wednesday, March 2, 2016
Issued at HKT 15:11

NNNN