Lost in transition: transpeople, transprejudice and pathology in Asia

Asia (particularly South and Southeast) is home to large numbers of transpeople: persons who are gender identity variant in that they present and identify in a gender other than that matching the gender assigned to them at birth. Many make a gender category transition early in life. Access to competent and transfriendly medical support services within the established health system is often difficult, and alternatives are risky. Regardless of physical transition, transpeople are often denied opportunities to change the gender recorded on key identification documents. The result is that transpeople wanting to live in stealth are frustrated in their attempts to do so. They become easy targets for transprejudice and discrimination, many being pushed towards work at society's margins (for example sex work). Where transpeople are denied the right to change documents specifying their legal gender status, they are also denied legal recognition for mixed-gender partnerships they enter into (i.e. the right to marry, as well as associated family rights, including adoption of children). Recent evidence suggests that psychiatry may exacerbate transprejudice by pathologising gender identity variance. The current debate in Western countries on de-pathologisation is therefore highly important for the future welfare of transpeople in Asia.