UPDATED on Dec. 6, 2024 at 11:42 am ET.
Read coverage of this story in Chinese
A transgender woman in China who won an unprecedented compensation payout after being subjected to electroshock ‘conversion’ therapy in a psychiatric hospital where she said she was held against her will.
The woman, known only by her nickname Ling Er for fear of reprisals, recently made headlines after winning 60,000 yuan (US$8,300) in compensation in connection with illegally administered electroconvulsive therapy inside the Qinhuangdao No. 5 Hospital in the northern province of Hebei.
Ling Er told RFA Mandarin in a recent interview that she was held there for 97 days from July 2022 and subjected to seven sessions of electroconvulsive therapy, which is only permitted in China for patients who are severely depressed, bipolar, or who need emergency treatment due to suicidal tendencies, and when medication is ineffective.
The Changli County People’s Court in Qinhuangdao heard the case in August, and the payment was made as part of an out-of-court settlement.
Ling Er said she was diagnosed by doctors in the hospital with “anxiety disorder” and “ego-dystonic sexual orientation” and held there against her will.
“The hospital adopted a closed management policy, so I couldn’t come and go through their metal gates,” she said. “I was taking psychiatric drugs, but I wasn’t mentally ill.”
Ling Er said her anxiety was entirely linked to society’s attitude to her transition, and that her parents had sent her to the hospital after she came out to them as transgender.
“I found that my anxiety didn’t improve at all after I was discharged from the hospital,” Ling Er told RFA Mandarin. “In fact, it became more severe and more painful.”
Learned about gender transition in college
Ling Er was assigned male at birth but had never enjoyed the company of boys, and sought out girls instead.
But she didn’t learn about gender transitions until her first year of college, initially believing it to be something she wanted to suppress in herself.
Later, she came to believe that the only way to alleviate her suffering and to avoid gender confusion was to allow herself to be who she was, and to “become one with her,” she said.
After graduating, Ling Er worked as a beauty live-streamer, but was unable to make a regular income, even living on the streets for several months. Yet her appearance meant that she was turned down repeatedly when applying for jobs.
China officially stopped regarding transgender as a mental illness from 2018, in keeping with World Health Organization, or WHO, guidelines. All levels of medical institutions are advised to adopt the latest version of International Classification of Diseases, or ICD-11 for diagnoses.
However, as of 2022, official guidelines from the National Health Commission, China’s health ministry, still reference “transsexualism,” an outdated term dropped by the WHO in favor of “gender incongruence.”
The new term reflects the view that trans-related and gender diverse identities aren’t forms of mental ill-health, while ensuring transgender people’s access to gender-affirming health care, according to the WHO’s official website.
Yet Ling Er’s experience suggests that some medical professionals in China still regard transgender people as having a “disorder.”
According to her medical records, Ling’er prescribed the anti-anxiety medication lorazepam, as well as tandospirone citrate, indicated for patients suffering from health problems believed by doctors to be “psychosomatic.”
Her notes show that doctors thought she showed signs of an “antisocial personality disorder,” and was “manipulative and deceptive.”
She also underwent relaxation and mindfulness sessions, therapy and meditation. But doctors appear to have believed she needed a more aggressive approach, carrying out seven treatments of electroconvulsive therapy between August and September 2022.
U.S.-based LGBTQ+ advocate Chen Junmi, who has edited a guide for LGBTQ+ survivors of “conversion therapies,” said the court had stopped short of ruling that the hospital had violated Ling Er’s rights, however.
But he hailed the settlement as a victory for the LGBTQ+ community, which has been increasingly targeted for “stability maintenance” under ruling Chinese Communist Party leader Xi Jinping.
“Most importantly, it shows the Chinese trans community that it’s possible to try to stand up for their rights via the law,” Chen said.
‘Conversion therapy’
Ling Er’s case is far from being unusual.
A 2023 study in the journal Nature Mental Health showed that out of 7,576 trans people in mainland China, 2.8% had received some form of “conversion therapy,” whether formally or informally.
Some 16% were under the age of 17 at the time of the “treatment,” 61% were between 18 and 24, and around 23% were over 25.
Many reported depression, anxiety, post-traumatic stress disorder, and suicidal tendencies linked to this “treatment.”
A 2017 poll by the Beijing LGBT Center showed that more than 90% of the 1,640 trans people surveyed had experienced violence from their family of origin, while nearly 12% had been forcibly subjected to “conversion therapy,”
Darius Longarino, a senior fellow at the Tsai Center for China Studies at Yale Law School, said Ling Er’s case was the first positive development since the COVID-19 pandemic hit in 2019, and is the third case to be brought successfully against “conversion therapy,” which he described as harmful and fraudulent.
He said some parents of LGBTQ+ youth send them off to military-style camps aimed at any young people who are seen as troubled.
“They’re not psychiatric hospitals, the people who work there are not medical professionals,” Longarino told RFA Mandarin in a recent interview. “It’s more like a place where parents send youth that they think are having some kind of problem broadly defined, like they’re addicted to video games or aren’t doing well in school.”
“And this is the kind of place to instill discipline into them through a kind of military style way of living.”
He said young people would often called LGBTQ+ helplines and beg for help to escape the camps.
“It’s anecdotal evidence that this is pretty common,” Longarino said. “It’s also kind of abusive practice.”
He said the settlement in Ling Er’s case sent a strong message to hospitals and other institutions, many of whom may be tempted to cash in on families' distress over an LGBTQ+ child with a big bill for psychiatric treatment.
“Not only is it wrong if hospitals do these kinds of things, they can be held liable, they can be embarrassed in the media, they can be brought to court and they might even have to pay out money,” Longarino said. “You can sort of see a principle being established ... that these kinds of practices run afoul of the law.”
“[It’s] raising awareness that being trans is not a mental illness ... that [it’s] a natural part of humanity,” Longarino said.
Translated by Luisetta Mudie. Edited by Malcolm Foster.
Update corrects story to show that compensation derived from an out-of-court settlement, not a court judgment.
RELATED STORIES
China’s transgender ‘medicine girls’ can’t find the medicine they need
Chinese Communist Party continues crackdown on LGBTQ+ people
Calls grow for release of transgender activist held in Hong Kong