Yesterday I started looking into trans acceptance and understanding in china. I came across articles about Jin Xing, china first trans clinic for minors (opened in 2021), China's laws regarding obtaining HRT or GRS (mostly western sources), searched Bilibili and Baidu (videos) using the terms 同志, 變性 and 跨性别 combing through the comments. Finally looking through the stories of trans people who visited or worked in china.
I was surprised to find lots of roadblocks for trans people attempting to get HRT, GRS, change there paperwork etc. For example if you want to obtain HRT in china as a trans women you must notify your family, get written acceptance, prove you have no criminal record and undergo psychological treatment. This leads to a lot of trans people getting HRT online. However as of 2022 estradiol and cyproterone where added to a list making it illegal to obtain online.
The comment sections of videos on the topic are pretty bad id say similar to transphobic comments left in videos in America. The stories of non passing trans people who traveled to china getting mocked, belittled or in some cases having the police called on them. All of this shocked me and due to the language barrier I attempted to look past some of the comments or dismiss some of the horror stories.
It appears to me that china is severely behind on Trans acceptance and that's why I'd like to open this up as a discussion on the matter as I am only one person who understands little mandarin or other Chinese dialects and would greatly appreciate any information on the matter.
It will happen only very slowly, because China is huge with a vast rural population and the government will not force faster cultural change in a way that leaves people thinking they're being pushed into accepting ideals they don't want, no matter how wrong those people may be.
It's going to happen generationally, via schools and media teaching each successive generation to be more accepting.
But on the bright side what that means is we won't see massive reactionary surges repealing progressive laws like we're currently seeing recently over trans rights in Florida or Roe v Wade across the U.S.
When China steps forward on progressive issues they might only be small infrequent steps, but it's the whole country stepping forward and there will be no stepping back.
It's frustrating when you compare it to Western standards, but when you consider that most of China are culturally conservative, the progressive movement is doing quite well for itself.
Is there an urban/rural divide as well as a generational one?
Yes.
LGBTQ+ people tend to try to start lives in the cities, where prevailing attitudes are more progressive, where there's a LGBTQ community and where there's better surveilance (which means more safety). You also improve your chances of getting signed off on sex reassignment or gender affirming surgeries if you're trans living in the cities, because the mental health impact of the social fallout from how your community will receive your change is a far smaller concern or eliminated entirely, and your family is less worried about getting stigmatized by their community (which is something that will affect them whether they support you or not) if nobody actually knows because you live far away and never visit home.
There isn't really 'human rights' so much as 'human needs'. People need to eat, and a government declaring in its constitution that people have the right to food doesn't validate that need any more than saying they don't have the right to food doesn't mean they don't need it. That's a cultural and ideological difference that's worth pointing out because liberals will say 'China literally has no human rights' as a gotcha when it's really just a technicality.
Another way to put it:
People have needs. Usually an unfulfilled need means death or unacceptable suffering.
Liberal democratic governments bestow human rights on individuals to validate people's needs, prohibiting themselves or anyone else from denying people those needs.
Democratic Centralism (or at least China specifically) bestows responsibilities on organs of government to ensure people's needs are met, requiring organs of government to provide for those needs.
So when you talk about someone's rights, that's things like the right to farm a certain plot of land, the right to build a house in your ancestral village, the right to demand a refund for a defective product. Meanwhile food, healthcare, shelter, life, liberty, pursuit of happiness are all needs, and when governments declare people have the 'right' to their needs, they're just creating an extra layer of rhetorical complexity that allows them to avoid taking responsibility.
Sorry for such a long tangent to your question; I just really wanted to point out that technicality. But yeah so taking your question to mean the needs of the poor rather than their rights, China has improved tremendously from the poverty alleiviation scheme. Being out as queer is trickier though, because the organ of government responsible for a lot of your needs is your home province, while as a queer person you almost definitely want to be living in the cities. Unless your home province is actually one of the cities, you're kind of under pressure not to rely on the state for help.
If you're queer in China you want to live in one of the cities, because the queer culture is there; it's more tolerant. Far more tolerant than the very conservative culture in most rural areas.
So if you're born in the countryside or a small town but want to live in a city like Shanghai, you need to find a job in Shanghai and then pay rent for your accomodation in Shanghai - which is expensive. But pursuing a career in the city away from your hometown and family is very much an 'opt-in' thing. You've got to do it by yourself.
If things go badly for you and you want to fall back on the social safety nets in place for you... those are in your hometown. The government will set you up with cheap housing and find you a job and vocational training if you need it and do an amazing job at getting you off rock bottom and back into a place where you're mentally, physically and financially capable of looking after yourself again.
But if the reason you left home is because you're queer and wanted to be in a community where you could be out, you essentially have to get back in the closet when you go home. You have to give up on that city community. That's a huge deterrent.
Of course it's important not to generalize the whole of rural China as an equivalent to the US bible belt. It's a massive, extremely culturally diverse country.