Study Highlights Differences and Challenges in Gender-Affirming Care Among Transgender Adults in Hong Kong
Overview of Gender-Affirming Care Utilization in Hong Kong
A recent retrospective review examined the profiles and healthcare experiences of transgender adults attending a Gender Identity Clinic in Hong Kong over a six-year period. The study analyzed medical records of 609 individuals referred for gender-affirming interventions between November 2016 and December 2022, focusing on differences between those assigned male at birth (AMAB) and assigned female at birth (AFAB).
Key Findings on Demographics and Mental Health
Among the participants, 349 were AMAB and 260 were AFAB. Over half (51.6%) had attained tertiary education or higher; however, the overall unemployment rate was notably elevated at 16.4%, suggesting economic challenges within this population.
Compared to AFAB individuals, AMAB were generally older at the time of referral and more frequently reported unemployment. Marital status also differed, with AMAB more likely to be married or divorced.
Mental health conditions were more prevalent among AMAB, with 31.5% having psychiatric comorbidities versus 24.2% in AFAB. Notably, autism spectrum disorder and histories of suicide attempts were more common in the AMAB group.
Gender-Affirming Intervention Requests and Service Barriers
Requests for gender-affirming surgeries varied significantly: 73.4% of AFAB individuals sought surgical interventions compared to 56.2% of AMAB. The study also documented a substantial increase in waiting times for endocrine assessments, rising from approximately 105 days in 2017 and earlier to over 400 days by 2022. This reflects growing demand that current services are struggling to meet.
Barriers to accessing gender-affirming surgeries primarily involved prolonged waiting periods for appointments. Additionally, four AMAB individuals reported regret following feminizing genital reconstructive surgery.
Suicide Risk and Service Implications
Tragically, the review identified three deaths by suicide among patients awaiting care—two AMAB and one AFAB—highlighting the vulnerability of this community during periods of delayed treatment.
Implications for Healthcare Access
The findings underscore important differences in sociodemographic profiles, mental health status, and treatment preferences between AMAB and AFAB transgender adults. The extended wait times and unmet demand for gender-affirming care point to a critical need for improved, equitable access to these medically necessary services, with particular attention to the needs of AMAB individuals.
Study Limitations and Considerations
As a retrospective review based on medical records from a single clinic, the findings may not represent all transgender individuals in Hong Kong or other regions. The study identifies associations but does not establish causation regarding mental health outcomes or service barriers.
For more detailed information, the full study is available at PubMed.
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