Transgender individuals in China face a profound challenge in accessing safe, affirming environments due to a cultural context in which traditional norms often overshadow recent strides in medical understanding and human rights protections. One of the most distressing manifestations of this issue is the practice of so-called “reversal therapy” in specialized “schools,” where minors and adults alike are subjected to coercive interventions intended to force the abandonment of their transgender identity [1-2]. Although the existence of these facilities is not universally acknowledged in official discourse, numerous firsthand accounts and advocacy reports reveal a pattern of abuse, manipulation, and violence that undermines the fundamental dignity of transgender people.
The operation of these “reversal therapy schools” relies heavily on familial and societal pressure. Many parents, motivated by fear of social stigma or misconceptions about gender variance, place their transgender children in these facilities under the misguided belief that their identity can be “corrected.” In some cases, parents are aided by school representatives who impersonate police officers or otherwise deceive the children into traveling under false pretenses. Upon arrival, individuals report being subjected to physical and verbal abuse intended to “retrain” them to conform to the gender assigned to them at birth. These experiences are especially harrowing for transgender women who have already undergone sex reassignment surgery, yet are still forced into environments designed to negate their affirmed identity [3].
Such practices stand in stark contrast to international medical consensus and human rights standards. The World Professional Association for Transgender Health has long maintained that any form of “conversion” or “reversal” therapy is not only ineffective but also detrimental to mental health. The World Health Organization has similarly recognized that attempts to classify gender nonconformity as a disorder are scientifically and ethically unfounded [4]. Despite these robust professional guidelines, the unfortunate persistence of these schools highlights a significant gap between global best practices and local realities. In China, a lack of formal legal protection for transgender individuals, coupled with culturally embedded transphobia, enables these institutions to operate with minimal oversight or accountability.
The physical and psychological ramifications of forced “reversal therapy” are severe. Survivors describe extended periods of isolation, physical assaults, and relentless verbal assaults intended to demean their gender identity. Many experience enduring trauma, leading to depression, anxiety disorders, and in extreme cases, self-harm or suicidal ideation. Beyond the immediate harm inflicted on individuals, this environment fosters a culture of silence and stigma, where transgender people are reluctant to seek help, even from mental health professionals. The long-term societal cost is incalculable, as these abuses fuel misunderstandings around gender diversity and entrench discrimination that extends to broader institutional and community settings.
Challenges to ending these practices stem from legal loopholes and cultural taboos surrounding discussions of sex, gender, and sexuality. Current legal frameworks in China offer limited specific protections for transgender individuals, and there is often ambiguity over whether existing anti-discrimination statutes apply to gender identity. Family structures and the high value placed on conformity can discourage survivors from speaking out, fearing reprisal from their relatives or community. Media outlets may be reluctant to feature in-depth coverage of a topic considered sensitive, thereby stifling public scrutiny and reducing awareness of the issue. As a consequence, these schools can continue their operations, often cloaked in secrecy and fueled by the misapprehension that they provide an appropriate solution to parental or societal concerns.
Nonetheless, the tide may be turning. Advocates within China, including LGBTQ+ rights organizations and a small but growing number of healthcare providers, are increasingly vocal about promoting evidence-based mental health care. These advocates emphasize the importance of family counseling and community support as alternatives to coercive practices. International organizations and academic institutions also play a vital role by collaborating with local partners to conduct research, offer clinical guidance, and facilitate awareness campaigns. Such collaborations, grounded in cultural sensitivity and medical best practices, can dismantle the stigma that drives families to pursue harmful interventions.
Greater international engagement is critical. Heightened scrutiny from global health institutions, increased visibility in academic forums, can facilitate the development of legal protections and policy reforms. A sustained focus from medical journals and professional associations—ranging from formal statements condemning “reversal therapy” to the promotion of guidelines supporting transgender healthcare—can expedite the implementation of reforms and embolden activists on the ground. Moreover, international support can help generate robust data on the prevalence and nature of these schools, adding an empirical foundation to advocacy efforts.
The struggles faced by transgender people in China are deeply intertwined with broader questions of cultural norms and individual rights, yet they exemplify a universal truth: no one should be subjected to physical or psychological harm for expressing their authentic gender identity. An environment that tolerates such violations not only undermines the wellbeing of its most vulnerable citizens but also stands at odds with global commitments to health equity and human rights. Addressing this crisis demands a multifaceted approach that prioritizes survivor support, legal and policy reform, and a shift in public perception through education.
Ending the practice of forced “reversal therapy” in China requires collective dedication from government authorities, healthcare professionals, civil society, and international partners.By amplifying the experiences of survivors, advocating for stronger legal protections, and reinforcing medical consensus against harmful, archaic practices, we take one essential step toward ensuring the safety and dignity of transgender people in China and around the world.
