She sued over transgender 'conversion therapy', a first for China

Beijing: For years after coming out as transgender, Ling'er, an aspiring influencer in eastern China, struggled from heartbreak to heartbreak. Her family refused to accept her. When she tried to find an interim job to support herself, employers would not hire her.

And when her parents sent her to a hospital to try to change her gender identity, she was held there for three months, despite her repeated protests. She was forced to undergo treatment that included multiple rounds of electroshock therapy.

So when she later sued the hospital for subjecting her to unnecessary and unwanted treatment, she was not optimistic. Then the seemingly unthinkable happened: A court accepted her complaint, in China's first known lawsuit over so-called conversion therapy involving a transgender person. And the hospital agreed in October to pay her a sizable settlement.

"To me, this is a win. With this money, I can start my new life, and start my own business," said Ling'er, 28. "I can live my own life."

The case is a rare bright spot in the fight for LGBTQ+ rights in China. Ling'er's lawsuit was covered sympathetically by some mainstream Chinese news outlets, even as overall coverage of LGBTQ+ issues has diminished. That her lawsuit was accepted at all was a hard-won victory, her supporters said, in a country with no laws protecting LGBTQ+ people.

As China's leader, Xi Jinping, has overseen a crackdown on civil society, many LGBTQ+ advocacy groups have been forced to shut down and Pride celebrations have been canceled. Nationalist influencers have attacked LGBTQ+ activism as a hostile foreign force. People have been punished for displaying rainbow flags.

It is unclear whether the payout to Ling'er will have any effect on preventing future cases of conversion therapy, which has been widely discredited by medical experts. The hospital pressed for the exact terms of the settlement to be confidential, and it has not acknowledged wrongdoing.

Ling'er was initially reluctant even to file the lawsuit. "Sexual minorities in China have no guarantees," she said. "How could you possibly protect your rights?"

She was ultimately convinced by a group of LGBTQ+ advocates, in China and overseas, with whom she had connected online, and who helped her find lawyers. It was a support network that she could not have imagined finding in her rural, mountainous hometown in China's Hebei province.

Ling'er, who is using a chosen name, had known since childhood that she preferred spending time with girls, and she realized while studying at a vocational school that she was transgender. She eventually began taking estrogen and dressing in women's clothing. But when she came out to her parents in 2021, during a visit home, they said she was disgracing their family.

In 2022, Ling'er agreed to her parents' requests to see a psychiatrist at a hospital in the nearby city of Qinhuangdao, hoping it would appease them.

She explained to doctors at Qinhuangdao Jiulongshan Hospital that she did not think there was anything wrong with her gender identity, and that it was her parents who could not accept her. She acknowledged feeling anxious and depressed, but not to a serious extent. Hospital staff noted that she seemed clearheaded and spoke at a normal pace, medical and legal records show.

Even so, she was diagnosed with anxiety and "ego-dystonic sexual orientation." The term, which has generally referred to people who are unhappy with their sexual orientation, was dropped from the World Health Organization's official list of medical conditions in 2019, because of concerns that it contributed to discrimination against LGBTQ+ people and had been used as justification for conversion therapy.

Over Ling'er's protests, her mother had her involuntarily hospitalized.

She remained in the hospital for 97 days, despite repeatedly pleading to leave. She was given psychiatric medication and subjected to seven rounds of modified electroconvulsive therapy.

The doctors did not explicitly say that the electric shocks were intended to change her gender identity, Ling'er said, but they urged her to cut her hair short and wear men's clothing, and they made clear that they believed her transgender identity was wrong.

"The doctors didn't listen to anything I said," she said. "They thought I was sick, so I was sick."

Medical and private institutions offering "conversion therapy" are common in China, according to activists, because the stigma against transgender people is widespread.

The Chinese Society of Psychiatry removed homosexuality from its list of mental disorders in 2001, but it retained the ego-dystonic diagnosis, and it also continues to classify transgender individuals as having a mental illness. People are allowed to change their legal genders, but only if they undergo gender-affirming surgery and notify their families.

In two landmark lawsuits -- one concluded in 2014 and another in 2017 -- judges ordered clinics to compensate the plaintiffs, gay men who had been subjected to conversion therapy, noting that their rights had been violated. But previous court rulings are not binding precedents in Chinese law.

Authorities' continued classification of transgender people as mentally ill also makes it harder to build a legal case, said Chen Junmi, an LGBTQ+ rights activist in the United States who helped Ling'er bring her lawsuit.

When Ling'er was finally released from the hospital, she returned home to find that her parents had thrown away her clothes and makeup. At first, she tried to live as a man. But in September 2023, she decided to cut off her family and leave home.

For months, she drifted from city to city. She was turned away when she tried to find work as a server or caterer and at times slept on the street. Seeking solace, she connected with LGBTQ+ communities online, including Chen. In July, Ling'er sued the hospital. (Her lawyers also suggested suing her parents, but Ling'er said she could not bring herself to do that.)

The hospital denied any wrongdoing, arguing that Chinese law allows people with mental disorders to be hospitalized against their will with their families' consent, if they cannot consent on their own. The hospital could not be reached for comment.

The hospital initially offered only one-quarter of the 80,000 yuan ($11,000) that Ling'er had sought. But after months of negotiations, they reached a settlement that Ling'er said would allow her to start her own shop or street food stall, and to begin saving for gender-affirming surgery. She is now renting an apartment in the city of Tianjin, and she dreams of becoming an entertainer, playing instruments or chatting with viewers on livestream apps.

Ling'er said she thought she had won a favorable outcome in part because the judge overseeing the negotiations had been sympathetic to her.

"Her attitude toward me was: 'You are you. No one can change you,'" Ling'er said. "If all Chinese parents could be like that, our community's problems could be resolved very easily."

Chen said Chinese society has become more accepting of LGBTQ+ people. That has created room to keep pushing for change, even if explicit activism has largely been shut down.

"I think the government is learning too," Chen said.

Ling'er said she hoped to see legal protections for, and education about, diverse gender identities.

"My own strength is far from enough," she said. "We need all sisters to stand up and work together to improve the situation of transgender people in China."