Transgender people in China are driven to buy black market drugs and even attempt surgery on themselves due to widespread discrimination, according to a new report.

In China, trans people are classified as having a mental illness and gender-affirming surgeries require the consent of families, creating a major barrier in accessing safe treatment, according to human rights group Amnesty International in a report published today.

The prevalence of stigma, an 'alarming' lack of knowledge in the public health system and other restrictive eligibility requirements have driven young transgender men and women to seek unregulated and unsafe alternatives, researchers found.

A participant applies rainbow coloured facepaint before a 5.17 km run to mark the International Day Against Homophobia in a park in Beijing in May, 2018. Transgender people in China are forced to buy black market drugs and even attempt surgery on themselves due to widespread discrimination, according to human rights group Amnesty International.

'China is failing transgender people,' said Doriane Lau, China Researcher at Amnesty International.

'Discriminatory laws and policies have left many people feeling they have no choice but to risk their lives by performing extremely dangerous surgery on themselves and to seek unsafe hormone drugs on the black market,' Lau said.

Transgender people are 'invisible' in China, Amnesty said. They face entrenched discrimination at home, school, work and in the healthcare system.

There are no anti-discrimination laws protecting LGBTI communities in China.

The government has not released official statistics of the number of trans people in the country, or how many seek treatment.

Ran, one of the gender non-binary trans people interviewed by Amnesty, uses they/them pronouns. Above they are in a T-shirt that reads 'I am a transgender person, can you hug me?'

People take part in the LGBT parade in Hong Kong on November 6, 2015. Transgender people are 'invisible' in China, Amnesty said. They face entrenched discrimination at home, school, work and in the healthcare system

However, in 2017 a report stated that more than 1,000 people in the country had undergone gender-affirming surgery and 400,000 people were planning to do so.

Under China's Sex Reassignment Procedural Management Standards 2017, 'transsexual' people face a strict criteria before undergoing gender-affirming surgery.

In addition to familial consent, they must be older than 20, unmarried and have undergone psychological therapy for a year prior. They also have to demonstrate they've been wanting the surgery for five years 'with no history of hesitation.'

Two of the 15 trans people interviewed by Amnesty recalled their trauma after attempting surgery on themselves as a last resort.

Huiming, a transgender woman in her 30s, told researchers that she bought hormone drugs via the online black market while she was still in university.

Xiaomi, a self-described transgender, posing for a portrait in Shanghai in June, 2018. In China, trans people are classified as having a mental illness and gender-affirming surgeries require the consent of families, according to Amnesty

Accessing gender-affirming treatments at a hospital was not an option as she feared her family would reject her when she asked for their consent.

In 2016, she took the decision to attempt surgery on herself to get rid of her male genitals.

However, her attempt went wrong and and she was rushed to hospital. She asked the doctor to lie to her parents and say she had an accident.

'I thought I was an abnormal person. How could I explain this to my family? I was both happy and scared. I was scared because I was bleeding so badly, I could die right there.

'I feared I would still die a man, since I only did part of my surgery,' she said.

Huiming eventually travelled to Thailand for a gender-affirming surgery. Before the treatment, she came out as trans to her mother, who has now accepted her.

Other trans people told Amnesty of how they had little choice but to resort to buying hormone medication on social media chat groups, online shops and overseas surrogate shoppers.

Under China's Sex Reassignment Procedural Management Standards 2017, 'transsexual' people face a strict criteria before undergoing gender-affirming surgery (file photo)

Without knowing whether the drugs were genuine, or if they might cause harmful side effects, many experienced different levels of mood swings, with some even plunging into depression, with no medical supervision or access to a doctor to address these conditions.

Shanshan, a 21-year-old transgender female from Beijing, said she stared using hormones because she 'hated her male sex characteristics'.

'I couldn't tell if the drugs were authentic. I think there isn't anything lethal in these drugs … but what better options do I have?' she said.

According to Amnesty, Peking University Third hospital is the only multi-disciplinary clinic in China that specialises in a range of gender-affirming treatments. It only opened in September 2018.

'The authorities and medical profession must stop classifying transgender people as having a mental illness. The highly-restrictive requirements for accessing gender-affirming surgeries and lack of health-related information needs to change so people can access the health care they need,' Lau said.

In March, the Chinese government accepted recommendations by the UN human rights council to legislate to ban discrimination against LGBTI people.