By VIOLET LAW, Associated Press

HONG KONG (AP) — Hong Kong’s High Court refused on Friday to allow three transgender men to be recognized as males on their official identity cards because they have not undergone full sex-change operations.

The ruling was seen as a blow to the fledgling LGBT movement in the semiautonomous Chinese city of 7.4 million people, which is preparing to host the 2022 Gay Games.

The three, identified as Henry Tse, Q and R, are shown on their ID cards as having been born female, but are undergoing hormone therapy. A full sex change would require the removal of female sexual organs, making them sterile.

Appearing in court, Tse unfurled a banner that read, “Forced Sterilization is cruel and inhumane. Recognize our Rights NOW!”

In his ruling, Judge Thomas Au wrote that “the change of gender entry stated in the ID card does not only concern the private right of the transgender person but also the wider public interest.”

Like many Asian societies, Hong Kong has become more open about gender issues, although the legal system is sometimes slow to follow.

Amnesty International called the judgment “a missed opportunity to address the discrimination transgender people in Hong Kong face.”

“No one should be forced to undergo gender affirming surgery in order to have their gender legally recognized,” Man-kei Tam, director of Amnesty International Hong Kong, said in a statement.

Friday’s decision follows a ruling last week by Japan’s Supreme Court upholding a law that effectively requires transgender people to be sterilized before they can have their gender changed on official documents. That ruling was widely denounced by human rights and LGBT activists and may spark further legal action.

Japan is one of many countries with a sterilization requirement. In 2017, the European Court of Human Rights said 22 of the countries under its jurisdiction still required sterilization as part of a legal gender change, and it ordered them to end the practice.

Maria Sjodin, deputy executive director of OutRight Action International, which monitors LGBT rights issues worldwide, said she was unsure if all 22 of those countries have fully implemented the court’s order.

In Hong Kong, the judgment seemed at odds with a 2013 ruling that allowed a transgender woman known as W to have her gender changed to female on her identity card. W had successfully sued in the city’s highest legal body, the Court of Final Appeal, for her right to marry her boyfriend.

Following that case, the city’s Equal Opportunities Commission recommended that the government drop the requirement for complete sex reassignment. The government in 2017 held a public consultation on whether the commission’s recommendations should adopted but has yet to release the findings.