Research and discussion paper

Perceptions of MtF Transgendered Persons and their Sexual Partners in Hong Kong: A  Study of Social, Emotional, and Cognitive Sources of Biases

 Mark King, Graduate Research Student, Division of Learning, Development and Diversity, Faculty of Education, University of Hong Kong, Pokfulam Road, Hong Kong.

posted 4/6/03

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A sample of 183 Hong Kong Chinese secondary school teachers completed a questionnaire comprising two sections: (a) basic personal and demographic data and (b) questions related to perceptions and attitudes towards MtF transgendered persons and their sexual partners. The questions covered seven areas of perceptions of transgender: (a) social; (b) perceived attitudes towards psychological / medical issues; (c) beliefs about social / medical issues; (d) beliefs about family history; (e) sexuality and sexual relationships; (f) physical; and (g) legal.

Questions regarding the perceptions of sexual partners of transgender related to: (a) HIV epidemiology; (b) perceived sexual behaviors; and (c) beliefs about sexual identity / orientation. The preliminary results indicate a significant level of negative attitudes and discriminatory behavior towards these groups.

When you meet a human being the first distinction you make is “male or female?” and you are accustomed to making the distinction with unhesitatin certainty.’ Sigmund Freud (1933:113)


The aim of this study is to examine perceptions of MtF transgendered persons and their sexual partners in Hong Kong, focusing on the overlapping social, emotional and cognitive sources of biases.  These related social and psychological biases were investigated as possible influences on attitudes and behaviors in relation to transgender identities.


The research instrument was designed and administered to examine Hong Kong people’s perceptions of MtF transgendered persons and their sexual partners.  A 30-item questionnaire was originally developed in English and translated into Chinese for eventual completion by respondents in either language. All items were presented in 5-point Likert Scale. The questionnaire was estimated to take five minutes to complete.

The respondents were requested to give the following personal information: 

(a)    basic personal data: Sex, Age, Marital Status

(b)   demographic data: Nationality, Ethnicity, Religion, Occupation, and Educational level.

 The questionnaire covered specific aspects of perception and attitudes regarding the “transgendered female” in the following seven areas:

(a) social: ability of others to view transgendered females as normative (interesting and intelligent people), the willingness to leave children alone with transgendered females, the willingness to work with an openly transgendered female, the willingness to have a sexual relationship or marry a transgendered female, attitudes towards choices for life partners for transgendered females. 

(b) perceived attitudes towards psychological / medical: in terms of mental disorders or diseases that require treatment, transgendered females desire to marry a man and be accepted as a female.

(c) beliefs about social / medical issues: in terms of transgendered females fitting into   gender and sexual categories not being viewed as pathological.

(d) beliefs about family history: in terms of abnormal or atypical parents, siblings and other relatives, income and educational levels, effect of relationship with transgendered female family member.

(e) sexuality and sexual relationships: related to sexual desire of transgendered females seeking to have perverted sex with men, having multiple and indiscriminant sex partners

(f) physical: related to attractiveness in comparison to biological women, acceptance as human being.

(g) legal: including issues of personal privacy, equal opportunity for employment and education, human rights and the ability to live free of stigmatization and discrimination, ability to change identity/travel documents, government-sponsored counseling, hormonal treatment and sex reassignment surgery, and issues related to marriage and the adoption of children.

The questionnaire also covered specific aspects of perceptions and attitudes regarding the sexual partners or “men sexually attracted to transgendered females” in the following areas: 

(a) beliefs about sexual identity / orientation: in terms of the self-identification, orientation, and ability to “love” another human being.

 (b) perceived sexual behaviors: in terms of the sexual attraction to MtF transgendered persons as a perversion, one being able to act out sexual fantasy like rape and sodomy.

 (c) HIV epidemiology:  sexual partners of MtF transgender AND biological women acting as vectors of HIV into the heterosexual population.


A note on terminology

The word for transgendered female or male-to-female (MtF) transgender universally used in Cantonese is ‘Yen Yiu’. The medical term of 'Yik Sing Je' (alter sex person) and 'Bing Sing Yen' (change sex person) are commonly known but seldom used except by “politically correct” members of the public or medical professionals. Although some people in Hong Kong may conflate transgender with “gay” or “sissy” identities, the term ‘Yen Yiu’ is widely recognized as a distinct entity. For the purposes of this questionnaire, ‘Yen Yiu’ was emphasized to mean male-to-female transgendered persons.

 There is no word that explicitly denotes “men sexually attracted to transgendered females” in English (except “Gynandromorphophiles”) or in Cantonese. For the purposes of this study, the phrase “men sexually attracted to MtF transgendered” was used to denote individuals.


The sample was opportunistic, consisting of secondary school teachers approached during the period of January 2003 to March 2003 who were willing to complete the questionnaire.



The results of this study reveal that a group of people who we assume are well educated, fairly tolerant and liberal, and whom we entrust with the enlightenment of our next generation were found to have a significant level of discriminatory perceptions and attitudes towards transgendered females and their sexual partners.

Among the 183 teachers, 54% thought that TG’s are mentally ill and need treatment, 16% thought that TG’s are promiscuous, also 54% thought that TG’s are likely to have diseases requiring treatment. Of the sample teachers, 45% would not be happy leaving their own children alone with a GID/TG individual, 16% thought that they should not be allowed around any children.

While 29% of the sample teachers rejected the idea that TG’s should be able to live without stigma or discrimination, 20% thought that TG’s should not be able to change their ID, and 13% rejected the idea that TG’s should have equal opportunities for education / employment.

In summary, a group that remains virtually invisible in Hong Kong seems to be highly stigmatized and marginalized by society. Such findings did not only reflect the negative social and cultural attitudes, but also revealed the likeliness of a significant lack of knowledge regarding atypical gender and sexual identities, behaviors and lives. Such assumptions are supported by the initial interviews mentioned previously that numerous Hong Kong people claimed to have never had a discussion about GID/TG identity outside of the context of GID/TG in Thailand (a very popular conception in Hong Kong). However, the term “Yen Yiu” commonly used by Hong Kong people in referring to GID/TG persons, to a certain extent reveals the negative attitudes towards GID/TG and shows very little knowledge of or compassion towards GID/TG identities.



There are a number of reasons why transgendered persons and their sexual partners in Hong Kong may be especially at risk for rejection, stigmatization, and ostracism within local Chinese society. The constellation of social, emotional and cognitive sources of biases is deeply ingrained into local consciousness and greatly influences perceptions of non-normative gender and sexual identities.

Arguably, this lack of knowledge in Hong Kong may be the result of the inadequacies in education. An in-depth study conducted by Lam (1997) on the sexual knowledge, attitudes and behaviors of secondary school pupils revealed a number of deficiencies in sex knowledge. Prior to Lams’ study, investigations in Hong Kong focused primarily on the biology of sexual behavior and were unable to provide a full picture of students’ knowledge, attitudes and behaviors related to sex. Dr. Lams’ study was designed comprehensively and covers the biology of sex, personal identity and self-concept, social issues related to human sexuality, deviant psychology, and other aspects of love, marriage, and parenting, as well as the implementation of HIV prevention education.

In the report, Lam specifically addresses the sex knowledge and sources of sex knowledge as areas for concern among educators. The main source of secondary schools students’ sex knowledge is the newspapers (54.1%) followed by TV and biology classes in school. More than 78% of students report reading pornographic material and 47.9% report watching pornographic videos, with 17.2% consumers of pornographic telephone lines. Since families in Hong Kong still consider sexuality a taboo subject, less than 20% of students speak to their parents about sex. Extrapolating on the perceptions and attitudes data, students acquiring knowledge from the mass media may have very limited knowledge about atypical gender identities and hold very negative views of GID/TG or any on-normative gender identity.

From the findings of Lam’s report, it is clear that students (61.2%) think sex education is necessary and desire a change in the sex education curriculum to include issues related to self-development. The most interesting topic for students’ inquiry is self-understanding (86.6 %) followed by personality development (82.2%) and development of self-concept (81.8%). Although a high percentage of students are knowledgeable about HIV related issues and the risk of unprotected sex, knowledge seems to have little impact on the attitudes towards condom use. From these findings it becomes apparent that secondary students are concerned with sexuality, self-identity and sexual behavior, but it is also apparent that the sex education curriculum has become inadequate to meet students’ needs, especially in the time of HIV/AIDS.

This research examines perceptions of Yen Yiu in terms of family history, psychological and social relationships, as well as legal and human rights. Social and legal institutions appear to have a significant lack of knowledge or understanding of transgender (or atypical gender/sexual identity) and may hold very negative views towards such individuals which in turn, may have a significant impact on the transgendered individual’s ability to seek treatment or on the impact of HIV prevention education.

Initial results of this research indicate a prevalence of stereotypical misrepresentations of transgender identity may be prevalent in Hong Kong. Since the establishment of the Gender Identity Team at Queen Mary’s Hospital in 1989, there have been both an increasing number of transgendered individuals requesting sex confirmation procedures be performed, and an increase in Hong Kong people’s awareness of a “transgendered identity”, mainly through the local media, but also information about transgendered identity in other Southeast Asian countries

The local conceptualization of transgender may also have been conflated with images and ideas of transgender from neighboring Southeast Asian nations, particularly Thailand, Malaysia, and Singapore (and to some degree, the Philippines, Korea, Indonesia, and India). Hong Kong people may also hold ethnocentric views about the possibility of transgendered people within the Chinese race. Numerous informants, although familiar with the linguistic conceptualization in Chinese, declared disbelief about transgendered people of Chinese origin.

Numerous studies have shown that social conformity is a value most widely upheld by Hong Kong people, and their sexual attitudes are strongly influenced by the ancient Chinese philosophies of Confucianism and Taoism. Confucian concepts stress the maintenance of social order by everyone conforming to the Rule of Heaven and remands collective uniformity in terms of ideas and behavior. (Ma, 1997, 2003). Taoism, derived chiefly from the book Tao-te Ching (Lao-Tse, 3rd century BC) advocates a contemplative life in accord with nature and a focus on the harmonious unity of heaven and earth.

This research study attempts to examine sources of biases that include linguistic conceptualizations, Eastern religious and cultural factors, as well as Western religious and medical constructs of transgender that may contribute to Hong Kong peoples’ attitudes towards transgendered persons and their sexual partners.

Language is basic to the cultural life of a people, and forms of linguistic expression give insights into ways of thinking. Linguistic determinism powerfully conditions the understanding of the transgender phenomena and may even govern thoughts, attitudes and behavior. In the Chinese language, things are thought of as concrete entities, and as such, ideas related to transgender may have little room for divergent conceptualizations.

Nakamura (1964) claims the Chinese preference for concreteness may be related to their lack of consciousness of universals. The Chinese language has many different words used to denote subtle varieties of the same thing or action. The English word “carry” is differentiated into (in hand) ning; nik, (in the arms) pouh, (at two ends of the pole) daam, (on the back) me, mejyuh, (in the pocket) doih, doihjyuh, (on the head) ding, dingjyuh, (on the palm) tokjyuh, (on the shoulder) daam, (with the pole) tok, toih, (with both hands) bung, bungjyuh, (bulky things with more than one person) toih, in Chinese.

Nakamura postulates the Chinese emphasis on particular, vivid, and complicated details reflected in other aspects of culture, as in literature and art. In the world of Chinese martial arts, or kung fu, highly complex sequences of moves, transitions, and countermoves can be stated in very short order, but would very extremely difficult to describe in English.

The linguistic conceptualization of MtF transgender in Cantonese is “Yen Yiu” which translates to “evil person” and holds very little room for other constructs. Other uses for the character “Yiu” are “Yiu Gwai” which translates as “monster” or “Yiu Hou” which translates as “evil queen” or a woman that uses sexual power or attraction to get what she wants. Simply put, the term “Yiu” translates as abnormal and can never be regarded in a positive light.

These linguistic conceptualizations may have a deterministic influence in emotional and cognitive ideas about transgender as well. The socio-cultural aspects of Confucianism and Taoism may also play a significant role in determining attitudes and behavior towards transgender. Western Christian and medical thought also may contribute to the negative stereotypes of transgender in Hong Kong.

These are areas that require further research.