Ahead of Pride 2024 in Taiwan, TaiwanPlus speaks to Deven, a transgender man who says the high cost of gender-affirming surgery, which is not included under the National Health Insurance program, is holding him back from changing his ID and expressing his true identity.
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00:0028-year-old Devin is facing one of the toughest decisions in his life.
00:04He's one among an estimated 100,000 transgender people in Taiwan,
00:08and one of many who still possess IDs that show their sex assigned at birth.
00:13I think now, even though I can be very natural or very free,
00:19to a certain extent, I still feel a little uneasy.
00:24Because when I really need to show my ID,
00:28I feel like it's a huge challenge.
00:31Taiwan requires transgender men to surgically remove
00:33their female reproductive organs to change their ID gender.
00:37In the past four years of hormonal therapy,
00:39Devin had never considered the mandatory surgery,
00:42until years of microaggressions in his personal and work life started to take a toll.
00:47I actually want to be a man.
00:49I don't want to keep mentioning that I'm a transgender.
00:53Because some people who think they're sweet
00:56will say, for example, when we're moving things,
01:01they'll say, it's okay, I'll do it.
01:03I know you're not that...
01:05After all, you're still a girl.
01:07He says if he keeps avoiding surgery and getting his ID changed,
01:11these things will haunt him for as long as he can take it.
01:14But the costs of surgery are a bitter pill to swallow.
01:17Compared to the costs I have to pay,
01:20I don't really want to do this.
01:22I have to spend money, and my work needs to be interrupted.
01:25Because I need surgery, I need rest.
01:27Devin is not alone in his struggle.
01:30Gender-reaffirming surgeries are excluded
01:32from Taiwan's national health insurance coverage.
01:35The mandatory removal surgery alone
01:37may be well over US$6,000.
01:40And it's only the first step towards being freed
01:42from a body they don't totally identify with.
01:45We have to remove the uterus, ovaries, and ovaries.
01:50That's the basics.
01:51Some people don't like to have a baby,
01:53so they do it together.
01:56In fact, when they come for the surgery,
01:59the money is saved bit by bit.
02:02Unless you have a good family,
02:04your parents can afford it.
02:06Otherwise, it's very hard to rely on yourself.
02:10After the removal, some will proceed onto penis construction,
02:13which could raise the total cost to over US$30,000.
02:18It's optional for those who just want to get a new ID,
02:21including Devin himself.
02:23But for some, the high-stakes procedure
02:25is still last resort to live the life they want.
02:27First, we want Devin to be able to stand up and go to the bathroom.
02:34To stand up and pee.
02:36This is also a symbol of male behavior in society.
02:43We also want him to be able to have sexual intercourse.
02:50My gender is my choice.
02:53Since 2019, there have been legal efforts
02:56to challenge the surgery requirement.
02:58Devin says he would love that for himself
03:00and those who also cannot afford the procedures.
03:03But the community has some concerns.
03:06People who need surgery
03:08may be worried that
03:10after the penis is removed,
03:12there will be no doctors to perform the surgery.
03:14Or their families may be against it.
03:16If you don't need surgery,
03:18you can go to a gynecologist.
03:20The threshold will be higher.
03:22Transgender people have diverse ways
03:24of expressing their gender.
03:26Some change their physical appearance,
03:28such as by growing facial hair.
03:30Others, through body modification,
03:32instill others through legal pursuits.
03:34None are easy.
03:36But ensuring the right to decide
03:39one's gender and bodily autonomy
03:41is ultimately their shared goal.
03:43John Su and Ai-Ring Lin for Taiwan Plus.