Human Rights | Medical Malpractice | Society | Asia

In a groundbreaking decision that could reshape the legal landscape for LGBTQ+ rights in China, a Chinese court ruled in favor of a transgender woman, Ling’er, awarding her compensation for undergoing involuntary electroshock therapy at the behest of her family and a psychiatric institution. The case, decided in November 2024, marks the first judicial victory for a transgender plaintiff challenging “conversion therapy” practices in China’s healthcare system.

While the lawsuit did not directly name the Chinese government as a defendant, it nonetheless casts a critical light on state-regulated medical practices, the legal status of gender identity, and the constitutional right to bodily autonomy in China.

Case Background

Ling’er, a transgender woman in her late twenties, was forcibly admitted in 2022 to Qinhuangdao City Fifth Hospital in Hebei Province after her parents—opposed to her gender identity—classified her as mentally unstable. During her stay, she was subjected to seven sessions of electroconvulsive therapy (ECT), often referred to as “electroshock,” despite her repeated refusals and lack of informed consent.

The hospital reportedly diagnosed her with “anxiety disorder and discordant sexual orientation,” an outdated and discredited classification. The procedures caused her to faint, suffer significant distress, and develop ongoing cardiac complications.

Legal Claims and Ruling

The plaintiff, supported by a network of civil society advocates and legal professionals, brought suit under China’s Civil Code and Mental Health Law, asserting:

• Violation of Informed Consent (Article 1215 of the Civil Code)
• Medical Malpractice and Personal Injury
• Unlawful Psychiatric Confinement

In a rare but decisive ruling, the court sided with Ling’er and awarded her 60,000 yuan (~£6,550 / $8,200 USD) in damages, citing the hospital’s failure to obtain consent and the lack of medical necessity for the ECT procedures.

“The hospital failed to demonstrate that its actions were necessary, proportionate, or compliant with the statutory protections of the patient’s rights,” the court noted in its written opinion.

Legal Significance

This ruling represents a major step forward for the recognition of transgender rights in China, where LGBTQ+ identities are not criminalized but lack formal legal protection or anti-discrimination statutes.

Key takeaways for legal professionals include:

• Recognition of Bodily Autonomy: The decision reinforces Article 29 of the Mental Health Law, which prohibits involuntary treatment unless a person poses a danger to self or others.
• Establishing Liability for Conversion Therapy: Although not explicitly illegal under Chinese law, so-called “conversion therapy” practices now face higher legal risk.
• Judicial Receptiveness to Civil Liberties Arguments: The court’s emphasis on consent and patient rights signals a potential shift toward broader judicial acknowledgment of civil liberties, particularly in the healthcare context.

Challenges and Context

While the ruling is historic, the case also highlights ongoing structural and cultural barriers:

• Lack of Comprehensive LGBTQ+ Protections: China has no specific laws prohibiting discrimination based on sexual orientation or gender identity.
• Institutionalized Conservatism in Healthcare: Many psychiatric institutions continue to rely on outdated medical guidance and remain susceptible to family coercion, particularly for LGBTQ+ individuals.
• Limited Press and Legal Visibility: The lawsuit’s success was reported mostly through foreign and independent media, reflecting the muted domestic discourse on LGBTQ+ legal rights.

Conclusion: Impact and Looking Forward

Ling’er’s legal victory offers hope for transgender and LGBTQ+ individuals in China facing institutional abuse, and it may inspire further litigation aimed at holding psychiatric and medical facilities accountable. Though not binding nationally, the ruling may serve as a persuasive precedent in future rights-based lawsuits.

Human rights observers and legal scholars consider the case a catalyst for advocacy, urging lawmakers to introduce clearer guidelines banning involuntary treatment based on gender identity or sexual orientation.

As Ling’er said in a public statement following the verdict:

“This is not just about me. It’s about dignity. No one should have to go through what I did—and now, maybe they won’t have to.”