Ministry of Education and Training

National Economics University

-----------------------------

Topic:
“The perceptions on sex reassignment
surgery (SRS) in Vietnam society”
Subject: Project level 3

Instructors: Students do: Group 6

Pham Phuong Lan − Nguyen Minh Hanh
− Nguyen Thi Bich Ngoc
− Hoang Van Phuong
− Hoang Trinh Huyen Trang
1. Introdcution.........................................................................................................5
1.1. Topic.................................................................................................................. 5
1.2. The reason to choose the topic........................................................................5
1.3. Purpose.............................................................................................................5
1.4. Research question............................................................................................5
1.5. Secondary question..........................................................................................6
1.6. Method..............................................................................................................6
1.7. Research subjects:............................................................................................6
2. Literarutre Review..............................................................................................6
2.1. What is transgender?.......................................................................................6
2.2. What is gender dysphoria?..............................................................................7
2.3. What is sex reassignment surgery (SRS)?......................................................8
2.4. How does sex reassignment surgery work?....................................................9
..................................................................................................................................... 9
2.4.1. Male – to – female.............................................................................................10
2.4.2. Female – to – male............................................................................................10
2.4.3. Conclusion.........................................................................................................10
2.5. After sex reassignment surgery work...........................................................11
3. Major..................................................................................................................11
3.1. Chapter 1: The current situation of transgender and transgender surgery
by two groups of subjects........................................................................................11
3.1.1. The reality of transgender and transgender surgery in Vietnam......................11
3.1.2. The reality of people's perception about transgender and transgender surgery
in Vietnam........................................................................................................................14
3.2. Chapter 2: The cause of the views of target groups.....................................18
3.2.1. The reasons for choosing transgender surgery.................................................18
3.2.2. The reasons for the attitude towards transgender people.................................19
3.3. Chapter 3: The effects on transgender people and society.........................21
3.3.1. The effects on transgender people:....................................................................21
3.3.2. The consequences to society in terms of transgender vision:............................24
4. Questionnaire.....................................................................................................27
4.1. Questionnaire for heterosexual people:........................................................27
4.2. Questionnaire for LGBT people (especially transgender people)..............30
5. Reference list......................................................................................................33
1. Introdcution
1.1. Topic
The perceptions on sex reassignment surgery (SRS) in Vietnam society

1.2. The reason to choose the topic

Sexual and gender minority younger generation in Vietnam deal with stigma and
discrimination at home, school and in society, especially people who performed sex
reassignment surgery. Although the Vietnamese government has carried out significant
pledges to recognize transgender people, progress in awareness has not yet been
established and discrimination has been still happening in the community which cause
bad impacts with young people. Therefore, the recognition of Vietnamese society
towards the LGBT (lesbian, gay, bisexual, transgender) community in general and
transgender people in particular is extremely necessary.

Although sex reassignment surgery and transgender people are a hot topic in
Vietnamese society, there is currently no specific research topic about them and the
issues surrounding them. We choose this topic with the desire to offer more professional
research to improve its understanding and awareness about it.

1.3. Purpose
After the study, the project will give an overview of SRS in Vietnamese society
nowadays. More importantly, after analyzing the positive and negative aspects of the
issue, the project will decide whether or not to support SRS in Vietnam. From there, we
hope to change public perception about this issue.

1.4. Research question

− What is the current situation of transgender and transgender surgery by two
groups of subjects in Vietnam?
− What is the cause of the views of target groups in Vietnam?
− What are the effects on transgender people and society in Vietnam?
 1.5. Secondary question
− What is the current situation of transgender people and transgender surgery
in Vietnam?
− What is the reality of people's perception of transgender and transgender
surgery in Vietnam?
− What is the cause of the person wanting to have transgender surgery in
Vietnam?
− What is the cause of the views of people about transgender?
− What are the consequences for the person wanting to have transgender
surgery and transgender?
− What are the consequences to society in terms of transgender vision?
1.6. Method
− Method of information gathering: + Using the Experimental exam method
is the Questionnaire survey method.
+ Using the Document
research method
− Methods of analysis and inference: Using the Inductive method and
Deductive method.
1.7. Research subjects:
− Sort by position: Inside and outside.
− Sort by ages: + From 16 to 30 years old
+ From 31 to 50 years old
+ Over 50 years old
2. Literarutre Review
2.1. What is transgender?
Alina Bradford, who is Live Science contributor, said that “Transgender” is an
umbrella term that explains people whose gender identity or individuality not be suitable
with the sex they were asigned at birth. To illustrate this, a transgender person could be
recognized as a woman in spite of having male’s body since she/he was born. (Bradford,
2018)

Similarly, according to the Planned Parenthood – a well-known website

professionally delivers vital reproductive health care, sex education, and information to
millions of people worldwide, “Transgender” expresses people who feel that thier sex is
shown through their body does not macth with the gender that they feel they are inside.
(Planned Parenthood, 2015)

All things considered, “Transgender” is group of people that owns a sexual

orientation that is different from the sex shown on their body and expects to be
recodnized exactly the gender they feel inside.

2.2. What is gender dysphoria?

As the author poited out on site “Transgender Identities” of website Planned
Parenthood, “Gender dysphoria” is a term that psychologists and doctors use to describe
the pessimistic feelings of transgenders because they can not feel the connection between
their bodies and their gender identity. However, it is not considered a mental illness.
(Planned Parenthood, 2015)

In addition, in the text about “What is gender dysphoria?” of American Psychiatric

Association, “Gender dysphoria” is a phenomenon about a conflict between a person’s
physical gender and the sex that she/he/they identify in their mind. These people always
find painful with the gender they were assigned, especially they don’t accept their body
and the expected roles of their assigned gender. (Parekh, 2016)

In summary, “Gender dysphoria” can be understood as a mental symptom that

makes people feel that they are not living according to their true gender because of their
body. These people tend to lack confidence in themselves and always desire to have a
physical and spiritual harmony.
 2.3. What is sex reassignment surgery (SRS)?
According to the medical professionals of the ISSM’s Communication Committee,
sex reassignment surgery, also known as gender reassignment surgery, is carried out
transition from one gender to another of a person with gender dysphoria. (The medical
professionals of the ISSM’s Communication Committee, 2015)

Besides, following to Scott Sundick, is a board-certified vascular and endovascular

surgeon, sex reassignment surgery is known clinically as genitoplasty procedures, are
performed to surgically switch the genitalia from male-to-female or from female-to-male.
Regarding most people undergoing SRS, the surgery is done so as to connect their
physical gender with what they find emotionally and intuitively is their true sex.
(Sundick, 2019)

In addition, Tonya N. Thomas asserted that gender affirmation surgery lends

transgender patients a hand to change both physically and socially and reduces the
physical and mental distress made happen by gender dysphoria. (Thomas, 2020)

In conclusion, in my opinion, sex reassignment surgery is a plastic surgery that not

only hepls people can convert their sex about physical appearance but also helps them
live up to their personality.
2.4. How does sex reassignment surgery work?

Image 1 All about sex change surgeries

 2.4.1. Male – to – female

According to an infographic summarized from a study of the U.S. Army, in order to

carry out male – to – famale surgery, patients need to amputate the male genitals
including the testicles and penis to reshape the famale genital tissue and create a new
vagina and labia with excess skin while retaining the prostate gland. (Toro, 2013)

After the surgery is completed, a female hormone called estrogen helps the chest
and hips develop, inhibits hair follicle growth and enhances voice. (Toro, 2013)

2.4.2. Female – to – male

According to the above infographic, the author points out that female – to – male
conversion surgery is less successful due to the difficulty of creating a real penis from the
clitoral tissue of the female genitals. (Toro, 2013)

According to the research, in order to perform female – to – male surgery, the uterus
and ovaries are the two organs that need to be removed, instead a penis created using the
clitoris or free tissue taken from the arm, thigh or abdomen and an erectile prosthetic.
(Toro, 2013)

Besides, the breast also needs to be changed to be more masculine by removing

excess breast tissue and skin, shrinking and correctly positioning the nipples and areola.
(Toro, 2013)

After the surgery is completed, a male hormone called androgen helps to develop
hair follicle and chest muscles, and make the voice deeper. (Toro, 2013)

2.4.3. Conclusion

From the above study, in our opinion, a transsexual surgery is simply understood
that the patient's genitals will be removed by the doctor and re-created a new genitals that
match the gender. that they want. New genitals are made up of discarded excess tissue or
from excess tissue of other parts of the patient's body. After surgery, hormones will help
the patient to gradually improve his or her body.

2.5. After sex reassignment surgery work

According to Jayne Leonard – one of the writters in Medical News Today,
the recovery of female-to-male surgary is different, basing on each person’s body,
especially medical care and lifestyle choices. To illustrate this, if patient use stimulants
like nicotine, it will slow down the recovery process and can bring risks after surgery.
Most people need to be followed in the hospital about a couple of days. When they
come back home, they should be relaxed and restrict heavy activities for a long
time. Some risks that people can face: urethral fistula, urethral stricture or scarring.
More dangerous, they can be infected, bleeded or reacted to anesthesia. Therefore,
people should find a safe and high quality hospital to persorm surgery. (Leonard,
2019)
3. Major
3.1. Chapter 1: The current situation of transgender and transgender surgery by
two groups of subjects

3.1.1. The reality of transgender and transgender surgery in Vietnam

Although transgender and transsexual people are present at every time and place in
the world, this concept is quite new in Vietnam. It was not until 2012 when it marked an
important turning point in the social awareness of transgender people in Vietnam.

After a period of research to explore the transgender community of men and women
in Hanoi and Ho Chi Minh City, the Institute for Studies of Society, Economics and
Environment (iSEE) published the report "Desire to be yourself: transgender people in
Vietnam - practical and legal issues "(iSEE 2012) and host the first transgender workshop
in Vietnam - attract the attention of lawmakers and media. The study addresses general
issues about the trans-male community (FtM) and transgender women (MtF) in Vietnam.
After this study, transgender people were officially present in the press and known by the
public opinion as a group of residents with specific characteristics and needs, different
from homosexuals. This also facilitates these concepts to be widely promoted in
Vietnamese society. Moreover, the number of transgender people available will depend
on how open society will encourage them to be open. iSEE uses a percentage estimate
that has been studied around the world, from the perspective that transgender percentages
are the same across all cultures, only differing in publicity.

In 2011, the Williams Academy of UCLA School of Law published two studies on
the transgender community. The first study, titled "How many people are homosexual,
bisexual, transgender" by Gary Gates, estimates that the transgender community accounts
for 0.3% of the US population, which is about 700,000 people. Some studies offer double
figures, but what is certain is that all are lower than they actually are. If this ratio is
applied in Vietnam (estimated at 91.3 million currently according to the General
Statistics Office), the number of transgender people in Vietnam is more than 270,000. In
summary, only in public cases we can conclude that it is possible that the number of
transgender people in Vietnam is not small.

In a 2015 iSEE study, 1 in 10 transgender people had at least one body surgery.

Transsexual surgery rates

Full transfer
14.20%

Partial transfer
85.80%
 According to a 2014 study of ICS, 100% of all genital-related surgeries are
performed overseas (Vietnamese hospitals are prohibited from performing transgender
surgery). For transgender men and women (MtF):

Only work in Thailand, at 01 popular place because of cheap price (please remain
anonymous), we have the data collected as follows:

Total transfer: average of 2 days / person = 183 people/year

Partial transfer: average of 3 people / day = 1,095 people/year

Total estimated: 1,287 people/year to Thailand to have partial / full conversion

surgery. (This figure is only at the 01 most popular location)

Another survey from iSEE pointed out that:

In 35 people who have had at least one operation Transsexuals, 40% have gone
abroad to do so surgery, 37.1% performed at domestic private facilities; 69.4% had a
thorough evaluation before surgery, 28.6% assessed but not done full, satisfactory as they
wish; 2% said no get pre-surgery assessment; 14.3% did not receive postoperative care
and advice, 25.7% did receive the service but did not feel it crush. 60% said they received
full medical examination and psychological counseling after surgery; Only 40% can pay
for sex reassignment surgery. For those who cannot pay for themselves, 61.1% borrow
money from friends or acquaintances, 44.4% were family sponsored or lent; 11.1% bank
loan; 11.1% received support from a hospital or facility service provider; 71.4% said that
after surgery, they had trouble related to an ID, due to the fact that the appearance does
not match the information and pictures on papers; 14.3% noticed the following declining
health during surgery.

As a result of these observations that transgender people face many difficulties

before and after transgender surgery.
 3.1.2. The reality of people's perception about transgender and transgender
surgery in Vietnam

By the questionnaire method, there is the result of a small survey of how people
perceive transgender and transgender surgery.

Over 50 years old From 31 to 50 years old From 16 to 30 years old

10%
30% 30%
50%

60% 20%
100%

Agreeing Disargeeing Agreeing Disargeeing Agreeing Disargeeing

Other idea Other idea Other idea

Table 1: The proportion of consensus on transgender population by age group

Pie charts show and compare people's attitudes towards transgender surgery by age.
If it is hypothesized that one of their acquaintances intends to transgender, whether they
agree or not. There are generally mixed opinions about transgender surgery. The ratio of
people over the age of 50 choose not to agree is 100%. Likewise, people age 31- 50
disagree has accounted for the highest proportion, at 60% of the total people in this age
group. The figures for agreeing was double lower, at 30% respectively. Meanwhile, only
10% of the total people were had other ideas. On the other hand, the majority of people
age 16-30 agree about fiftieth, while in disagreeing, this category is the smallest. Many
young people think that they will consider based on their situation, neither like nor
objection about transgender surgery or transgender, this section accounts for 30%.

From these data, it is shown that the minority of people at this age in the modern age
or those who were born more than 30 years ago tended to disapprove transgender and
transgender surgery. In particular, the older the person, the more fierce the opposition is.
Young people today have different ways of thinking, but not everyone has an agreeable
view on this issue, especially the object is their acquaintance.

In addition, keeping the same methodology, the small survey also found the comfort
level of people with transgender people.

Over 50 years old From 31 to 50 years old Over 50 years old

20% 20%
10%
30%

40%

Very uncomfortable Very uncomfortable Very uncomfortable

A little uncomfortable A little uncomfortable A little uncomfortable
Neutral Neutral Neutral
A little comfortable A little comfortable A little comfortable
Very comfortable Very comfortable Very comfortable

Table 2: Percentage of the comfort level of people working with transgender people by age

The pie chart shows how comfortable people are if they communicate with a
transgender person. There are many different opinions depending on age. However, the
common point among all three age groups is that no one feels very comfortable. The ratio
of people over the age of 50 choose very uncomfortable is 80%, the rest is a little
uncomfortable. In contrast, people age 31- 50 feel a little uncomfortable has accounted
for the highest proportion, at 60% of the total people in this age group. The figures for
feeling neutral and very uncomfortable were equal and lower than a little uncomfortable,
at 30% respectively. On the other hand, the majority of people age 16-30 feel neutral
about the sixtieth, while in feeling a little uncomfortable, this category is the smallest.
The rest is feeling a little comfortable.

In conclusion, when working with transgender people, the higher the age group, the
more uncomfortable they feel, while the majority of young people have a neutral attitude.
This can be a good sign for a harmonious environment for transgender people. However,
there are still barriers as very few people feel comfortable working with transgender
people. Thus, the formation of an environment regardless of transgender people still faces
certain problems

The above data also easily explain the current situation facing transgender people,
which is discrimination in the community. When people's perceptions have created an
uncomfortable feeling with transgender people, the common manifestations are acts of
division between people and people from the smallest such as alienation, refusal of
requests, to the strongest such as discrimination, violence against transgender. The above
manifestations have also been clearly statistically stated in a few iSEE studies in 2019
recently

According to a recent study by the Institute for Social, Economic and Environmental
Research (ISEE) 3,53% of transgender women and 60% of male transgender people were
rejected by employers while working meet all conditions on capacity. And even when
employed, up to 69% of transgender women and 66% of transgender men are
discriminated against in the workplace.

The research also shows that they are not only discriminated against in public
spaces, transgender people are also discriminated against, shunned by their own relatives,
right under the roof of their house. According to sociological statistics on family
discrimination of transgender people, 62% of transgender women, 80% of transgender
men were verbally abused, pressured, 61% of transgender people in general were forced
change of appearance, gesture, even up to 14% of them suffered from violent acts such as
detention, beatings, eviction. Particularly at the family level, the acts of discrimination
against transgender people also aim to prevent information about family members of
transgender people from being disclosed while trying to change the trend of calculation.
their sexuality and gender identity by means of medical measures, spirituality or way of
life and discouraging their emotional relationships. In general, discriminatory acts
stemming from prejudice and discrimination of gender identity and sexual orientation of
transgender people are 'different' from gender identities and sexual orientation which are
considered as 'common'.

Along with the above realities, there is also an expression of perceptions about
transgender knowledge in particular and heterosexuality in general. The small survey, we
conducted also showed that up to 60% of people agree that "Transgender is unusual",
with the highest proportion of people over 50 years old, followed by people aged 31 to 50
years old and from 16 to 30 years old. Likewise, this ratio is almost approximately 47%
with the comments that "Transgender people are mentally ill and never develop or mature
as usual" and "Transgender without sex is obviously a mistake of nature". On the
contrary, with the comments that "Transgender people are the result of excessive freedom
in a country that is losing traditional family standards" and "Transgender people should
be treated better, more acceptable in society", there is a difference. Most people object
that an overly free country is the cause of the emergence of transgender people. In
another development, most people, especially people between the ages of 16 and 30,
think transgender people should be treated fairly. This also shows that in Vietnam, there
are still many different views about transgender people and transgender surgery. There
are even many people who do not really understand this issue. The evidence is that they
still agree with some misconceptions about transgender knowledge and view the
difference between transgender people and others.

Also in the small survey that we did, the results showed that nearly 90% of all ages
agree that their families often never mention transgender and transgender surgery.
Meanwhile, most of their friends will disagree in part or only partially agree. This result
also shows that, for those who want to choose transgender surgery, they will have many
difficulties in being accepted and supported by their families and friends.

Currently, the legal system in Vietnam has undergone fundamental changes to

protect transgender rights, but this is only the starting point for many subsequent efforts
to not only recognize the obvious rights of transgender people, but also have to change
the perception of society in dealing with them. Facing stigma and prejudice from all
sides, most transgender people expect society to recognize their identity based on legal
recognition, typically transgender rights in the Code Civilians 2015. Although some of
the provisions in this "right" are still controversial because they require surgery to be
recognized for transgender, basically with this transgender right, transgender people can
amend it. information on civil status and gender are written on paper, which makes it
easier for them to carry out administrative procedures than before. For example,
transgender people will avoid getting a job but the gender shown on the paper does not
match their appearance, or more simply, they will enter the right public toilet for their
real gender. You don't have to be scrutinized when you enter "the wrong" public restroom
for the other gender.

However, even when legally recognized, transgender people still face many other
difficulties, mainly due to the infrastructure of public services, especially health services.
support for transgender people. According to a recent study by Pham Quynh Phuong and
partner, most transgender people use hormone-regulating drugs with instructions based
on the "word of mouth" mechanism in the transgender community, but not Right advice
from the doctor.

In concluding, transsexual surgery and transgender people are currently struggling

with the support and support of the community and society in Vietnam.

3.2. Chapter 2: The cause of the views of target groups

3.2.1. The reasons for choosing transgender surgery

When asked about the age and the reasons for thinking about transsexuals, the
survey results showed that transgender people in the questionnaire survey, in general,
have first thoughts about gender change surgery around 18 years old. They say that they
have this thought as early as 12 years old, as late as 28 years old. The perception of a
mismatch between the desired sex and body (88.6%) or uncomfortable confidence in the
body (65.7%) is the most common cause of transgender thinking. (iSEE, 2019)
 The need to live with the desired body, if not met, can create a sense of gender
frustration, leading to psychological stress. Many cases lead to long-term psychological
effects such as depression, affecting the life of transgender people. However, in Vietnam,
at present, there are very few psychiatrists with expertise and knowledge to support
transgender psychological assistance needs. Frustration and depression can create
emotional stress, reduced self-esteem, and prolonged depressive states can have a
devastating effect on transgender lives. Therefore, the sex change, which can start with
just hormones, helps to give them confidence:

On the other hand, understanding after accessing knowledge about gender and
gender also brings thoughts about transgender (34.3%). A significant proportion of
respondents said that their depression, psychological depression, depression in their body
(25.7%), or the knowledge they gained from joining associations also motivated them.
they think body transformation (11.4%). There are also cases of not using hormones but
still deciding to have surgery, sponsored by a beauty salon, on the condition that she will
have to promote the image to them. External stigma is also the reason behind the
transgender decision.

3.2.2. The reasons for the attitude towards transgender people

According to the survey results, it is shown that, through different age stages,
attitudes, and perceptions about transgender people are clearly different. Especially in
terms of the acceptability towards transgender people and how people feel when
communicating with them. The reason for such perceptions is due to a few reasons as
below the report will present.

First and foremost, the changes in times and social concepts in different periods
have led to differences in perceptions of transsexualism and transgender surgery. At the
age of over 50, the survey found that 100% of people in this age group do NOT ACCEPT
transgender people and up to 80% of interviewees feel extremely uncomfortable when
communicating with transgender people. The biggest cause of such awareness is that
people at this age are living with the common views and perceptions of the old century.
At this age, they assume that everyone is forced to accept and live the appearance that
was born with. When transgender people try to change themselves, want to live true to
their gender, people at this age think that it is abnormal, which leads to uncomfortable
attitudes and feelings when interacting and talking with transgender people. On a more
severe level are the stigma and disregard. In addition, people over 50 years old do not
have much contact with young people and modern society, they are slow to update news
as well as current trends. This also contributes to hindering their understanding of gender
identity as well as their perception of transgender people. On the other hand, most of the
people over the age of 50 are quite conservative, they always think that their knowledge
and experience about life and society are correct, and do not want to receive any
additional information beyond their understanding.

For the age group from 30 to under 50 years old, the percentage of people who do
not accept transgender people has decreased, but it is still quite significant: up to 60%, of
which 40% of people feeling extremely bad about having to communicate with
transgender people. Only 30% of the interviewed people fully accept transgender people
and feel happy and comfortable talking to them. The main reason 30% of people in this
age group accept transgender people is that they have become more integrated with the
new era, more integrated with their thoughts and attitudes about LGBT. They grasp news
as well as era trends faster than the age of over 50, therefore, they accept to change their
thoughts, their inherent thinking, not restrict themselves in the old prejudices of the era
ago. In another aspect, people at this age have also been exposed to more young people,
their thoughts will be more open and comfortable. Around this time, the development of
information technology and the development of social networks have also contributed to
helping people at this age understand more about gender identity and more easily accept
transgender people.

The last one is the age group from 16 to 30. This is the age group with the highest
transgender acceptance rate among 3 ages. The rate of agreeing up to 50% and only 30%
of people disagree. Out of that, only 10% of respondents feel uncomfortable
communicating with transgender people. Most people at this age live with the thoughts
and thoughts of the new generation. They tend to always try to find out and absorb more
information. They accept to let go of prejudices to absorb new things. Moreover, the age
group from 16 to 30 is the age group with the highest proportion of transgender people,
so people with normal identities at this age can meet and interact with transgender people
more, helping them better understand and have certain knowledge about transgender
issues.

Last but not least, a common reason for the majority of people disagreeing with
transgender people and transgender surgery is about inaccurate or incomplete information
reception. Inaccurate information about sexual orientation and gender identity is
widespread in Viet Nam. Some of them originate in schools. Viet Nam's gender
education policies and practices are inconsistent with international standards and do not
include compulsory discussion of sexual orientation and gender identity. The central
curriculum for schools is also silent on LGBT issues. While some teachers and schools
arbitrarily include such lessons, the lack of inclusion at the national level leaves the
majority of students in Vietnam having no basic knowledge of sexual orientation and
identity gender format.

In conclusion, the general explanation of the appearance of the data outlined in the
status section includes: The difference in times and inaccuracies in information in
education in Vietnam.

3.3. Chapter 3: The effects on transgender people and society.

3.3.1. The effects on transgender people:

Although in recent years, Vietnamese society has had a more open view and a more
positive attitude towards transgender people. However, due to the prejudices and wrong
views of everyone in the community, it has resulted in extremely serious injuries both
physically and mentally to them.
 Transgender people are often stigmatized through actions such as ridicule,
discrimination, violence or even isolation. Because of these things, they become anxious
and depressed, not only that, when transgender people fall into a deadlock, they intend to
commit suicide. It can be said that the social perception has had a significant impact on
the psychology as well as the life of transgender people. When facing the pressure of
society, many transgender people have doubts about themselves. They themselves also
think that they are abnormal against the standards of society. They feel confused and lost
and become guilty when they feel like they are not like everyone else. Most transgender
people do not dare to disclose their true gender because they fear that their families will
be affected by many prejudices and social stigma. They are despised and treated unfairly
in society. It can be said that they suffer both physical and mental violence and gradually
withdraw from the outside society and live a fake life to hide their true self. It is the
pressure, the disgrace from the society that created for them psychological ghosts that
they always have to hide themselves, avoid contacting with the community. They are
afraid of revealing their past identity because the burden from society is always on their
shoulders.

Not only that, unlike homosexuals who can hide their sexual orientation,
transgender people cannot hide their gender identity due to the desire to show it out, so
stigma and discrimination against them are often heavier, direct, and more serious.
Stigma is often manifested in both calling and behavior. The male-to-female transgender
group (MTF) is stigmatized as pê-đê, androgynous, while the female-to-male group
(FTM) is often called “ô môi”. These words contain disparaging meanings, making
transgender people always feel offended. Stigma is sometimes shown not only through
words but also through behaviors and gazes. Among the two transgender groups, it is also
possible to see that the MTF group due to its “exposed” appearance and behavior (such as
makeup, female wear, nail polish), is considered “sick”, “perverted”, “monstrous”..., and
is the subject of more teasing and discrimination. Meanwhile, the "tomboy" movement of
girls also makes FTMs less likely to suffer prejudice.
 Besides, many transgender people were also brutally beaten, bullied and scolded
by their friends with extremely harsh insults. At the age of still attending school, many
transgender people were unable to hide their desire to express their gender identity, so
they easily became the focus of teasing and discrimination of teachers and friends. in
school. There is an MTF that says that you are so often “beaten on the council” in high
school that even thinking about going to school you feel scared and have to skip school
often. Because the MTF stigma is much heavier than the FTM group, while many FTMs
are able to go to university and beyond, very few MTFs are able to go to higher
education, especially the mid-dropout rate (because the family doesn't help and the school
doesn't accept it) quite a lot. Stigma in school has many consequences for transgender
people, especially from boys to girls, such as depression, drop out of school, and even run
away from home. Stigma in schools has been a barrier that deprives transgender people
of knowledge, employment, and growth opportunities.

The alienation and stigma from family members are often more evident. According
to a 2016 study by the Institute for Studies of Society, Economy and Environment
(iSEE), transgender people are not only discriminated against in public places but are also
shunned by their relatives living together in a roof. Sociological statistics on the
discrimination in the family of transgender people show that 62% of transgender people
are female and 80% of transgender people are male cursed at, causing pressure, and 61%
of transgender people in general have been forced to change appearance, gestures. Even
up to 14% of them have suffered acts of violence such as beatings and detention. Not
only that, the discrimination against transgender people also aims to try to change their
sexual orientation and gender identity with medical, spiritual measures and prevent their
sexual relationships. In fact, all is also derived from the love for children, wanting their
children like normal people to get married and have children, so we can use all means to
prevent children. It is from this misunderstanding that their health and mental status are
seriously affected.
 However, transgender people still suffer many influences and they are stigmatized
when living with their gender identity. For example, when applying for a job, transgender
people also face many difficulties in finding jobs and suffer from stigma at work as well
as in other public spaces. According to Phong - a young person interviewed shared:
“When I applied for a job, seeing that my gender is different from the one in the profile,
they questioned my gender. affirm that I am not suitable for that job. Even when I got the
job, they checked my gender and knew I was transgender, and they said that the client
didn't want contact. I have certain work experience but they do not accept the capacity
just because I live true to myself ”(Nguyen Thu Quynh, 2016). This is not a rare case that
has happened quite a lot. According to a 2016 study by the Institute for Studies of
Society, Economy and Environment (iSEE), 60% of transgender people per year and 53%
of transgender people are rejected by employers despite responding to the interview. meet
the eligibility conditions. And even when employed, up to 66% of transgender men and
69% of transgender people are often stigmatized and alienated in the workplace. Faced
with prejudices and stigma from all sides, most transgender people are looking forward to
social recognition of their identity. It is this injustice that makes many transgender people
with talent and energy seriously affected their health and spirit, not having the
opportunity to find jobs and contribute to society. The stigma and discrimination against
transgender people have caused many unforeseen consequences for themselves and the
whole society.

In conclusion, transgender people are suffering a lot of negative effects, both

physically and mentally. They need to be treated with respect and equal in work and life.
Since then, transgender people can have many beneficial contributions to society.

3.3.2. The consequences to society in terms of transgender vision:

In addition, the general perception of transgender people in particular or the

LGBT community in general in Vietnam is also weak, not clearly understood. Many
misinformation of the media and disrespectful treatment of some people in society also
make transgender people face many difficulties, facing negative reactions leading to
undue consequences.

The lack of protection for LGBT people is largely due to myths about sexual
orientation and gender identity hindering human rights. According to Human Rights
Watch stated (Bangkok) in a public report that: Popular myths about sexual orientation
and gender identity in Vietnam contribute to increased discrimination and violence has a
strong impact on LGBT youth. Barriers to the educational rights of LGBT youth in
Vietnam note the situation that LGBT youth in Vietnam face prejudice and
discrimination at home and school due to myths, such as the erroneous belief that same-
sex preference is treatable, and curable mental illness. Many of these people have
experienced verbal harassment and bullying, with a number of cases leading to physical
assault. Human Rights Watch found that teachers are often not trained and equipped to
deal with discrimination against LGBT people and that lectures at school often preserve
the myths that prevail in In Vietnam, liking people of the same sex is a disease.
Therefore, the Vietnamese government needs to fulfill its commitments to protect the
rights of LGBT. Human Rights Watch say: “LGBT youth are particularly vulnerable due
to a lack of legal protection, and the spread of misinformation about sexual orientation
and gender identity”.

Inaccurate information about sexual orientation and gender identity is still

widespread in Vietnam and has a devastating impact, especially among young people.
Although there are a number of laws that prohibit discrimination and guarantee the right
to education for all children, the current curriculum at the national level as well as the
policy on sex education in Vietnam do not meet international standards, and lack of
mandatory discussion on sexual orientation and gender identity. Human Rights Watch
found that, although some schools and teachers have the ability to put those lessons into
the curriculum, the gap at the national level leaves the majority of Vietnamese students
without basic knowledge on sexual orientation and gender identity.
 Although nowadays, with the strong development of the media and the press has
helped people to have a more open and sympathetic view of transgender people, but the
unacceptable psychology still exists in a number of parts of society, especially the
elderly. They often still keep conservative ideas, it is harder to accept transgender people
than young people. For the elderly, they feel transgender is something quite new. It is
contrary to nature, contrary to fine customs and things that are considered true from past
to present. Meanwhile, the young group had a more glimpse of this. They receive a
modern and civilized education, have close contact with many transgender people. So
they feel that transgender people as well as other ordinary people have the right to be true
to their gender, to be loved and treated equally.

On the other hand, in Vietnam, the pressures of social life with many close
relationships make transgender families afraid of being judged by neighbors and
acquaintances, so asking their children not to wear a dress and have different behaviors to
save face for the family. More seriously, due to lack of knowledge, many families believe
that their children are demanding to follow their friends, they have no future if they are
transgender, so they have taken strong measures to "adjust" or force their children must
return to their real gender. Forms of violence can range from verbal (insulting) to actions
(violence) and often the MTF community suffers more than the FTM. It can be said that
in general, many families completely do not accept that their children are transgender, or
if accepting, it is a long process, because they love their children and gradually accept
them, but often find ways to cover them, hide people around out of shame and want to
save face.

There are many levels of stigma against transgender people: within families,
neighbors, schools, and in society in general, as well as within the LGBT community. In
the family transgender people, most have difficulty in coming-out with their family.
Some cases have "come out" at different times but parents have "ignored". Some families
believe that their children are mentally ill, so many families think about solutions for
their children to see a psychiatrist for treatment, and this further deepens the separation
and sharing between parents. and child. In the memories of male-to-female transgender
people, in the family, they are often treated most cruelly compared to brothers and sisters,
with no love and acceptance. A transgender person said that with 7 siblings in her family,
she was treated most harshly.

Besides stigma and discrimination, there are also bright spots of hope as some
families have accepted their children as transgender. Depending on family circumstances
and levels of acceptance, they have different solutions, from avoiding, creating a screen,
or accepting their children to be themselves. It is noteworthy that in the families of
female-to-male transgender people, accepting a child is easier than in the family of
transgender people. This is similar to the general perception of the whole society that
easily accepts girls with personality, and shows masculinity, rather than accepts the
femininity of boys.

In conclusion, it is the prejudiced view of society that has a very negative impact on
the life of transgender people in all aspects. As Dr. Khuat Thu Hong said: “In my
opinion, the most important thing for transgender people is to change social perception,
that is to recognize them - that they have a right to exist like all non-transgender people
and completely equal to all. Transgender people are not at fault, but the way our society
is treating them now is as if they are at fault ”(Nguyen Thu Quynh, 2016).

4. Questionnaire
4.1. Questionnaire for heterosexual people:
− What is your age?
¨ From 16 to 30 years old

¨ From 31 to 50 years old

¨ Over 50 years old

− What is your gender?

¨ Male

¨ Female
 ¨ Others

− How many transgender people do you know?

¨ Nobody

¨ Person

¨ Two people

¨ Three to five people

¨ Six or more people

− Are you comfortable interacting with transgender people?

¨ Very uncomfortable

¨ A little uncomfortable

¨ Neutral

¨ A little comfortable

¨ Very comfortable

− Please respond to the extent that you agree or disagree with the following
terms regarding transgender people.

Very Agree Partially Totally I don’t

agree somewhat disagree disagree know
Transgender is unusual.
Transgender people are
mentally ill and never
develop or mature as
usual
Transgender without
sex is obviously a
mistake of nature.
Transgender people are
the result of excessive
freedom in a country
that is losing traditional
family standards.
Transgender people
should be treated better,
more acceptable in
society

− If an acquaintance wants to be transgender, do you accept them?

¨ Disagree

¨ Agree

¨ Other idea

− Do you think transgender people also contribute to society?

¨ Yes

¨ No

¨ I don’t know

− What do your family and friends think about transgender people?

Very Agree Partially Totally I don’t know
agree somewhat disagree disagree
My family never
talked about
transgender people
My friends never talk
about transgender
people
My family accepts
and supports
transgender people
My friends accept and
support transgender
people

− If you have other ideas to share, please fill in the box below.

4.2. Questionnaire for LGBT people (especially transgender people)

− What is your age?
¨ From 16 to 30 years old
¨ From 31 to 50 years old
¨ Over 50 years old

− You identify yourself as …

¨ Lesbian
¨ Gay
¨ Bisexual female
¨ Bisexual men
¨ Trans girl
¨ Trans guy
¨ Other

− What is your current living status?

¨ Living alone
¨ Living with friends
¨ Living with lover, partner
¨ Living with parents, siblings, grandparents
¨ Living with lover, partner and parents, siblings, grandparents

− When in contact with family members, have you ever been in the following
situations are because of transgender people?
Never Seldom Sometimes Regularly It doesn’t
apply to me
Force or suggest move
other places
Being assaulted, beaten
Scold or use words to
pressure you
Silence, does not talk
Prohibit relationships
Forced to marry
Forced to change
appearance, gestures
Claim not to enjoy
inheritance
− During your pre-18 years of schooling, have you ever been go through the
following situations?
Never Seldom Sometimes Regularly It doesn’t
apply to me
Being bullied, harassed
by friends
Forced to change
hairstyle, gestures,
posture
Publicly criticized and
reviewed in front of
class and school
Being contacted with
parents for criticism
and review
Being treated unfairly
because of their LGBT
views
Must drop out of
school because of
stigma and
discrimination
 Refused to participate
in extracurricular
activities
Hearing, seeing
comments, acts
negative passions from
friends

− During years of work, have you ever experienced the following situations?
Never Seldo Sometimes Regularly It doesn’t
m apply to me
Fired
Limited promotion
Being paid poorer than
people of the same position
and capacity
Was denied employment
while eligible
Forced to transfer to another
job position
Seeing negative comments
and actions from colleagues
Hearing, seeing negative
comments, actions from
boss

− During the past 12 months, have you ever felt that you have been
discriminated against because you are transgender?
¨ No
¨ Yes

− How many times have you been discriminated against in the past 12
months?
¨ Never
¨ Once to three times
¨ Four to ten times
¨ Over ten times

− The person (s) responsible for the act are …

¨ Female
¨ Male
¨ Both male and female
¨ I do not know

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