project-trans · mkpoli · May 11, 2026
diff --git a/content/en/docs/hrt/korea/_index.md b/content/en/docs/hrt/korea/_index.md
@@ -0,0 +1,5 @@
+---
+title: South Korea
+weight: 1500
+collapsible: true
+---
diff --git a/content/en/docs/hrt/korea/hrt-overview-korea.md b/content/en/docs/hrt/korea/hrt-overview-korea.md
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+---
+title: HRT Overview (South Korea)
+description: How feminizing HRT is initiated and maintained in South Korea — pathway, drugs, monitoring, costs.
+slug: overview
+weight: 1
+---
+
+{{< notice info >}}
+This page is informational. It is not medical advice. Always consult a qualified clinician before starting or changing any therapy.
+{{< /notice >}}
+
+## Overview
+
+Feminizing HRT in South Korea generally uses **estrogen**, with an **anti-androgen** added as needed.[^jmm-review][^single-center] Reported anti-androgens include spironolactone, cyproterone acetate (CPA), and GnRH agonists; estrogen is prescribed in oral, IM, and transdermal-gel forms. Prescribing clinicians come from a mix of specialties — psychiatry, endocrinology, urology, OB/GYN, and general practice.[^namu] All gender-affirming care is **out-of-pocket**; psychiatric diagnosis, labs, drugs and injections are not covered by the National Health Insurance Service.[^lgbt-health][^kihasa]
+
+## Typical Pathway
+
+These three steps are often split across clinics, but some trans-competent providers can combine them.
+
+1. **Psychiatric evaluation and diagnosis**
+   - Typically one or more sessions with interviews and psychological tests.
+   - A certificate of **F64.0 (Gender Identity Disorder)** or ICD-11 **HA60 (Gender Incongruence)** is issued. The same certificate is used downstream for HRT, SRS, and legal correction.
+   - Cost is non-reimbursable: roughly ₩300,000 at private clinics and ₩400,000–500,000 at university hospitals.[^namu-trans][^transroadmap]
+2. **Pre-HRT workup**
+   - Baseline labs: LFTs, renal panel, electrolytes, lipids, glucose, CBC.
+   - Sex hormone panel: testosterone, estradiol, LH/FSH, prolactin, SHBG.
+   - VTE risk assessment for smokers, those over 35, obesity, or family history.
+3. **Initiation**
+   - Bring the diagnosis to an endocrinologist, urologist, OB/GYN or general practitioner — or stay with a trans-competent clinic that prescribes directly.
+   - Choose oral / transdermal / IM with your clinician based on lifestyle and risk profile.
+
+## Drugs & Doses
+
+Adult dose ranges commonly used in South Korea:[^jmm-review][^single-center]
+
+### Estrogen
+
+| Form | Typical Dose |
+| :--- | :--- |
+| Oral / sublingual estradiol (e.g. Progynova) | 2–6 mg/day |
+| Transdermal estradiol gel (e.g. Divigel) | 2–6 mg/day |
+| IM estradiol valerate (e.g. Progynon Depot) | 5–20 mg every 1–2 weeks |
+
+> Transdermal estradiol has a lower VTE risk and is preferred for patients > 35, smokers, obesity, hypertension or a thrombotic family history.
+
+### Anti-Androgens
+
+| Drug | Typical Dose |
+| :--- | :--- |
+| Spironolactone | 100–300 mg/day |
+| Cyproterone acetate (CPA) | 12.5–50 mg/day |
+| GnRH agonist (leuprolide, goserelin) | 1- or 3-month depot |
+
+> Cyproterone acetate (CPA) has been linked to an increased risk of meningioma at high doses, long durations, or higher cumulative exposure. Dose and duration should be decided carefully with the prescribing clinician.[^cpa-meningioma]
+
+### Adjuncts
+
+- Micronized progesterone may be added for breast development; evidence is limited.
+- 5α-reductase inhibitors (finasteride/dutasteride) are usually unnecessary if androgens are adequately suppressed.
+
+## Monitoring
+
+The standard cadence is **every 3 months for the first year**, then every 6–12 months.[^jmm-review][^wpath]
+
+- Labs: testosterone, estradiol, LFTs, renal panel, lipids, electrolytes (especially K⁺ on spironolactone), prolactin, glucose.
+- Reference ranges:
+  - Testosterone: cis-female range, or roughly < 50 ng/dL.
+  - Estradiol: roughly 100–200 pg/mL is commonly cited, but with IM dosing the measured value depends heavily on time-since-injection and must be interpreted alongside clinical signs.
+- Clinical: breast development, blood pressure, weight, mood.
+
+## Minors
+
+- Some Korean centers use **GnRH agonists** for puberty suppression, but access is limited and guardian consent is required.[^single-center]
+- Suppression is generally considered from Tanner stage 2 onward.
+- Adult-dose HRT before age 19 depends on institutional policy and guardian consent — there is no standardized national protocol.
+
+## Cost
+
+- All out-of-pocket. Drug costs alone run roughly **₩30,000–150,000 per month**.[^namu-trans][^transroadmap]
+- Psychiatric certification, labs, and injection administration are billed separately.
+- A few drugs may be reimbursable for *other* indications (menopause, hypertension), but only if those indications independently apply.
+
+## Foreign Patients
+
+- An alien-registration card or passport is generally sufficient ID to be seen at most facilities. If you are enrolled in Korean National Health Insurance, bring your insurance documentation as well.
+- Some university hospitals (e.g. Korea University Anam, Kangdong Sacred Heart) operate international clinics with English-speaking staff.[^medical-avenue]
+- Foreign diagnoses and HRT records may not be accepted as-is by Korean physicians — expect re-evaluation.
+- If you plan to use Korean medical records back home, request English-language documents and arrange notarization / apostille before leaving.
+
+## Reported Providers (examples)
+
+These reflect community reports and are not exhaustive. Always confirm availability directly with the facility.
+
+### Hospitals
+
+- **Dong-A University Hospital** (Busan) — psychiatry, endocrinology, plastics together.
+- **Kangdong Sacred Heart Hospital LGBT+ Medical Center** (Seoul) — multidisciplinary.[^transmap]
+- **Korea University Anam Hospital** (Seoul) — international clinic; HRT prescribing reported.[^medical-avenue]
+
+### Independent Clinics
+
+- **Kim Sang-jun Psychiatric Clinic** (Seoul) — frequently mentioned for trans diagnosis certificates.[^namu-trans]
+- Various OB/GYN, endocrinology and general-practice clinics also prescribe. Confirm via Korean advocacy groups or community resources first.
+
+## Resources
+
+- [Trans Roadmap — Korean trans health guide](http://transroadmap.net/transgender-health/)
+- [트랜스젠더 호르몬 치료 — Korean Wikipedia](https://ko.wikipedia.org/wiki/%ED%8A%B8%EB%9E%9C%EC%8A%A4%EC%A0%A0%EB%8D%94_%ED%98%B8%EB%A5%B4%EB%AA%AC_%EC%B9%98%EB%A3%8C_(MTF))
+- [WPATH SOC v8](https://www.wpath.org/soc8)
+
+[^jmm-review]: Kang Y, Han Y, Cho S, et al. *A Review of Gender-Affirming Hormone Therapy for Transgender and Gender Diverse Adults in South Korea.* J Menopausal Med. 2022. [PMC9843037](https://pmc.ncbi.nlm.nih.gov/articles/PMC9843037/)
+[^single-center]: Lee H et al. *Gender affirmative care of transgender people: a single center's experience in Korea.* [PMC6333764](https://pmc.ncbi.nlm.nih.gov/articles/PMC6333764/)
+[^lgbt-health]: [LGBT health in South Korea — Wikipedia](https://en.wikipedia.org/wiki/LGBT_health_in_South_Korea)
+[^kihasa]: Lee Ho-rim et al., "An Exploratory Study on Access to Trans Medical Care in Korea", [Health and Social Welfare Review 35-4, 2015](https://www.kihasa.re.kr/hswr/assets/pdf/908/journal-35-4-64.pdf)
+[^namu]: [트랜스젠더 호르몬 치료 — Namuwiki](https://namu.wiki/w/%ED%8A%B8%EB%9E%9C%EC%8A%A4%EC%A0%A0%EB%8D%94%20%ED%98%B8%EB%A5%B4%EB%AA%AC%20%EC%B9%98%EB%A3%8C)
+[^namu-trans]: [Medical transition process — Namuwiki](https://namu.wiki/w/%EC%84%B1%EC%A0%84%ED%99%98(%EC%A0%A0%EB%8D%94)/%EC%9D%98%EB%A3%8C%EC%A0%81%20%EC%84%B1%EC%A0%84%ED%99%98%20%EA%B3%BC%EC%A0%95)
+[^transroadmap]: [Trans Roadmap — Healthcare](http://transroadmap.net/transgender-health/)
+[^medical-avenue]: [Gender transition in Korea — Medical Avenue Korea](https://medicalavenuekorea.com/en/gender-transition-in-korea/)
+[^transmap]: [South Korea transgender surgery — Transgender Map](https://www.transgendermap.com/guidance/medical/surgery/south-korea/)
+[^wpath]: [WPATH Standards of Care Version 8](https://www.wpath.org/soc8)
+[^cpa-meningioma]: Weill A, et al. *Use of high dose cyproterone acetate and risk of intracranial meningioma in women: cohort study*, BMJ 2021. [PMC7889036](https://pmc.ncbi.nlm.nih.gov/articles/PMC7889036/) — risk increases with cumulative exposure.
diff --git a/content/en/docs/srs/_index.md b/content/en/docs/srs/_index.md
@@ -0,0 +1,7 @@
+---
+title: Sex Reassignment Surgery (SRS)
+weight: 4000
+collapsible: true
+---
+
+Sex Reassignment Surgery (SRS), also known as gender-affirming genital surgery, refers to the surgical procedures that reshape the external and internal genitalia of a trans woman to align with her gender identity.
diff --git a/content/en/docs/srs/korea/_index.md b/content/en/docs/srs/korea/_index.md
@@ -0,0 +1,5 @@
+---
+title: South Korea
+weight: 1500
+collapsible: true
+---
diff --git a/content/en/docs/srs/korea/dong-a.md b/content/en/docs/srs/korea/dong-a.md
@@ -0,0 +1,37 @@
+---
+title: Dong-A University Hospital (Kim Seok-Kwun)
+weight: 10
+---
+
+Surgeon: **Prof. Kim Seok-Kwun (김석권)**
+
+Institution: [Dong-A University Hospital](https://www.damc.or.kr/), Plastic Surgery / multidisciplinary clinic — Busan, South Korea.
+
+## Overview
+
+Kim Seok-Kwun performed Korea's first known MtF SRS in 1986 and is reported to have completed more than 320 gender-affirming surgeries — believed to be the highest individual count among Korean surgeons. He is often referred to as "the father of South Korean transgender medicine".[^kim-wiki][^transhealthcare]
+
+Dong-A University Hospital operates a multidisciplinary gender clinic involving psychiatry, endocrinology, urology and plastic surgery, allowing assessment, HRT, surgery and follow-up under one roof.
+
+## Techniques
+
+- Penile-inversion vaginoplasty (primary)
+- PI + scrotal flap combination
+- Sigmoid colon vaginoplasty (in collaboration with general surgery / urology)
+
+## Pre-operative Requirements (reference)
+
+- Psychiatric diagnosis (typically F64.0 Gender Identity Disorder)
+- Hormone therapy history (typically ≥ 1 year) and RLE recommended
+- Pre-op workup: CBC, electrolytes, HIV, HBV, HCV, EKG, chest X-ray
+- Guardian consent if under 19
+
+Exact requirements vary by case — confirm at consultation.
+
+## References
+
+- [Dr. Kim Seok-Kwun — TransHealthCare](https://www.transhealthcare.org/kim-seok-kwun/)
+- [Kim Seok-Kwun — Wikipedia](https://en.wikipedia.org/wiki/Kim_Seok-Kwun)
+
+[^kim-wiki]: [Kim Seok-Kwun — Wikipedia](https://en.wikipedia.org/wiki/Kim_Seok-Kwun)
+[^transhealthcare]: [Gender Surgeons in South Korea — TransHealthCare](https://www.transhealthcare.org/south-korea/)
diff --git a/content/en/docs/srs/korea/kangdong.md b/content/en/docs/srs/korea/kangdong.md
@@ -0,0 +1,28 @@
+---
+title: Kangdong Sacred Heart Hospital (LGBT+ Medical Center)
+weight: 20
+---
+
+Surgeons: **Kim Jin-Hong (김진홍)** — urology / genito-urinary reconstructive surgery; **Kuylhee Kim (김퀼희)** — plastic surgery.[^transmap][^transhealthcare]
+
+Institution: [Hallym University Kangdong Sacred Heart Hospital — LGBT+ Medical Center](https://www.kdh.or.kr/), Seoul (Gangdong-gu).
+
+## Overview
+
+As of recent reporting, Kangdong Sacred Heart is **the only general/university hospital in South Korea openly advertising LGBTQ+ medical services**.[^lgbt-health] Its LGBT+ Medical Center provides multidisciplinary care covering psychiatric evaluation, HRT, MtF and FtM surgeries, and post-operative follow-up.
+
+- Kim Jin-Hong (Genito-Urinary Reconstructive Surgery Institute) — penile inversion, scrotal flap combination, and sigmoid colon vaginoplasty.
+- Kuylhee Kim (Plastic Surgery) — breast augmentation and feminizing procedures.
+
+## International Patients
+
+An international patient department is available, with English-language support reported by patient directories. Direct written enquiry in advance is recommended.[^transmap]
+
+## References
+
+- [Genito-Urinary Reconstructive Surgery Institute — Transgender Map](https://www.transgendermap.com/guidance/medical/surgery/south-korea/)
+- [Gender Surgeons in South Korea — TransHealthCare](https://www.transhealthcare.org/south-korea/)
+
+[^transmap]: [South Korea transgender surgery — Transgender Map](https://www.transgendermap.com/guidance/medical/surgery/south-korea/)
+[^transhealthcare]: [Gender Surgeons in South Korea — TransHealthCare](https://www.transhealthcare.org/south-korea/)
+[^lgbt-health]: [LGBT health in South Korea — Wikipedia](https://en.wikipedia.org/wiki/LGBT_health_in_South_Korea)
diff --git a/content/en/docs/srs/korea/legal-id.md b/content/en/docs/srs/korea/legal-id.md
@@ -0,0 +1,52 @@
+---
+title: Legal Gender Recognition in South Korea
+weight: 100
+---
+
+## Overview
+
+South Korea has no statute on legal gender recognition. Applicants must petition a **Family Court** (or the registry-competent district court) for *"gender correction permission"* under the Supreme Court's **Family Relations Registration Directive No. 550**.[^예규][^lawtimes-2024]
+
+{{< notice warning >}}
+This page is informational. Outcomes still depend significantly on the assigned judge. For an actual filing, consult a lawyer or one of the Korean organizations listed below.
+{{< /notice >}}
+
+## Reference Requirements
+
+- **Age** — 19 or older.
+- **Marriage** — not currently married.
+- **Children** — having minor children is no longer an absolute bar (2022 Supreme Court en banc decision).[^supreme-2022]
+- **External genital reconstruction** — reclassified from criterion to **reference point** in February 2024.[^lawtimes-2024][^khan-2025]
+- **Sterilization** — likewise reclassified, though some courts still consider it in practice.
+- **Psychiatric diagnosis** — F64.0 Gender Identity Disorder (or ICD-11 HA60) certificate.
+- **HRT history** — typically at least one year.
+
+## Typical Process
+
+1. **Gather documents** — family relations certificate, basic certificate, resident registration extract, psychiatric diagnosis, HRT records, surgical records (if any), personal statement.
+2. **Petition** — file with the family court of your residential jurisdiction.
+3. **Hearing** — non-public examination. Some judges additionally require statements from family members or co-workers.
+4. **Decision** — once granted, register the correction at the city/ward office within one month. Subsequent changes to the resident registration number suffix, driver's licence, passport, and health insurance follow.
+
+## Foreigners
+
+The Korean Family Relations Registration system applies only to Korean nationals. Foreigners' residence cards reflect the gender shown on their home-country documents. If you intend to use Korean medical records for gender correction in your home country, arrange **notarization and an apostille** in advance.
+
+## Military Service
+
+Before legal correction, applicants registered as male are subject to military examination. Completion of external genital reconstruction with completed legal correction exempts from the examination; surgery alone (without legal correction) typically results in a Grade 5 (wartime reservist) classification.[^scmp-2024] Plan around possible conscription notices while your case is pending — coordinate with your lawyer.
+
+## Korean Legal & Advocacy Resources
+
+- [SOGI Law & Policy Research Group](https://sogilaw.org/)
+- [GongGam — Public Interest Law Foundation](http://www.kpil.org/)
+- [Hope and Law](https://hopeandlaw.org/)
+- [Trans Liberation Front](https://twitter.com/transliberation_)
+- [Jogakbo — Trans Human Rights Group](https://transgender.or.kr/)
+- [Solidarity for LGBT Human Rights of Korea](https://lgbtpride.or.kr/)
+
+[^예규]: Supreme Court of Korea, *Family Relations Registration Directive No. 550* (enacted 2020, revised Feb 2024).
+[^lawtimes-2024]: ["Surgery requirement in Supreme Court directive is contrary to law" — Lawtimes](https://www.lawtimes.co.kr/news/198163)
+[^supreme-2022]: [Library of Congress: South Korea Supreme Court 2022 ruling](https://www.loc.gov/item/global-legal-monitor/2023-01-25/south-korea-supreme-court-decides-transgender-person-with-minor-children-can-change-gender-in-family-relations-register/)
+[^khan-2025]: [Kyunghyang Shinmun, 2025-08-14](https://www.khan.co.kr/article/202508140600011)
+[^scmp-2024]: [SCMP — 2024 South Korea conscription rule](https://www.scmp.com/news/asia/east-asia/article/3249265/south-korea-conscript-transwomen-who-have-yet-complete-more-6-months-hormone-therapy)