Hong Kong activists and lawyers slammed a new policy governing the changing of gender on ID cards Wednesday, saying the rule shift, which follows a court decision, still requires invasive surgery.

The city's top court decided in 2023 that it was unconstitutional for the government to require a person to complete full gender reassignment surgery before the "sex entry" on their ID card could be changed.

The policy presented "an unacceptably harsh burden on the individuals concerned", the Court of Final Appeal ruled at the time.

But new rules revealed by authorities on Wednesday keep most of the existing surgical requirements -- dropping only the need for applicants to remove their uterus and ovaries, or to construct a vagina.

Applicants must still submit proof of having completed surgeries to modify sexual characteristics such as removal of the breasts, penis and testes. 

They must also show that they have experienced gender dysphoria, have lived as their preferred gender for at least two years and will do so for the rest of their lives, and have undergone hormonal treatments and will continue those treatments.

While lawyer Wong Hiu-chong for the activists behind the lawsuit last year -- Henry Tse and an appellant identified as "Q" -- welcomed the revised policy, she raised concerns about "the heavy emphasis" for blood tests and hormone levels reports being the core requirements.

"We do not see the justifications but the contravention of individuals' rights by forcing them to take unnecessary medical tests and their right to privacy," said Wong in a statement.

Advocacy group Quarks and the Hong Kong Trans Law Database said in a statement that they were "extremely disappointed".

"The new policy continues to violate transgender people's right to privacy and bodily integrity," the groups said.

The policy imposes unequal surgical requirements, lacks clear medical standards and pathologises trans people, the groups added.

Human rights lawyer Mark Daly told AFP that the new policy would be open to further challenge, as it demands "an invasive procedure that is not necessarily medically required by many of the transgender community".

'Proportionate'

The 2023 court decision was hailed as a hard-fought victory for LGBTQ rights, but some activists complained afterwards that the ruling was not immediately implemented and that their ID card amendment applications had stalled.

The Immigration Department -- which oversees identification and visa issues -- said Wednesday it would process applications and "take the initiative to contact the relevant individual applicants for follow-up".

But the statement also noted that "the sex entry on a Hong Kong identity card does not represent the holder's sex as a matter of law", without further explanation.

The Hong Kong government defended its policy changes on Wednesday, saying the eligibility criteria and requirements were "reasonable and proportionate" and came after "careful consideration" of the court's ruling last year.

Veteran pro-Beijing politician Regina Ip said the new policy was a sign of "progress", as the department lowered the bar on the surgeries required.

"They have to establish a threshold -– it's not any person coming up to the Immigration Department and saying, 'I now feel I am male, not female.' You have to satisfy certain medical requirements," Ip told AFP.

Ip explained that the change of gender was limited to the ID card.

"Whether it entitles you to benefits under other laws... that's a separate matter."