Demographics and a Historical Perspective
1. Basic Sexological Premises
2. Religious and Ethnic Factors Affecting Sexuality
3. Sexual Knowledge and Education
4. Autoerotic Behaviors and Patterns
5. Interpersonal Heterosexual Behaviors
6. Homoerotic, Homosexual, and Ambisexual Behavior
7. Gender Conflicted Persons
8. Significant Unconventional Sexual Behavior
9. Contraception, Abortion, and Population Planning
10. Sexually Transmitted Diseases (STDs)
12. Sexual Dysfunctions, Counseling, and Therapies
13. Research and Advanced Education
References and Suggested Readings

Man-Lun Ng, M.D.

Demographics and a Historical Perspective

A.  Demographics

            Located at the mouth of the Pearl River about 90 miles southweast of Canton, the former British crown colony of Hong Kong is a very small but important Asian country with about 416 square miles, including the 32 square mile island of Hong Kong ,

            Hong Kong's 1997 estimated population was 6,487,500 million, including less than 20,000 British.  Between 1949 and 1962, Hong Kong absorbed more than a million Chinese refugees.  The major religious affiliation of Hong Kong people is Buddhism and Taoism (90%). Other religions are Christianity (7.8%), Muslim (0.8%), Hinduism (1.8%) and Jewism (0.15%).  In 1996, the median age of Hong Kong people is 34. The age distribution was 18.5% fourteen and younger, 71.4% percent between ages fifteen and sixty-four, and 10.1% sixty-five or above.  Life expectancy at birth in 1996 was 79 years, 76 for Males and 81.5 for females.  The 1996 birthrate was 11.2 per 1,000 and the death rate 5.1 per 1,000, for a natural annual increase of 0.6 percent.  Hong Kong's 1995 total fertility rate (TFR) of 1.3 child-per fertile woman places it among the slowest growing nations with a ranking of 220 among 227 nations.  Infant mortality was 5 per 1,000 live births.  In 1995, Hong Kong had one hospital bed per 218 persons and one physician per 700 persons.  The literacy rate was over 95 percent, with over 90 percent attendance in 9 years compulsory schooling.  The per capita domestic product in 1996 was Hong Kong dollars 1.195 billion.

            Long a major British naval base and one of the world's great trans-shipment ports, Hong Kong also benefits from some of the world's best spinning mills and a booming electronics industry.

B.  A Brief Historical Perspective

            In 1841, the 32 square mile island of Hong Kong was ceded to Britain.  In 1860, Britain annexed Stonecutters' Island (1/4 square mile), 200 other islands, and the 3 square mile Kowloon Penisula.  In 1898, Britain leased 355 square miles of agricultural land in the New Territories on the adjoining mainland.  As a crown colony, Hong Kong was, despite it tiny size, a vibrant capitalist enclave and free port on the edge of China.  In 1994, following two years of painstaking negotiation, the British and Chinese governments agreed that Hong Kong would return to Chinese soverignty on June 30, 1997, when Britain's lease on the New Territories expired.  The agreement specified that the territory would retain its social, economic, and legal system as a special administrative region of China under a unique "One Country, Two Systems" arrangement for the next 50 years.  The agreement guaranteed freedoms of speech, press, assembly, association, travel, the right to strike, and religious belief.  However, the chief executive and some of the legislature are appointed by Beijing.

1./2. Basic Sexological Premises / Religious and Ethnic Factors Affecting Sexuality

Different sexological premises or a mixture of them co-exist in Hong Kong.  Religious and ethnic factors determine which premise a Hong Kong Chinese holds and for how much.

A.  The original Taoist-confucian premise:

This most ancient sexological premise of the Chinese Hans (the major Chinese tribe) has a documented history of over 5000 years.  It holds a very natural and utilitarian view of sex.  The interaction of two cosmic forces, Yin and Yang, is thought to be universal and essential for the existence, change and growth of all matters, and sex is just one mode of this interaction in living things.  For their well being and prosperity, human beings are advised to follow this natural interaction to the full as long as it does not jeopardize social harmony which is Yin-Yang interplay of the higher order.  Basing on this doctrine, both the reproductive and pleasurable aspects of sex were given high considerations. Sex within marriage must serve the purpose of procreation and outside marriage for erotic satisfaction. Within marriage therefore, contraception is discouraged, and infertility is a good enough reason for divorce or for the husband to take a second wife.   Outside marriage, except for incest and rape, a wide range of sexual behavior is acceptable or at least tolerated, including homosexuality, bestiality, prostitution, fetishism and paedophilia.   This explains why for the Chinese, before the second half of the twentieh century, prostitution, homosexuality and paedophilia were openly practiced and not considered illegal.   Fetishism, taking the form of bound feet in the females, had even become an open culture in China for a thousand years. From the beginning of the second millenium down to the early decades of this century, well bred Chinese women had to undergo extreme pains in childhood to orthopedically deform their feet to a size and shape supposed to be sexually stimulating and fascinating to the males. 

B.  The Neo-confucian premise:

A group of scholars in the Song dynasty (960-1279 A.D.) started to reinterpret the original Confucian doctrine and have since been influential to the Chinese concept of sexuality up to the present day.  Selective books or passages in the Confucian teaching  were  given new and strict meanings to denounce sexual intimacy, pleasure and all types of physical enjoyment. On this premise, the harm of sexual pleasure to bodily health and to spiritual pursuit was very much emphasized.  Sexual chastity, especially for the females, had to be guarded at all costs, even at the price of one's life.  Premarital sex, extramarital sex and remarriages were seriously frowned upon.  Socially, sex must not be discussed openly, dresses must be all covering up to the neck, and males and females not belonging to one family must not touch one other under any circumstances. For example, even when a male physician was to feel the pulse of a female patient, he should only do it by feeling the tight extension of a piece of string tied to the patient's wrist.

C. The Christian premise:

Christianity came into China as early as the Tang Dynasty (618-907 A.D.) but its influences became significant only after the eighteenth century when Western civilization, supported by strong military superiority, entered China with its scientific technology and different life style. The fundamentalistic Christian ideas on sex were sown, developed, absorbed and practiced.  They include the denunciation of sexual pleasure, the love-marriage-sex trilogy, and the exclusively monogamous marital system.  As a result, at the establishment of modern China in 1949, monogamy replaced polygamy as the only legal marital system of the country.  In Hong Kong, polygamous marriage was also made illegal after 1971.  Although Christians represent less than 10% of the Hong Kong population, the influence of the Christian premise on the sexual ethos of the territory must not be underestimated. Up to June 30, 1997, Hong Kong had been under the governance of Great Britain, a Christian country.  Hence, Christianity had a great advantage over other religions in promoting their ideology and practices in Hong Kong.  For example, up to now, of the about twenty per year government designated public holidays, five are Christian holidays (Christmas and Easter), but there are none for Buddhism, Taoism or Confucianism. Most of the elite schools in Hong Kong are Christian run too.  They feed the Christian doctrine to the youngsters whether or not they will ultimately be converted Christians. Many of these elite students become the ruling or influential class in Hong Kong and help to spread the Christian premise consciously or subconsciously.

D. The male domination premise:

All the above three premises assigned a dominant role of men over women, making Hong Kong still a society tilted in favor of men.  Although the Hong Kong females' participation rate in the labour market has increased from 36.8% in 1961 to 49.5% in 1993 and 49.2% in 1996 (Hong Kong Government, 1996), their employment is mostly concentrated in traditional service industries (e.g., clerical and secretariat jobs, hotel, financial sector) with lower job status and lower payment in comparison with their male colleagues.  Among all the working women, less than 5% of working women are in administrative and managerial jobs (Westwood, Ngo and Leung, 1997). The situation of Hong Kong women is more or less similar with women's situation living in the urban cities in Mainland China and Taiwan.

The educational statistics also demonstrate that male dominance.  According to the mid census report in 1996 (Census and Statistical Department of Hong Kong 1996), in 1986, 66.38% of students in degree courses in tertiary institutions were male and 33.62% were female, while in 1996, 57.15% were male and 42.85% were female. Although the difference had decreased, there was still a sizable 15% difference.

However, the mental health of Hong Kong women is definitely better than the mental health of women in Mainland China. The suicide rate among Hong Kong women has increased from 4 to 8 per 100,000 between 1981-1994 (Yip, 1995), which is lower than the female suicide rates both in urban and rural areas of Mainland China. The suicide rate among women is 78.3 per 100, 000 in the rural areas and 15.9 per 100,000 in the urban areas of China (Pearson, 1998).  In a survey on married women's gender views (FPAHK 1993), 22% of the respondents believed that their career achievement should not be higher than that of their husbands and 17.9% indicated that they would get respect from friends and relatives by giving birth to a son. Because of the disadvantaged position of women in society, it is not surprising to find from a youth sexuality survey (FPAHK 1998) that 8.7% of girls age between 18 to 27 wished to have a change of gender, compared with 2.7% of boys of the same age range.

E. The liberalism premise:

This is a growing premise in Hong Kong.  It could be just reckless sex due to ignorance on sexual knowledge and ethics, but is more likely due to the influence of a wide range of modern philosophies which call for gender equality, human rights, elimination of sexual discrimination, scientific rationalism, democracy and freedom. They go hand in hand with the general political change of the territory, engineered by the British government before 1997, major examples being the decriminalization of homosexuality in 1991 and the establishment of the Equal Opportunities Commission in 1996.  Implicit changes can also be seen from the growing social tolerance to prostitution and sexually explicit materials. To live by the income of prostitution is illegal in Hong Kong, but patronizing a prostitute is not.  Sexually explicit materials are subject to the monitor and rating of the Obscene and Indecent Articles Tribunal, but only after they are published and distributed. Publishers are penalized only if found to have produced sexually explicit materials that are obscene or indecent and distributed to readers in the inappropriate age range.  It is commonly believed that sexually liberal ideas come from the West.  This belief however, may be too simplistic, at least for Hong Kong, since as mentioned above, the Chinese culture has a long history of tolerance to varied sexual practices. Hence, modern liberal sexual ideas could be seen partly as a revival of the traditional Chinese sexual attitude. 

3. Sexual Knowledge and Education

Surveys have been directed towards specific groups to evaluate their sex knowledge.  The Education Department (1994) performed a Study on Knowledge and Attitudes Of Secondary School Pupils on Sex and Sex Education on 4087 pupils. In this study, 60 was the passing mark and the average mark the students obtained was 68.4.  The subjects showed that they were knowledgeable about AIDS and the risks associated with unprotected sex with an HIV infected person.  However, they got low marks in two areas which should be the concern of all secondary school pupils'.  Only 24.6% of them stated correctly that masturbation can induce psychosomatic illness and only 47.7% stated correctly that the size of penis does not reflect the sexual ability of a man.  The main sources of secondary school students sexual knowledge were the newspaper (54.1%), television and biology and science classes at school.  For the self evaluation of sex knowledge, only 41% of the pupils claimed to have sufficient knowledge.  45.8% claimed to be insufficient and 10.9% claimed to be very insufficient. 

Sexual Knowledge of couples preparing for marriage was studied by Wong WLE (1996).  There were 41 pairs with male age range 19 to 37(mean 28.5) and female age range 19-35 (mean 26.5).  They obtained a mean score of 67%. The female respondents got lower mean score than the male but the differences was not statistically significant. Knowledge on female sexuality was particularly poor. Approximately half of the sample believed that women must have pain and bleeding at first sexual intercourse. The location of clitoris was not known to one-third of the respondents.  Furthermore, the knowledge of those couples who had attended a pre-marital preparation course (23%) was not necessarily higher.  The association between sexual experience and sexual knowledge was tested but was found not significant except for knowledge about female.  Experienced subjects were more likely to understand that orgasm in women could be produced by various means of fore-play and clitoral stimulation, and not solely by vaginal intercourse. Association between education background and gender on the overall level of sexual knowledge was not observed. One exception was that the higher the level of education, the more correct answers could be obtained regarding the differences in female and male orgasm.  Female respondents were generally ignorant on male erection problems.

            Knowledge on AIDS was studied by Chung and Fung (1999).  On testing 1160 women within the age range of 20 to 50, the average correct answers obtained was 7 out of 10 questions. Only 55% of the respondents knew that HIV could be transmitted via breast-feeding.  Only 11% of the respondents knew that the incubation period for AIDS was 8 to 12 years, not 7 years as formerly claimed.  For the source of sex knowledge, the result was similar to the secondary school pupils.   The ranking of the sources was television (94%), newspaper and magazines (75%) and radio (67%).

Sexual Attitudes and Values:

The Family Planning Association of Hong Kong (FPAHK) provides the most detailed, reliable and longtitudinal data on sexual knowledge, attitudes and behaviors in Hong Kong.  Since 1981, the Association has been conducting sexuality surveys on secondary school students once every five years (FPAHK 1981, 1986, 1991a, 1991b, 1996).   In each of these surveys, to ensure comparability of data from different years, Hong Kong students of form 3 to form 7 (age range 14 to 19) were sampled by stratified random sampling and given similar questionnaires to answer.  Despite problems of non-response and other inevitable technical deficiencies of sexuality surveys, the sexual data represent the most reliable that can be obtained in Hong Kong.  Since 1986, the survey has added a part on the out-of school youths aged from 19 to 27, making it possible to trace the direction of change in the sexual knowledge, attitudes or behaviors of the subjects when they grow older.   

According to the FPAHK data, the sexual attitudes of Hong Kong youths are not as open or liberal as many people think.  Liberal or not seems to depend on which sexual attitude or value one is looking at. Although an overall picture can be drawn that the Hong Kong youths are getting increasingly open and permissive in sexual attitudes, there are items also to show that in some aspects they are holding on to sexual repression and conservatism.  In the in-school surveys for example (FPAHK 1986, 1991a), an increasing percentage of males were found to be dissatisfied with their own gender, from 1.4% in 1986 to 2.9% in 1991.  In the three out-of-school surveys which spanned a period of 10 years (FPAHK 1986, 1991b, 1996), roughly the same percentage of males could accept single males to have sex with prostitutes (36.2% in 1986, 28.4% in 1991 and 30.7% in 1996).   

Using and reanalyzing part of the 1986 survey data of the Family Planning Association of Hong Kong, Lui et al. (1993) confirmed that different types of traditional sexual values in Hong Kong change at very different speeds.  They examined three items in the survey representing three different sets of sexual values: sexual enjoyment, social conformity in sex and sexual equality.  It was found that social conformity in sex was upheld by the greatest majority of the subjects (81.7%) and it was quite resistant to social changes, since covariate analysis demonstrated small contribution of the subjects' social contextual factors to any of its variation.  The even more important finding is that in these subjects, their strong adherence to social conformity went in parallel with their support for the value of sexual enjoyment which was also quite high (65.9%).  The message is that, although for whatever reason, the Hong Kong youths might increasingly recognize and accept the enjoyable side of sex, the recognition does not necessarily make them less socially responsible in sexual attitude and behavior.  The moralists could have been misled or misleading when they sound out alarms simply basing on a changing social attitude to the function and value of sex.       

It is interesting to find that despite a high acceptance of the value of sexual enjoyment, compared with their counterparts in China, Hong Kong youths show a much more conservative sexual attitude in general.  Of the Hong Kong secondary school students in 1991, 80.4% supported the idea of monogamous marriage and said they planned to get married in future (FPAHK 1991).   In the Shanghai secondary school students of 1988 however, only 49.5% had the same idea.  For pornography, 39.5% of the Hong Kong secondary students of 1991 accepted its existence in the community.  In China of 1989 to 1990, already 63.5% of the secondary school students from a large variety of regions could accept pornography as harmless and that they should be allowed to read it (Liu et al. 1997).  Some scholars (Fan et al. 1995) found evidence that the greater sexual conservatism in the Hong Kong students to be due to the greater Christian influences in the territory.   

4. Autoerotic Behaviors and Patterns

In the FPAHK 1996 survey, of the 4116 students of age 15 to 18, 46% of the boys and 17% of the girls had masturbation experience.  Girls had more negative feelings and perceptions about masturbation than boys.  About 36% and 51% of boys and girls indicated that masturbation was immoral, and about 37% and 43% respectively thought it was not good for mental or physical health.  Compared with the FPAHK surveys of 1991 and 1986, the percentages of subjects who masturbate have kept on rising and those who held negative thoughts about it have kept on decreasing.  There is no data on the methods of masturbation.  Clinical information suggests that simple manual manipulation is the most common method, followed by squeezing the genital by the thighs or pressing it onto the bed sheets.  Sex aids are rarely used, although they are available openly in the "adult shops" which are not very different from the "sex shops" that can be found in Western countries.  

However, the survey indicated that the more common form of autoeroticism among the youths was through the consumption of sexually explicit materials.  About 66% and 39% of the boys and girls under 18 reported that they had seen pornographic movies and about 60% and 39% had bought pornographic comics.  Other channels of consumption included video discs, internet and sexual telephone services.   This finding should be a surprise to some policy makers in Hong Kong because by law, youngsters below the age of 18 are supposed to be prohibited access to these materials or services.  The degree of sexual explicitness or "obscenity" of all published media in Hong Kong are subject to rating by government officials in consultation with representatives from the public whom the government appoints.  The law imposes heavy penalty to anyone who distributes "obscene" materials to any body or "indecent" materials to youngsters below the age of 18.   

5. Interpersonal Heterosexual Behaviors

A. Youths

By comparing the in-school surveys of FPAHK in 1986, 1991 and 1996, a trend of increasing heterosexual activity can be identified among the secondary school students. Dating behavior among the boys increased from 42 percent to 54.2 percent, and among the girls from 42.5 percent to 55.0 percent in five years. In terms of having experience with sexual intercourse, the boys' figure increased from 5.7 percent to 6.1 percent and the girls, from 3.5 percent to 4.3 percent. The frequencies of other types of physical intimacy increased much more. The out-of-school surveys further confirm the sexually permissive behavior among the youths. A greater number of these youths in 1991 perceived that their friends and relatives were sexually permissive, in terms of premarital sex, and visits to prostitutes or other "vice" establishments. A greater percentage of the boys, 32.8 percent in 1986 and 36.7 percent in 1991, reported having had sexual intercourse. The 1991 survey shows that 16.7 percent of the males and 15.1 percent of the females of age eighteen to nineteen already had sexual intercourse. However, the out-of-school survey shows that, although the Hong Kong youths of 1991 were becoming more sexually active, they are also more cautious in many respects. For example, much more of those who had sex before marriage did so with their dating partners, 52.2 percent in 1986 compared with 79.8 percent in 1991, and much less with prostitutes (28.4 percent compared with 10.8 percent). The percentage of males who had ever used prostitutes decreased from 16 percent in 1986 to 11.7 percent in 1991. The percentage of males who used condoms in their premarital sexual intercourse increased from 64.5 percent to 84.2 percent and for females, from 50.6 percent to 76.5 percent between 1986 and 1991.

    With these findings, it would appear that the increase in sexual activities among Hong Kong youths has been moderate. The Hong Kong youngsters are not as promiscuous or reckless with sex as some moralists are trying to portray. The sexual self-control of Hong Kong youths is more obvious if they are compared with their counterparts in China, who are often thought of as very much under the influence of traditional sexual repression and conservatism. Yes, if they are compared with their counterparts from all parts of china, their rates of sexual experience are higher. For example, in 1989, Liu, Ng, Chou & Haeberle (1997) did a sexuality survey of 6,092 secondary school students in ten cities in China. It was found that found only 461 (7.5%) of the China youths had experience of sexual contact (kissing, embracing, petting and coitus) and of these, only 8.4 percent of the males and 20.5 percent of the females reported having experienced sexual intercourse (Liu, Ng & Chou 1992).   However, if an equal degree of modernization is taken into account by comparing the Hong Kong youths with the shanghai youths only, the story is different. In 1991, the Hong Kong Tertiary Institutions Health Care Working Group (1991) did a sexuality survey on all university freshmen of Hong Kong in that year and found 3.5% of the males and 1.4% of the female had experience of sexual intercourse.  In the same year, Hong et al (1994) did a sexuality survey on a random sample of the university freshmen in Shanghai.  Their data showed that 6.3% of the males and 2.9% of the females had experience of sexual intercourse.  The percentages were nearly double of those of Hong Kong.  For those who had sexual experience, 19.5% of the Hong Kong male students had sex with more than one partner.  For Shanghai, the corresponding figure was 25.0%, also showing that the Shanghai students were more sexually permissive and active.  On the other hand, only 15.0% of the males and 20.0% of the females in Shanghai had the habit of using condoms, while the corresponding figures in Hong Kong were much higher, at 69.5% and 37.5% respectively.   It could be seen therefore that although there are data to show that Hong Kong subjects are getting increasingly open and permissive in sexual behavior, the openness could just be part of a universal trend in modern cities. The magnitude of change is far from that of many Western societies, even not up to that of China or Shanghai.   If this change is a necessary adaptation for people in modernizing and developing societies, the slow change of Hong Kong sexuality should be a cause for worry rather than delight since Hong Kong is supposed to be one of the more modernized of the Asian cities.

B. Adults:

The only legal form of marriage now in Hong Kong is the Western Christian form of monogamous marriage. The old Chinese marital system that allowed a man to take an unlimited number of wives was not legal any more after 1971 and arranged marriages are now hardly practiced.  For two or more generations, Hong Kong people have subscribed increasingly to romanticism, freedom in dating, courtship and choice of marital partners.  Nuclear family is the rule after marriage, although the older generations are kept respected and supported.  

The mean age of first marriage in Hong Kong in 1997 was 30 for males and 27 for the females.  The age has increased by three years in both sexes over that of 1981.  The rising marital age is associated with a paralleled rise in cohabitation and other extramarital sexual practices like one-night-stand, casual sex, premarital sex and prostitution, but the exact extent is not known. 

There are signs that Hong Kong people are getting progressively dissatisfied with the monogamous marital system. The annual number of divorce cases had doubled from 5507 cases in 1989 to 10,492 cases in 1997, while the number of marriages in the same period had dropped from 43,952 to 37,593 (Hong Kong Government 1998).  In recent years, the high number of males who take mistresses in mainland China has caused a number of serious marital tragedies and become a social concern. In 1996, it was estimated that out of the approximately two million married couples in Hong Kong, about three hundred thousand husbands had mistresses in China. If unfaithful wives and those husbands who have mistresses in Hong Kong or practice casual sex are included, it is reasonable to estimate that at least about one third of the married couples are or have been unfaithful to their spouses.

The Family Service Division of the Hong Kong Council of Social Services Clientele Information Service, a major marriage counseling center in Hong Kong, reported that extramarital affairs constituted 26.1% of their cases from 1988 to 1990.  The Hong Kong Catholic Advisory Council reported that extramarital affairs occupied about 38% of their case load in 1993 and 32% were husbands' affairs and 6% wives' affairs.  The Caritas Family Service in the same year reported a similar proportion, and 40% of the extramarital affairs involved a stable partner (Young et al 1995).

6. Homoerotic, Homosexual, and Ambisexual Behaviors

Due to the influence of the British laws, up to 1991, male homosexual practices in Hong Kong were illegal, punishable up to life imprisonment for anal intercourse and up to two years' imprisonment for any act of "gross indecency".  After 1991, consensual sexual conduct between two males aged 21 or over was decriminalized, akin to the provision of the Sexual Offences Act of England (1967).  The decriminalization has permitted the coming-out of homosexuals in Hong Kong, with the opening of homosexual bars and founding of a number of new homosexual societies.

There are now more than ten well known Gay bars in Hong Kong. Together with some special disco and suana baths, they are places where the male homo and ambisexuals get together to meet new friends and spend their leisure.  Lesbians get less venues to go to, limited to a few bars or so called lesbian karaokes in Causeway Bay, a well known shopping district in Hong Kong.  Some selected public toilets are hot places for male homosexuals to find suitable partners. There are also magazines that help homosexuals to find partners or establish friendships.  Homosexual erotica are available in adult shops, cabled or interactive televisions.

The gay societies in Hong Kong are all voluntary organizations established by homosexuals and ambisexuals.  They provide mutual support, information and social activities to their members.  The one with the longest history is the Ten Percent Club.  Established around 1984, the club assumed an academic flavor.  The Horizon, which provides professional hot-line or face-to-face counseling and produces regular publication for members, was established in 1992.  After 1997, it began to receive sponsorship from the Home Affairs Bureau, Government of the Hong Kong Special Administrative Region.  In 1993, came the Satanga, which gives medical and psychological advice on the health of the homosexuals. Two lesbian groups, the Female Homosexual Club and Homosexual Sisters, were founded in 1996.  At around the same time, a Christian homosexual group and a Buddhist homosexual group were also formed.  There are no formal governmental agencies that serve specifically the needs of the homosexuals.  The idea is that it is less discriminative if the life problems of homosexuals are helped through the usual services provided to the general public. 

Despite decriminalization, homosexuals still do not enjoy equal rights with the heterosexuals in Hong Kong. They could not be legally married, adopt children and are barred from certain types of jobs.  In 1996, the government of Hong Kong started a public consultation to propose legislation to ban some types of discrimination on the ground of sexual orientation.  Public opinions received were divided and the matter is still under consideration.

7. Gender Conflicted Persons

Hong Kong started its first sex revision surgery in 1981.  In 1986, a special team for the evaluation and assessment of patients requesting sex change was established in Queen Mary Hospital.  The team is headed by a psychiatrist, and its members consist of psychologists, social workers, endocrinologists, lawyers, geneticists, gynecologists and surgeons.  They provide the standard assessment and test procedures practiced internationally for gender conflicted persons (Green and Money 1969).  Up to the end of 1998, a total of 78 gender conflicted patients have been assessed. Forty-eight have received sex revision surgery and 7 are still under evaluation.  The numbers of patients who come to the team have remained rather stable throughout the years and so is the percentage who passed the assessment and given the surgery.  Since there is only one team in Hong Kong for doing sex revision surgery, it might be assumed that the team receives most of the transsexuals in the territory.  Basing on this assumption, the prevalence of true transsexualism in Hong Kong is estimated to be about one per 200,000. 

Cross-dressing is not illegal and the law does not actively interfere with the transsexuals as long as their appearances or behaviors do not upset public peace.  However, they are given a strange eye socially, often the subject of gossip and ridicule and are disadvantaged at work or in social rights.  By the certification of the attending doctor, transsexuals can have their names and identity cards changed to agree with their chosen gender, but legally, the law would only recognize and stick to a person's chromosomal sex in case of any judicial disputes.  Hence, a male to female transsexual cannot be raped according to the legal definition of rape.  The law also does not recognize or permit a marriage if one of the partners involved is a transsexual, because the law only recognizes heterosexual monogamy.  Because of this legal non-recognition, a transsexual runs the risk of losing many of the social rights enjoyed by ordinary citizens, such as public housing, tax deduction and children adoption for married couples.  Any documents or contracts they sign may become legally invalid if they do not state their chromosomal sex on paper.  

The discrimination on transsexuals has caused a lot of suffering to this minority group.  In the series of transsexuals who have undergone sex revision surgery by the recommendation of the Gender Identity Team, none have regretted receiving the surgery and all have found the post-surgical complications mild and tolerable.  It is the social and legal discrimination that has caused in them the greatest tragedies.  A female-to-male transsexual was turned down by the Marriage Registry at the last minute, after he had announced his marriage to all relatives and friends.  A male to female transsexual killed herself after her cohabitation with a male was widely publicized as entertainment news for years. 

In the same bill for the homosexuals, the government of Hong Kong has started public consultation to propose legislation to ban some types of discrimination against transsexuals.  However, the proposal focuses on superficial and trivial matters only.  It does not say anything on the discrimination created by the legal adherence to chromosomal sex, which is the root of all other discriminations on transsexuals.  The Gender identity Team takes it as its duty to enhance public awareness to the problem of discrimination and to correct it.  It has organized self-support groups for the pre or post-surgical transsexuals too.  But all this work is still at its infancy and far from being successful.    

8. Significant Unconventional Sexual Behaviors

Little is known about the type and extent of unconventional sexual behaviors in Hong Kong such as child sexual abuse, sex crime and spouse sexual violence. The issue of child abuse has not called public's attention until 1979 when the first comprehensive survey over 22 organizations involved in child abuse was conducted, with the aim to understand the prevalence of the problem and to develop better coordinated service for the abused children and their families (Mulvey 1997).  In the 1979 survey conducted by the Hong Kong Council of Social Service, a total of 358 cases were identified; it was found that child neglect, that is, the failure to provide the child with adequate supervision, guidance and care, constituted the largest category (80.7%), while the percentage of sexual abuse cases was 4.2% only. However, the percentage of sexual abuse reported has increased from 4.2% in 1979 to 17.9% in 1995 (Tang and Davis 1996).  The increase may probably be the result of increased awareness and reporting.  In a review of 134 sexual abuse cases (Ho and Mak-Lieh 1992), the typical victims of the sexual abuse were females with the mean age of 12.2; 96.3% of the perpetrators were male.  These perpetrators are: the victims' friends or household (N = 96, 64.2%), stranger (N = 50, 37.3%), father (N = 16, 11.9%), elder brother (N = 4, 3.0%), stepfather (N = 2, 1.5%), parents' co-habitees (N = 2, 1.5%) and unknown relationship (N =7, 5.2%).  Vaginal intercourse (N = 93, 69%) and inappropriate fondling (N = 59, 44%) were the most frequent types of abuses reported.  All the above studies informed us about the rate, patterns and characteristics of child sexual abuse in Hong Kong.  However, in reading these figures, one has to be cautious of a bias of under-reporting.  Chinese families tend to protect the welfare of the family rather than to fight for the welfare of the victim. Hence, the Chinese families would be hesitant and reluctant to report the sexually abuse incident to helping professionals or the police as the family would avoid losing 'face' and suffering from shame and pains  during the process of investigation.

  In view of an increasing awareness of the problem of child sexual abuse, much public education on the issue has been provided by the government and voluntary organization in recent years. Due to these increases, however, the social work and legal circles have improved their methods of investigation, identification and trail processes for child sexual abuses cases.  Considerations are given to minimize false accusations and psychological trauma to the child during the investigation and trial.    

Sex crime rate is a frequently discussed topic because many local moralists have kept on trying to use it as a reason for purging commercial sexual institutions, prostitutes and pornography.  The fact however, is that there is yet no reliable data to show that the rate of sexual offenses in Hong Kong is on the rise.  There are only two sources from which reliable figures of sex crime rate can be obtained in Hong Kong, the annual reports of the Royal Hong Kong Police (on rape and sexual assault cases) and the Family Planning Association of Hong Kong (on victims of sexual assault counseled).  The police figures (Royal Hong Kong Police 1988 to 1997) show that in the ten years from 1988 to 1997, neither rape nor indecent assault cases, reported or arrested, showed any clear evidence of rise (Table 1).  From the number sex criminals below the age of sixteen, there is no evidence also to support the fear or claim that the age of the sex offenders is getting lower also.

Table 1: Annual sex crime rates in Hong Kong, 1988-1998 (police figures)

(Figures in parenthesis are the numbers of offenders aged below 16)





Indecent Assault




Indecent Assault














































































The Family Planning Association  figures in the same years (FPAHK 1997 to 1988) are : 104, 79, 104, 91, 115, 112, 105, 95, 90, 90.   They also do not suggest any trend of increase. The number of cases counseled in 1996 was even the lowest of the 10 years. 

It might be argued that these official figures could not reflect the actual situation since they depend very much on self reporting which could be affected by a lot of social, legal or psychological factors.  However, without more reliable figures or any clear evidence that people are getting reluctant in reporting sex crimes, it is at least justified to say that there is no proof to show that sex crimes are on the rise in Hong Kong.

Spouse sexual violence has been a topic of concern in recent years in Hong Kong.  The exact rate of this type of violence is unknown before 1980, because it has not been surveyed and few people reported it to the police even if it happened.   In the service statistics of institutions that provide counseling and asylum to battered wives such as the Harmony House and Wai On House, the average number of admission was around 300 cases for 1986 and 1987 (Yeung, 1991; Tang, 1994).   The official data may not reveal its actual prevalence in society.  As estimated by a current survey among 246 female and 136 male undergraduate students at a local university (Tang, 1994), 14% of the respondents' parents have made use of physical force against each other; the rate of spouse aggression is comparable to that reported in the United States.

Among the various forms of family violence, there has been an increasing number of spouses who reported having been sexually assaulted by their partners in recent years.  In 1998, sexual violence occurred in 6.5% of all the spouse violence cases handled by Harmony House and the assault was invariably associated with other types of non-sexual bodily or psychological violence.  It took the form of forced sexual intercourse, genital injury or forced sexual behavior.  The victims were predominantly female (96.08%) and they were mostly between age 30 to 40 (41.7%).  Women experiencing spouse abuse (N = 21) were the most depressed and anxious, in comparison to those women seeking help from family service for marital problems (N = 20) and the normal group (N = 18) (Tang, 1997).   Local scholars (Tang, 1994; 1997) argued that patriarchical beliefs and values from the traditional Chinese culture have legitimized and sanctioned men's use of violence toward their wives.  However, such a view is too simplistic and naive as it fails to take into account the issues of continuity versus change within culture (Ho, 1995). While being influenced by the traditional Chinese norms and beliefs, Hong Kong people are also subjected to the influence of western values such as individualism, autonomy and feminism. Spouse sexual abuse is a complex issue.  It is likely to be the results of the interactions among forces at different levels: individual, family and society.

9. Contraception, Abortion, and Population Planning

Contraception is widely practiced by Hong Kong people.  This is partly due to the hard and successful propaganda work of the Family Planning Association of Hong Kong, and partly due to reality needs in a crowded city.  The accepted motto to follow is "Two (children) is enough".  Couples of higher social status and education tend to want only one child even, and it is why for more than twenty years, Hong Kong has kept its annual natural population growth down below 1%.  The popular contraceptive methods by ever-user couples are oral contraceptive pills (50.1%) which are freely available over the counter, the male condom (32.4%), rhythm (5.9%), intrauterine device (3.9%), injection (3.3%) and female sterilization (1.6%)(FHAHK 1993). Vasectomy is the least popular.     

In essence, there are three conditions for legal abortion in Hong Kong:

1. Approval from two medical doctors to verify that the pregnant woman or the child will be in physical or mental or social danger if pregnancy continues or allowed to come to delivery;

2. The pregnant woman is under 16 years old;

3. Evidence that the pregnancy is a result of rape.

Most educated women know these conditions.  Among those who have been pregnant, 22% have experienced an induced abortion and the rate is increasing.  Younger females with lower income tend to have a higher incidence of having an induced abortion (FPAHK 1993).  However, only about 45% of abortions the women received were legal abortions because it is very convenient for them to secure illegal abortion in secret clinics in Hong Kong (15%) or in proper hospitals in mainland China (25%).  An abortion round trip to China needs only one day. The laws there are much more lenient and the costs lower.   

10. Sexually Transmitted Diseases

Government statistics (table 2) show that traditional types of sexually transmitted diseases are rather well controlled in Hong Kong.  This could be due to the generally effective therapies available and the good public knowledge about precautions.  But government statistics are not reliable in this respect because many cases go to the private practitioners for treatment and these cannot be recorded. 

Table 2 : Annual number of new cases of gonorrhea and syphilis treated in public hospitals, correctional institutions and private hospitals from 1990 to 1997  (Department of Health 1990-1997).





























The statistics on HIV/AIDS come from voluntary reporting since 1984. The cumulative number of HIV/AIDS cases up to June 1998 and their breakdowns are shown in table 3 (Department of Health 1998). 

Table 3: Cumulative Reported HIV/AIDS Statistics from 1984 to June 1998






















Age at diagnosis






Age 13 or less



Exposure category












Injection drug user



Blood/blood product transfusion












The trend is an increasing number of HIV/AIDS cases reported year after year, with a continued narrowing of the male-to-female ratio of the newly HIV infections.  Mother to baby transmissions were found only in the recent five years, numbered between 1 to 2 cases per year.  The number of HIV cases in the homosexuals and bisexuals has continued to rise, but its ratio with the heterosexual cases was inverted since 1989. 

There are four basic components in the strategies for AIDS prevention, care and control in Hong Kong.  The first is to prevent its transmission by the provision of transmission information and education, to bring about behavioral modification, early detection and treatment of sexually transmitted diseases.  Secondly, the AIDS care programs aim to relieve physical and psychological suffering.  Thirdly, to better understand the dimensions and impact of HIV/AIDS in Hong Kong, epidemiological surveillance studies and monitoring are conducted regularly to obtain useful and accurate information about HIV/AIDS distribution in the community.  The fourth component consists of partnership, with the community and internationally to bring about a coherent and constantly updated method of prevention and control.  These strategies are carried out jointly by governmental and non-governmental organizations. The main governmental organizations come from the Department of Health.  They are the AIDS Hotline for public education and the AIDS Unit for the screening and treatment of AIDS patients.  On the non-governmental side, there are the Hong Kong AIDS Foundation which centralizes and distributes public donations for running AIDS education, counseling or research programs, the AIDS Concern to give assistance to AIDS patients and their relatives, and the TeenAIDS which run AIDS educational programs for the youngsters. The government Secretariat has an Advisory Council comprising of AIDS experts from various fields to advise on the implementation and coordination of all these organizations and strategies. 

12. Sexual Dysfunctions, Counseling, and Therapies

Before the advent of the modern sex therapies in the seventies, the treatment and counseling of sexual dysfunctions relied mainly on folk medicine or traditional Chinese medicine.  These treatment methods include herbs, health tonics, physical exercise (Kung-Fu) or breathing exercises (Chi-Kung), acupuncture, acupressure, sex aids.  There is some evidence that some of these treatment methods are effective (Ng 1988) and they still have a place currently in Hong Kong (Liu and Ng 1995).

The first sex clinic which offers the Western type of sex therapy in Hong Kong was formed in about 1979 as a clinic coming out from the general psychiatric clinic in the Department of Psychiatry, Queen Mary Hospital.  The clinic receives referrals from all other clinic cases of sexual dysfunction, paraphilia or miscellaneous sexual problems.  Referrals in the early years were few, but they have kept on increasing.  The male to female ratio of initial presenters has also changed from 5:1 in 1977 to around 2:1 in 1997, showing a rising awareness and initiative among the females in looking for their sexual rights.  There is a gradual change in the type of cases attending the sex clinic too.  For the males, the most common cases have changed from retarded or inhibited ejaculation to erectile dysfunction.  For the females, they have shifted from vaginismus to general sexual dissatisfaction.  These changes are found to be associated with a diversification of referral sources which indicates a general awareness of the medical profession and general public to the effectiveness of the Western type sex therapy in dealing with a variety of sexual problems (Ng 1990b). 

Despite this increasing demand on sex therapy, only one more formal  sex clinic was established in Hong Kong in 1997.  The reason for this will be discussed in a later section.   Other less specialized or comprehensive sex therapy or counseling is offered by social workers or psychologists in private practice or in welfare organizations such as the Family Planning Association, the Social Welfare Department or Agencies for the mentally or physically handicapped.  Some psychiatrists, gynecologists and family physicians have also made a name for being able to provide sexual counseling.  Urologists of course have always helped to manage a large share of erectile dysfunction cases that are principally of organic origin.

All types of medication found to be useful for erectile dysfunction are used in Hong Kong, including intracavernosal injection or urethral insertion of prostaglandin E1.  Most recently, in February, 1999, Sidenafil was approved and as in many other places, the drug has caused sensational public reaction even before its approval, leading to abuses and illicit sales.  However, there have not been any reported cases of death or severe complications due to the drug up to the time of writing (April 1999).  The government has imposed strict regulations on the prescription and dispensing of the drug to prevent abuses. 

13. Research and Advanced Education

Sex Education in Schools:

Hong Kong claims to have started public sex education at around the fifties, headed by the Family Planning Association of Hong Kong.  Various social service and volunteer agencies joined in afterwards (Ng 1988).  Late in 1971, the Education Department issued a memorandum to all schools in Hong Kong to take the liberty to include sex education topics in their standard subjects and made a summary suggestion on what could be taught.  In the subsequent years, efforts were made to put sex education as part of social education in the junior secondary grades.  In 1986, the Education Department issued a Guideline to Sex Education to Secondary Schools (Education Department 1986).  It proposed an interdisciplinary approach to sex education and made further and more detailed recommendations on resources and references.   In the same year, a Sex Education Resource Centre was set up by the Department as to further assist school sex education. Frequent sex education seminars, lectures and short courses have been held to train the teachers too.  These efforts to sex education have received official applause. Some official statistics also showed that things did seem to be heading to the satisfactory direction (Pau 1991).  A growing number of schools or teachers were reported to show interest in strengthening sex education and have assigned teachers as coordinators.  In 1990, 40% of the schools which responded to a sex education survey conducted by the Education Department felt that their sex education plans had been successful.

However, these official figures are far from being a firm proof that sex education is making good progress.  In 1989, the Family Planning Association of Hong Kong did a survey of sex education in schools. They found the topics taught were mostly the fundamental topics like "puberty bodily changes" and "menstruation".  The teachers were unprepared for topics like "contraceptive methods" or "prostitution" which are in fact also very important topics (FPAHK 1989).  In the in-school portion of the sexuality survey of the Association (FPAHK 1986, 1991a), it was found that the percentage of students who reported having acquired sexual knowledge from their teachers had decreased from 26.4% in 1986 to 21.4% in 1991.  The percentage of students who got sexual knowledge from seminars had decreased even further, from 58.4% to 31.6%.  Most of them had turned to newspapers and magazines.  How this drop has affected the students' sexual knowledge was shown by the figures in the same surveys that, except for the question on the safety function of condoms, there was on the average a 12.4% decrease of students who were able to give correct answers to some simple sexual knowledge questions.  The cruel fact is that, despite a lot of statistics and "a lot of work" by the educational bodies, they are not meeting the students' educational needs.  How this situation has come about cannot be discussed in detail here.  The obvious problem is that the "sex education" efforts in Hong Kong so far have only been superficial, consisting of empty words much more than effective action or support.  Memoranda, guidelines, resources, lectures and theories abound without paying enough concern to practicality or feasibility.  Restricted by the insistence that sex education has to be an interdisciplinary and therefore a hidden subject, sex education teachers in schools lack identity, promotion prospect of any psychological or material reward.  Due to the heavy contents and examination pressure of other "more important" subjects, it is also impossible for them to squeeze enough sex education materials into the school curriculum to make their sexuality teaching continuous, meaningful or interesting.  There seems to be little hope for big improvement in the foreseeable future because the official bodies appear to be sitting tight with their established principles.  Their work plans are still geared toward setting up more resource centers, publishing more sex education bulletins and organizing more piecemeal sex education seminars, lectures and courses.  For the crucial issue of independent subject, time and recognition, nothing substantial is to be done as reflected in the second Sex Education Guideline the Department of Education recently produced (Education Department 1997).  In this guideline, all secondary schools are advised to set a minimum amount of teaching time for sex education.  The students of form 1 to form 3 are to have an annual minimum of 20 hours of Life Education, the contents of which include civics, social ethics, politics, environmental protection etc. etc., and among all these, also sex education!  The general feeling among sex educators is that the requirement of 20 hours per year is still too low, and that, since there are so many other things a teacher can teach in Life Education, in view of the special difficulties in sexuality teaching, like before, teachers are likely to use most, if not all the time for the other "more important" contents.     

Advanced Sex Education:

There is no territory based sex education in the advanced level.  Different faculties in different universities run their own sex courses to meet the specialized needs of their students.  The oldest advanced sex education course in tertiary institutuions is the Human Sexuality Course in the Medical faculty of the University of Hong Kong.  It was started in 1981 by the Department of Obstetrics and Gynecology, taken over by the Department of Psychiatry in 1990.  Its aim is to provide the medical students a basic understanding of the interdisciplinary nature of the study of human sexuality and its relation to the practice of medicine. The course is run at the end of the third year of the medical curriculum and lasts for five half-days (about 20 hours).  The topics include introduction to medical sexology, Chinese sexual attitudes and practices, sexual philosophy, social construction of sexuality, psychosexual development and sex education, sexual variations, forensic sexology, sexual attitude reappraisal, sexual problems in medical practice, sexual interview, introduction to sex therapy, sexology and AIDS.  The teaching format consists of lectures, video demonstrations, intranet computer interactive teaching, group discussion, opinion polling and role-plays.  Besides medical practitioners, non-medical specialists including social worker, philosopher, educationalist and psychologist participate in the teaching significantly. Prominent sexologists from different parts of the world have been invited regularly to take part and advice on the teaching also.   This has helped to ensure the quality of the course and that its contents are updated. From the post-course feedback, the course has been found to be one of favorite courses for the students.

There are other sexuality courses in other departments or universities, but they are of shorter history and less systematic, usually focussed on areas of direct interest to the discipline concerned.  For instance, in 1993-1994 a general education course known as Sexuality and Culture was started in The Chinese University of Hong Kong, with the aim to equip the undergraduate students with a cultural perspective on human sexuality. This course was stopped in 1995 and was introduced again in 1998 upon the request of the students. The popularity of this course can be reflected by the fact that over 100 students attended.  

Even less systematic are those short or part-time courses organized ad hoc by health or family planning agencies.  These courses do not have set structures, formats or contents but are run to meet immediate social or professional needs only. 

Generally, although advanced sexuality courses in Hong Kong are improving both in quantity and quality, they are still of a piecemeal nature.  There is no advanced sexuality course that could lead to a separately recognized degree in sexology or sex education, although a postgraduate student can take up a sexuality subject as a research project for a master or doctorate thesis.

Sexual Medicine and Research:

Hong Kong claims to offer good medical services.  It is the first Chinese community in the world to provide good organized service on sexual problems too.  The excellence of this service has been well supported for a long time by statistics on obstetric care, infant mortality, neonatal care, population control, and the treatment and prevention of sexually transmitted diseases (Ng 1990a).  The sex clinic in Hong Kong, set up in 1979, is the first in Chinese communities. It was also in Hong Kong that the first Chinese sexology association, the Hong Kong Sex Education Association, was set up in 1985.   The Association was instrumental in the organization of the Asian Federation for Sexology which was established in 1992. Despite an early start, the subsequent growth of sexual medicine in the territory has been slow.  Not counting the clinics run by traditional healers, there is only one more sex clinic in the public hospitals in Hong Kong in 1997, and, not counting the gynecologists or urologists with partial interests in sexual problems, only one new medical doctor has really joined the field of medical sexology or sex therapy.  The deep rooted and strong antisexual atmosphere Hong Kong might be the cause for this slow development.  A clinic cannot exist with just a doctor and a consultation room.  It takes nurses, social workers, psychologists, technicians and many other auxiliary personnel.  It also needs laboratories, drugs, reading materials, instructions and treatment devices that could be easily assessed by the public.  Patients also have to know where and when to come and they must not be shy to come. All these mean a sexually enlightened and open social atmosphere.  Yet, this is not the kind of atmosphere in Hong Kong.   Like many conservative societies, Hong Kong is hypersensitive to anything about sex.  Politician, society and religious readers harp constantly on the mythical harm of pornography and, making use of the excuse that sex education and treatment materials can also be pornographic, they control the contents and means of these materials through the publication laws to suit their own sexual idiosyncrasies or beliefs. Therefore, it happened in the  Obscene and Indecent Articles Tribunal that a passage in a clearly sex educational article was judged to be indecent simply because it warned youngsters not to use certain dangerous and unsafe means of contraception. Another recent event is that when an acclaimed adult sex education tape produced by a doctor in England was dubbed into Chinese and submitted to the Television and Entertainment Licensing Authority for permission to  market, the Authority required some explicit scenes in the tape to be cut away .  Apparently, the lay jurors serving in the Authority thought that they knew better than the specialists and that the Hong Kong Chinese were more sexually intelligent than the British and need fewer and less explicit instructions to understand what was taught.  Laymen in Hong Kong also control what sex aids can be on sale and where, because a few years ago, a sex shop was prevented from opening simply due to the negative sentiments of the tenants in the same building.  The tenants insisted that a sex shop sold obscene objects. They could not be convinced that sex aids and related materials are also useful for the treatment or rehabilitation of those suffering from sexual dysfunction or who are sexually underprivileged.  As long as Hong Kong continues to maintain this principle of legally appointing the lay public to govern the sexual health of its people, the development of sexual medicine can only be slow and continue to face great difficulties.

To understand the basic sexual characteristics of its people, like all other societies making a start on sex research, Hong Kong spends quite a lot of effort on  sexuality surveys.  These surveys have ranged from the broad KABP surveys to specific ones focussing on the consumption of pornography, experience and attitudes toward rape (Cheng, Ip, and Cheung, 1984; Cheung, Audry and Tam, 1990), sexual harassment (Tang, Yik, Cheung, Choi, and Au, 1995), child sexual abuses (Tang and Davis, 1996), homosexuality, gender inequality (Westwood, Ngo and Leung, 1997), sex among the disabled and the mentally handicapped. Some are commissioned by the government to guide its social or health policies, some by voluntary agencies to evaluate their work, some by religious or political groups to support their views and affirmations, and some are by academics for theoretical interests.   The quality of these surveys is very variable.  The religious and political surveys are well known to be very unscientific.  They use vague and broad definitions and unrepresentative samples.  Good surveys attain an international standard and their data have been used for making cross-cultural comparisons. 

Clinical sexuality researches have been on the development and application of sex therapy, family and psychotherapy, drugs and devices in the treatment of sexual dysfunction and transgender problems.  There are also sexuality researches of the more traditionally medical kind, such as researches on contraception, assisted reproduction, prostate and penile surgery, sex hormones and women health. Similar to most other countries, sexuality research in Hong Kong is difficult to obtain funding.  Except for the more traditional researches related to health and diseases such as those on reproduction, sex hormones AIDS and STDs, researches on sexual behavior, psychology, sexual minorities are often thought to be unimportant and unscientific and attract little financial support unless they are done for specific political or ideological causes. This is a principle reason for the highly uneven quality of sexuality researches in Hong Kong.   


Hong Kong is a very special place as far as sexuality is concerned.  One finds it very sexually open if one reads the newspapers, watches the "illegal" videotapes or disks that are easily available in street shops, listens to sexual discussions on the radio and television, experiences how easy it is to find casual or commercial sex and follows up the life style of some of the movie stars and social celebrities.  On the other hand, the laws are strict, voices for sexual conservatism are loud, sex education activities or serious discussion on sexual matters are difficult to find.  Such a sexuality split is found probably in many communities also, but certainly more so in Hong Kong.  This could be due to the strong influences of  both the Chinese and Western civilizations which often fight and crash vigorously with each other creating difficult choices for the common people.  Luckily, and probably due to the high level of mutual tolerance in the Chinese, open physical violence between antagonistic camps has rarely happened, if ever.  This type of sexuality environment should make Hong Kong a particularly interesting place for sexologists to work in and study, to see how sexual diversities can coexist peacefully and be properly managed and conduce to growth.    

References and Suggested Readings

Against Child Abuse Society (1988, 1997) Annual Reports. Hong Kong.

Census and Statistical Department (1996) 1996 Population By Census: Summary Results. Hong Kong. Hong Kong Government.

Chung SF & Fung E (1999) Survey on Women and AIDS: AIDS knowledge, attitudes, opinions, about condom use and practice with spouse or sexual partner(s).  St. John's Cathedral HIV Information and Drop-In Centre.  Hong Kong.

Department of Health (1998) Hong Kong STD/AIDS Update. 4:3,2.

Education Department (1986) Guidelines on Sex Education in Secondary Schools.  Hong Kong, the Department.

Education Department (1994) A Study on Knowledge and Attitudes of Secondary School Pupils on Sex and Sex Education. Hong Kong, the Department.

Hong JH, Fan MS, Ng ML, LKC Lee, Lui PK and Choy YH (1994) Sexual Attitudes and behavior of Chinese university students in Shanghai.  Journal of Sex Education and Therapy, 20:4, 277-286.

Fan MS, Hong JH, Ng ML, Lee LKC, Lui PK and Choy YH (1995) Western influences on Chinese sexuality: insight from a comparison of thesexual behavior and attitudes of Shanghai and Hong Kong freshmen at universities.  Journal of Sex Education and Therapy, 21:3, 158-166.

FPAHK (1988 to 1992) Annual Report. Hong Kong, Family Planning Association of Hong Kong.

FPAHK (1981) Hong Kong School Youths. Hong Kong, Family Planning Association of Hong Kong.

FPAHK (1986) Adolescent Sexuality Study. Hong Kong, Family Planning Association of Hong Kong.

FPAHK (1991a) Youth Sexuality Study, In-school Youth. Hong Kong, Family Planning Association of Hong Kong.

FPAHK (1991b) Youth Sexuality Study, Out-school Youth. Hong Kong, Family Planning Association of Hong Kong.

FPAHK (1993) Report on Women's Health Survey. Hong Kong, Family Planning Association of Hong Kong.

FPAHK (1998) Youth Sexuality Study 1996.  Hong Kong, Family Planning Association of Hong Kong. (In print)

Green R and Money J (Eds.)(1969) Transsexualism and Sex Reassignment.  Baltimore, Johns Hopkins Press.

Hong Kong Government (1998) Hong Kong Monthly Digest of Statistics, August.  Hong Kong.

Hong Kong Tertiary Institutions Health Care Working Group (1991) Survey on Sexual Behavior of Students in Tertiary Institutions in Hong Kong.  Unpublished data. 

Liu DL & Ng ML (1995) Sexual dysfunction in China. Annuals of the Academy of Medicine of Singapore. 24:728-31.

Liu DL, Ng ML, Chou LP, Haeberle (1997) Sexual Behavior in Modern China - A Report of the Nation-wide "Sex Civilization Survey" on 20,000 subjects in China.  New York, Continuum.   

Lui PK, Cheung CF, Chan KL and Ng ML (1993) Differential erosion of three traditional Chinese sexual values in Hong Kong.  In Sexuality in Asia (Eds. Ng ML & Lam LS), Hong Kong, Hong Kong College of Psychiatrists. 21-32.

Ng ML (1988) Transsexualism -- service and problems in Hong Kong.  The Hong Kong Practitioners. 11:12, 591-602.

Ng ML (1990a) Sexual problems in Hong Kong -- a medical perspective.  In Sexuality in Dissent (Ed. Ng ML). Hong Kong, Commercial Press. 198-210. (In Chinese)

Ng ML (1990b) Sex therapy for the Chinese in Hong Kong. Sexual and Marital Therapy, 3:2, 245-252.

Ng ML (1998) School and public sexuality education in Hong Kong. Journal of Asian Sexology 1:32-34.

Pau WN (1991) Sex education in schools and its outcome.  In An Analysis of Hong Kong Education (Eds. Hong Kong Federation of Sex Educators and Hong Kong Education Resource Centre), Hong Kong, Wide Angle Press. 377-385. (In Chinese)

Pearson V (1998)  The mental health of women in China. Hong Kong Journal of Psychiatry. 8:1, 3-8.

Royal Hong Kong Police (1988 - 1996) Annual Reports. Hong Kong, Hong Kong Government.

Hong Kong Police (1997-1998) Annual Reports. Hong Kong, Hong Kong Special Administrative Region Government.

Tang CSK (1994) Prevalence of spouse aggression in Hong Kong. Journal of Family Violence. 9: 4, 347-356.

Tang CSK, Yik MSM, Cheung FMC, Choi PK, and Au KC (1995).  How do Chinese College students define sexual harassment? Journal of Interpersonal Violence. 10:4, 503-515.

Tang CSK (1997) Psychological impact of wife abuse -Experiences of Chinese women and their children. Journal of Interpersonal Violence. 12:3, 466-478.

Tang CSK,  Davis C (1996) Child abuse in Hong Kong revisited after 15 years: Characteristics of victims and abusers. Child Abuse & Neglect.  20:12,  1213-1218.

Westwood RI, Ngo HY, and Leung SM (1997) The politics of opportunity: Gender and work in Hong Kong. In Engendering Hong Kong Society (Ed. Cheung FM). Hong Kong: The Chinese University Press. 41-100.

Wong WLE (1996) To talk or not to talk- a study of the knowledge, communication pattern and expectation about sex of couples preparing for marriage.  M.S.W. Dissertation.  The Department of Social Work And Social Administration.  The University of Hong Kong.

Yeung C (1991) Wife abuse: A brief historical review on research and intervention. Hong Kong Journal of Social Work. 25, 29-37.

Yip PSF (1995) Suicides in Hong Kong: 1981-1994. Hong Kong: Department of Statistics, the University of Hong Kong.

Young KPH, Chau BCH, Li CK, Tai LYY, Yim VPL and Cheung WY (1995) Study on Marriages Affected by Extramarital Affairs. Hong Kong, Family Service, Caritas-HK.