China is set to (51) its first clinical guideline on sex-change surgery, according to a notice put on the website of the Ministry of Health yesterday. The ministry is now soliciting public and professional opinions on the draft guideline. The coming guideline aims to regulate and standardize sex reassignment surgery, part of a treatment for gender identity disorder in transsexuals. Experts (52) nearly 2,000 Chinese have undergone sex-change surgery while 100,000 to 400,000 are still considering it. However, no official number is available. In the draft, the MOH sets (53) criteria for both surgical candidates and medical institutions. Candidates for the surgery must be older than 20 and single, the draft guideline said. They are also required to prove a persistent desire for a sex change, to live for at least five consecutive years full-time in the new gender role, and to engage (54) mental therapy for at least one year. Before surgery can take place, a candidate must receive a recommendation for the operation from a (55) after an appropriate series of therapy sessions. Also, several legal requirements (56) be met before the procedure. The candidate must provide proof from police that he or she has does not have any criminal offenses in the past. Police must also agree to change the sex status on the identity card of the (57) receiver before the operation can, take (58) . The advent of such a guideline (59) to show that the government is concerned (60) the needs of a relatively small (61) of people who want to change sex. But doctors also warn that all stakeholders, including the hospital and prospective receivers, should be highly cautious about this surgery. The operation is more than a medical procedure due (62) its huge social and legal consequences. Doctors should make it clear to those (63) sex-change surgeries that the option always remains to continue to live in the original role. The guideline requires surgeons to tell patients about other options (64) hormone therapy. They are also required to explain the risks involved, and underlying social barriers including discrimination, and administrative recognition and approval. For the candidates, the surgery itself is not the big issue (65) the long run. The real issue is the kind of life he or she will have to lead afterward.