The govt there recently banned the sale of hormones online which really complicated things for trans women.

That's if you don't have a prescription, while the process is some what tedious to get a prescription people were giving themselves doses far above what is recommended so it was out of concern for safety not a malicious intent unlike what we see in Western countries. I would like to see China do informed consent for HRT and lift some of the barriers though.

As far as the rural v urban divide, it is a tale as old as time, not something unique to China, but at least they are doing something about it.