A historical case study tracing Zhang Kesha’s 1983 confidential operation, local oral visibility in Changsha, years of private life-writing, and the 2003 publication and press tour around Woman’s Dream. It proposes a public-history relay and a narrative-provenance ledger for studying how a clinical event became public transgender history.

A source-critical guide that decomposes “first” claims in mainland China’s transgender medical history into procedure scope, geography, institution, publicity, administrative effect, event time, and source role, comparing the 1983 Zhang Kesha surgery, regional surgery histories of the 1990s, marriage registration in 2003, Geng Zi’s public identity in 2005–2006, and national technical rules from 2009 to 2022.