The Global Times, a state-backed media outlet, wrote about the clinic, noting that China’s transgender youth are at higher risk for depression and anxiety relative to the broad population. (That’s true everywhere.) Based at the Children’s Hospital of Fudan University, the clinic plans to bring together specialists in psychologists, endocrinologists, geneticists and others to “serve as a bridge between transgender children, parents, doctors and the various circles of society,” according to the story.

It’s not clear why the clinic opened now, nor why it’s getting positive coverage by official media at a time when the Communist Party has been cracking down on LGBTQ activists and emphasizing more traditional gender roles and values.

For example, this summer, Tencent’s social media platform WeChat closed down the accounts of LGBTQ associations at some of the nation’s leading universities including Tsinghua and Peking. All that was offered by way of explanation was that they violated unspecified rules. More recently, regulators took aim at androgynous pop idols and told state media not to promote men with a more feminine esthetic.

Barriers to medical services remain steep for trans people. Before they can qualify for hormone treatment or gender reassignment surgeries, they’re required to undergo psychological intervention, prove they don’t have a criminal record, and notify family — a step that experts say amounts to parental consent, even for adults.

In some cases, the obstacles are too much, and it’s not uncommon for trans people to pursue underground avenues, including self-dosing with hormones acquired online. Self-mutilation, too: Amnesty International reported the case of one transgender woman who obtained her family’s approval only after she removed one of her own testicles by herself.

But there has also been progress. “Surveys show increasing acceptance among younger generations, views of pro-LGBT social media hashtags have reached into the hundreds of millions several times (though are often censored shortly after), and LGBT plaintiffs have won pioneering rights in court,” according to a report by OutRight Action International. And the Shanghai clinic is much more than a symbolic achievement. For the children among China’s estimated 4 million transgender people, it could be a lifeline.