If a citizen applies for changing the gender of his/her registered permanent residence after the sex change operation, he/she must issue a certificate that the sex change operation was successfully carried out in a hospital at or above the prefecture level. After the examination and approval by the county and city public security organs, the police station shall go through the formalities for changing gender items. The ID card is just a gender change, and the ID card is still a normal ID card.
TS refers to people who are dissatisfied with their gender identity and want to change their gender through surgery. Many people just don't have the ability to change sex, or are actively preparing for sex change, or are taking some estrogen drugs.