["American Ethnologist, Volume 53, Issue 1, Page 22-33, February 2026. ", "\nAbstract\nTo access prescriptions for gender‐affirming hormone therapy in China, trans adults need to provide proof of parental acknowledgment (fumu zhiqing). This requirement was established during, not before, geopolitical rivalries between China and the US. Drawing on fieldwork in one of China's major trans medical care clinics, I offer the concept of geobiopolitics to capture how trans medicine has been recalibrated amid rising China‐US geopolitical tensions, arguing that the geo cannot be bracketed off from the biomedical regulation of trans bodies. Relying on parental acknowledgment, the geobiopolitics of trans medicine functions through both the biopolitical control of trans bodies (reflecting paternalistic state logic) and the geopolitical enactment of medical “response‐ability” (aligning trans medicine with Chinese state interests). Balancing the delivery of trans medical care and the preservation of its legitimacy, physicians invoke parental acknowledgment, which risks reifying trans in China—and China itself—as “family centered” and “local,” and thus exterior to “Western modernity.”\n"]