Born in Chiayi City to Hsu Shih-hsian (許世賢), a politician-doctor, Chang is a medical doctor educated in Kaohsiung Medical College (1968), the Institute of Public Health, National Taiwan University (1970, Johns Hopkins University (1974), and Kyorin University (1994).
She was the mayor of her home city, serving three terms (1983-89, 1997-2000), the first time succeeding her mother, Hsu; the last time succeeding her sister, Chang Wen-ying (張文英). The Chang daughters and mother are known as the Hsu Family of Chiayi (許家班).
She was the director of the cabinet-level Department of Public Health from June 2, 1979 to September 1, 1986, and the Minister of Interior from May 20, 1989 to February 1, 1991.
She is married to Chi Tsan-nan (紀展南) with a son and a daughter.