- Accessing Healthcare
- Changing Gender Marker
- Effects of HRT on other health measures
- Health Screenings
We recognise from experience that the process of seeking healthcare can be extremely uncomfortable for transgender people, to the point of being a deterrent. While things are slowly improving, there is still not much awareness around trans issues in our local healthcare systems, and things like having a nurse shout “Mr. Jennifer Tan!” across a crowded waiting room can be terrifying, especially when people stare at you. Healthcare staff can also be inquisitive, asking “you got surgery already?” or making comments like “you quite pretty what, why you want to be a boy?” when you’re just trying to make an appointment.
It is almost guaranteed that any doctor you see will also ask you whether you’ve had ‘the surgery’, even if you are there for something completely unrelated, like the flu; so that is something you might want to prepare yourself for, especially if you’re someone who gets uncomfortable when strangers start a conversation by asking you about your genitals.
These problems are greatly amplified when it comes to sex-specific healthcare, for example a bearded trans man trying to get a pap smear in a gynaecological office filled with women.
Difficult as it may be, however, your health is more important. We recommend bringing a opposite-sex friend or family member along with you for support. If you have medically transitioned but have not yet been able to legally change your sex, this can reduce the stares when nurses call for you (people might assume they’re referring to your friend instead). They may also assume that you’re there to support your friend rather than to see the doctor yourself.
Take heart, knowing that many of us have suffered through the awkwardness and survived to tell the tale.
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Changing Gender Marker
Some polyclinics will allow you to change your gender in the system if you have undergone HRT, even if you have not yet been able to change it legally. Your polyclinic doctor may request that you do so, because this will make it easier for them to automatically measure blood test results and other health standards that differ by sex, instead of doing so manually.
Try to get it changed if possible, for it can reduce a lot of the stress. You’ll be able to go through reception, height & weight, blood pressure, blood tests, pharmacy, cashier etc. without disclosing that you are transgender at every turn, and you can do without that extra stress when you’re already ill. The only person in that process who has any need to know that you are transgender is your doctor.
If you have undergone HRT and pass as a cis person of your gender, when registering at a private clinic, one trick is to leave the gender field blank and let them fill it in for you. Avoid this in cases where your transgender status may be relevant to your healthcare. This is more for things like dentists, where your reproductive organs are (hopefully) irrelevant.
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Effects of HRT on other health measures
Cross-sex hormone replacement therapy (HRT) changes the body’s sex on a biological level, and this has implications for healthcare. If you have undergone HRT, your blood test results, health risks and dosage levels of certain medications need to be measured against the standard for the sex you have hormonally transitioned to. This may further depend on how long you have been on HRT and your particular dosage. Where uncertain, please check with your healthcare provider.
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You will need to continue receiving appropriate healthcare for the reproductive organs you have. For trans women, this may mean continuing prostate examinations after genital surgery, as well as mammograms for those who have grown breasts on HRT, similar to other women.
For trans men, breast cancer screening is not necessary after top surgery, unless it was merely a breast reduction. Cervical screening should continue if a trans man has retained his cervix. If a total hysterectomy has been done, no further screening is required.
We are presently aware of one local gynecologist who has treated transgender men in Singapore. Please contact us for more information at contact(at)transgendersg.com.
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