Trans Healthcare in Singapore
If you are seeking medical transition in Singapore, you have the option of either seeing a private doctor or going through the public healthcare system.
Private doctors are much more expensive, but may allow you to start hormone therapy (HRT) on the very first visit. General hospitals require a longer process that may take months, but is much more affordable both for consultation and medication. Hospitals will also provide you with regular checkups and blood tests to ensure everything is fine, whereas private doctors usually only do so upon request, and tend to charge a lot.
If you are in a hurry to start, one option is to start going through the public system and see a private doctor in the meantime.
As medical transition is a big step, you may wish to consider first seeing a trans-friendly counsellor to talk through this decision in order to get a better understanding of your identity, your reasons for transitioning, the options available to you, and the steps you plan to take. This also helps you be clearer about what you are doing and why, and allows you to mentally prepare yourself for the challenges you may face on the journey ahead.
Public Healthcare: General Hospitals
In order to benefit from subsidised public healthcare, you need to first obtain a referral instead of going directly to the hospitals:
If you’ve already started HRT, you can ask for a direct referral to an endocrinologist at one of the hospitals. You may not need to mention you are transgender.
If you haven’t yet started HRT, we recommend that you ask to be referred to the IMH gender clinic. If you’re not comfortable with outing yourself to the polyclinic doctor, you can ask for a general referral to IMH (perhaps for depression, if applicable), although this may result in a longer waiting time as you won’t be able to go directly to the gender clinic. Either way, you would first need to undergo a psychiatric assessment before being approved for HRT, and the IMH gender clinic is a lot more experienced with trans individuals than the general psychiatrists at other hospitals. Nonetheless, you may still prefer the second option if you have a particular hospital in mind. (IMH works with TTSH). Polyclinics generally do not ask too many questions – it’s not their job to diagnose you – and you should be able to get a referral fairly easily.
Oogachaga is a local LGBT counselling organisation. They provide counselling and referrals to healthcare providers for transgender clients. They operate on a sliding-scale model, with their fees dependent on your income.
CHAT hub is a free community mental health screening programme for people under 30 housed at *SCAPE. You can call or fill in a form on their website, after which they will call you to set up an appointment in about one or two weeks. You will be screened by a psychiatrist who can refer you as necessary. One downside is that they are very thorough in assessing you for all possible mental illness, which may be tedious if you already know what you want.
This webpage provides a list of doctors (primarily based in the US) who do online consultations through instant messenger or video chat, and who are able to write and mail you a letter of recommendation for hormone therapy or surgery after they have assessed you. However, these may not be valid in local hospitals. Some provide counselling services, and others can give you referrals for blood tests (may not be subsidised) and will monitor the results. Their prices vary from around USD$35 to USD$200, but many offer discounts for those who need financial aid.
Due to the sensitivity of the information involved, feel free to contact us if you wish to find out more about pursuing transition via the public healthcare system. You can reach us by email at contact(at)transgendersg.com.
Public Healthcare: Institute of Mental Health
IMH runs a pilot gender clinic for transgender individuals to access psychiatric assessment and assistance. It is currently run by one doctor, and has a second in training to split the workload. The gender clinic is extremely sensitive to the needs of trans individuals and will ask for preferred pronouns and name. IMH itself is not as sensitive and may still call individuals by the wrong name and pronouns.
You can get a referral to the clinic from any doctor, but will only benefit from a subsidy if the referral is from a polyclinic. One of the most accessible routes is thus to visit a polyclinic, speak to a GP about gender dysphoria and ask to be referred to the IMH gender clinic. The gender clinic only runs psychiatric services (diagnosis, check-ins, prescriptions, referrals), but will write a referral to an endocrinologist for those seeking hormone therapy. It has minimal gatekeeping (but they will counsel you if your reasons for wanting to undergo medical transition are unclear), will not advise any kind of conversion therapy or counselling, and is supportive and sensitive.
Dr. Tsoi Wing Foo
Dr. Tsoi is the most well-known psychiatrist in Singapore who deals with transgender patients, with over 56 years of experience and tens of thousands of trans people treated. He practices out of Tsoi Clinic in Tanglin Shopping Centre.
Initial consultation fee is $180. Dr. Tsoi may allow you to start hormone therapy on the first day, but if you are under 21, he will first need your parents to sign a consent form. He can also write you a psychiatrist’s letter confirming that you have been diagnosed, and you can then bring this letter to another doctor if you wish to seek care from them instead.
Dr. Tsoi does not allow you to self-inject testosterone. Blood tests are only available on request. Each shot of Depo T costs $30+, and is administered once every three weeks. Sustanon and Nebido prices unknown. He may also write prescriptions that can then be filled at a lower cost at a public hospital pharmacy.
He’s in his 70s and may be retiring soon.
Dr. Alex Fok Chun Kwok
Dr. Fok is an endocrinologist with a long history of treating transgender people. His initial consultation fee is $180++, and he requires a letter from a psychiatrist (Dr. Tsoi or otherwise) before he can start you on hormone therapy.
For testosterone, Dr. Fok allows you to self-inject, or you can get a nurse to do it for $10.70. One vial of Depo T costs $62++ (will last a few months). Sustanon is $80 per shot, once every three weeks. Nebido prices unknown.