Trans Healthcare in Singapore
Singapore has two options for medical transition: public and private.
Public hospitals require a longer process that may take weeks to months. However, it is significantly more affordable for consultation and medication. Public hospitals also provide a consistent level of care, including regular checkups and blood tests to ensure you are receiving your hormone replacement therapy (HRT) in a safe and optimised manner.
Private doctors are much more expensive, but may allow you to start HRT with informed consent on the very first visit. Some private doctors only provide blood tests upon request and tend to charge a lot more. Consultations can cost upwards of $2-300 for a private doctor and $40-50 at a public hospital.
For both the public and private routes, you will typically have to see two specialists – a psychiatrist and an endocrinologist – in order to access HRT.
What each specialist will do
|The psychiatrist will evaluate and diagnose you for gender dysphoria. They can also write memos requesting for accommodations (e.g. at schools and universities, and for exemptions from National Service).
If you wish to pursue gender-affirming surgeries, you may need a second assessment from a psychiatrist. Some psychiatrists can also help with explaining gender dysphoria and transitioning to parents or loved ones.
|The endocrinologist will conduct blood tests and prescribe HRT. They provide for a consistent level of care, with regular blood tests to ensure that your HRT is administered in a safe and optimised manner.
As medical transition is a big step and can be very stressful, you may wish to consider seeing a trans-friendly counsellor to talk through this decision. This can help you get a better understanding of your identity, your reasons for wanting to go on HRT or for surgeries, the different options available to you, and the steps you plan to take. This helps you be clearer about what you are doing and why, be sure of your decision, and prepare yourself for the challenges you may face.
Ideally, you should also try and find a support network so that you have friends to lean on when times get tough, especially if your family is not supportive.
The public healthcare route
Singapore Citizens and PRs receive subsidised public healthcare when referred through a polyclinic.
If you are above 18 and wish to transition under the public healthcare system, or want a formal evaluation and diagnosis for gender dysphoria through the public healthcare system, your first step will be to make an appointment with a polyclinic.
If you are not a Singapore Citizen or PR, you should instead make an appointment directly with a psychiatrist, where you would be considered a private patient. (This is more costly, but typically still cheaper than seeing a private psychiatrist.)
Find out more about transfeminine HRT and transmasculine HRT.
If you are below 18, your options are drastically more limited as HRT is generally not prescribed to those under 18 through the Singapore public healthcare system. Click here for more information.
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What to expect at the polyclinic
What to expect when seeing the psychiatrist
What to expect when seeing the endocrinologist
The private healthcare route
Singapore has several private clinics that provide transgender healthcare services, including HRT. These cost significantly more than public hospitals, but have a shorter waiting time and provide a more discreet experience.
There are a small number of private GPs that prescribe HRT under informed consent.
However, they are not psychiatrists and thus will not be able to diagnose you with gender dysphoria, which you will need if you plan to transfer to the public healthcare system or if you require accommodations with regards to schooling or National Service (NS).
Private psychiatrists can evaluate you for gender dysphoria and write a memo with their diagnosis. You can use that diagnosis to see a private or public endocrinologist for HRT. Do note that private psychiatrists differ widely in their experience with trans issues, which can be a concern if you are unsure about transition being right for you.
Private endocrinologists require a psychiatrist’s memo in order to prescribe HRT. They can also administer blood tests.
You can email us at email@example.com for recommendations and more information.
Mixing public and private routes
Some people may choose to begin HRT through the private route while waiting for their appointment at a public hospital. This can be a good option if you can afford it and would prefer not to wait, or want a more discreet experience.
We do recommend shifting to a public route eventually as the difference in cost will be immense over the long run. The public route also ensures that you will have continuous care for the rest of your life, rather than risk an interruption if the private doctor suddenly quits or retires.
With most hospitals, an assessment from a private psychiatrist can be used to obtain approval for HRT at a public hospital endocrinologist. (Changi General Hospital is the only exception as they do their own internal assessments.)