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 weeks to months, but is significantly 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 more.
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. You may also wish to see a private psychiatrist for an assessment and referral letter, and then look for a direct polyclinic referral to an endocrinologist at a public hospital.
Both parents’ consent is required to start HRT if you are under 21. (This is even if your parents are separated, though exceptions may be made for extraordinary circumstances.) HRT is not available in Singapore to those under 17.
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.
This is especially so if you are under 21 and presently enrolled in a local school, as trans students typically face immense challenges within the school system and are unlikely to be accommodated on issues of uniform and toilet access. You may thus have to consider options such as withholding transition until after you graduate, or going on HRT without social transition. (e.g. if you are a trans male student, that would mean going on T but continuing to wear the girls’ uniform and presenting as female while you are at the school.)
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 began HRT fairly recently, it would help if you have a psychiatrist’s letter with you to bring along.
If you haven’t yet started HRT, we recommend that you ask to be referred to the IMH Gender Care Clinic. If you’re not comfortable with outing yourself to the polyclinic doctor, you can ask for a general referral to IMH or another public psychiatrist (perhaps for depression, if applicable), although this may result in a longer waiting time and additional appointments.
IMH Gender Care Clinic
IMH runs a Gender Care clinic for transgender individuals to access psychiatric assessment and assistance.
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), but will write a referral to an endocrinologist for hormone therapy, if that is what you want and you are assessed to be suitable for treatment. It has minimal gatekeeping, but they will counsel you if your reasons for wanting to undergo medical transition are unclear, or if there may be other issues you might want to work through first. They will not advise any kind of conversion therapy, and are supportive and sensitive.
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 youths 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.
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 contacttransgendersg(at)gmail.com.
Singapore has several private doctors who provide transgender healthcare services. These usually cost quite a lot more than public hospitals, but have a shorter waiting time. Some people may choose to first see a private doctor while waiting for their appointment at a public hospital. You can email us for more information.