Gender-affirming care for minors

As per the Ministry of Health’s latest guidelines in May 2026, gender-affirming care for minors (under 21) is controlled and restricted. However, there is no minimum age to be evaluated by a psychiatrist for gender dysphoria (which is required for HRT), although parental consent will be required for those under 21.

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Due to the sensitivity of the information involved, you should contact us if you wish to find out more about pursuing transition as a minor, require information on transitioning at school, or need support for your family.

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Obtaining gender-affirming care for minors

The private healthcare route

If you have your parents’ support and they can afford it, you can visit a private psychiatrist to be evaluated for gender dysphoria.

This will likely require several sessions, with each costing a few hundred dollars. Some psychiatrists are also able to speak with your parents to explain what it means to be transgender and address concerns they may have.

As of this moment, you will not be able to begin HRT with a private endocrinologist until you turn 21. However, this may change in future when there are private clinics that are able to adhere to MOH’s requirements. You can check this page or write in to us for the latest updates.

When you become of age (at 21), you can bring the psychiatrist’s diagnosis to a public hospital endocrinologist (via a polyclinic referral if you are a Singapore Citizen or PR). This might allow you to skip the assessment stage and go straight to HRT. Results may vary, as some hospitals may not accept diagnoses from some private psychiatrists.

Through public healthcare

Transition healthcare is strictly not available for minors under 18, regardless of circumstances and even with both parents’ consent. This includes puberty blockers and HRT.

If you are under 18 and your parents are supportive, you can still visit a polyclinic and request for a referral to a psychiatrist for gender dysphoria.

You can use these appointments and a psychiatrist’s memo as supporting documentation to gain accommodations in school or National Service.

If you are above 18, the polyclinic will refer you to a hospital to be assessed for gender dysphoria by a Treatment Review Panel consisting of at least: 1. A psychiatrist; 2. A psychologist, counsellor or social worker (as many as are involved in your care); 3. An endocrinologist or paediatrician; 4. A surgeon if surgical options are being considered; and 5. One more non-treating medical specialist from any of the above groups.

This panel will only be able to approve you for gender-affirming hormone replacement therapy (HRT) and/or gender-affirming surgeries should they deem there to be “exceptional circumstances where there is clear evidence of benefit or harm reduction (which may include medical/mental health grounds)”. Both your parents will also need to consent to your treatment.

If you are under 21 but started the process before the change in policy took effect in May 2026, gender-affirming care may still be provided, but requires a review by the hospital’s clinical ethics committee, as well as parental consent from both parents.

Puberty blockers

Puberty blockers are not available for trans youths in Singapore.

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In countries where puberty blockers are available for transgender youths, a minority of those who desire medical transition and who have been assessed by doctors as suitable candidates for treatment may choose to undergo temporary puberty suppression with puberty blockers.

This will solely halt the development of secondary sex characteristics, allowing them time to physically and mentally mature before making the irreversible decision to undergo either typical male or female puberty.

Subsequent HRT will then allow them to develop bodies that – genitalia aside – are phenotypically similar to others of their gender.

Trans women will be able to retain high voices; trans men will not have to grow breasts. Both will develop the height, musculature and skeletal structure typical for their identified gender. This eliminates most sources of body dysphoria, increasing quality of life.

It will also make it much easier for them to blend into society, significantly reducing their risk of discrimination, abuse and violence and give them the ability to live a normal life.

At this point, assessments are rigorous enough that roughly 98% of these youths persist in trans identification as adults, indicating that non-treatment is far more likely to do harm than good, and allaying common fears that many may cease to be trans in adulthood.

The remaining 2% include those who are still trans but have decided not to medically transition at that point, those who realise they are non-binary, and a small minority who no longer consider themselves trans. These youths can stop taking blockers and proceed with regular puberty, retaining their fertility, and will likewise look no different from others of their sex.

A large scale study of 20,619 transgender adults aged 18-36 found that past access to pubertal suppression, for those who desired it, was associated with reduced lifetime suicide ideation and improved mental health outcomes.

Prior long-term studies of transgender youth who undergo puberty blockers treatment have consistently produced extremely positive results.

In one study, 55 transgender youth were monitored over a period of about eight years from the administration of puberty blockers at an average age of 13 to hormone therapy at ~17 to surgery at ~21, after which they scored equal or better on assessments of mental health compared to their non-trans peers.

This is especially significant in light of the astronomical rate of mental illness and suicide that has long been observed in transgender youth denied treatment until adulthood.

As with all medication, there is a risk of side effects. Every young person’s individual health profile, existing conditions and family medical history are thus also taken into consideration alongside the severity of dysphoria and other concerns. These risks may need to be separately monitored and managed as appropriate, such as through calcium supplements to address possible side effects affecting bone density.

Side effects are more common with extended use of puberty blockers over many years, as is the case for children with precocious puberty, and it is not recommended to be on them for more than two to three years.

In rare cases where a young person has found relief from dysphoria through puberty blockers and has expressed a strong and persistent gender identity across many years that shows no sign of changing, but has been on blockers for several years or experienced concerning side effects, earlier access to HRT should thus be considered appropriate on a case-by-case basis.

What you can do while waiting to medically transition

It is difficult – and sometimes outright impossible – to access psychological care and support for gender dysphoria without parental approval.

However, some services have a lower age limit. Support and befriending services begin at 16 at Transbefrienders.

Befriender support at Transbefrienders

If your parents can afford it and are open to it, you can ask to go to a LGBTQ-affirming counselling or therapy service. Some provide family counselling sessions that you can attend together with your parents.

Reach out to us to find out more.

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Coming out to parents – I’ll Walk With You

I’ll Walk With You is a comprehensive resource guide for parents of transgender children and is available in all four of Singapore’s official languages – Malay, English, Chinese and Tamil.

If your parents would like additional support, there is also a support group for parents called My Family Matters.

You can find I’ll Walk With You and our other resources for parents below.

Resources for parents

Things to consider as a young trans person

There is no single ‘right’ way to transition

Some trans people experience little or no body dysphoria and are content with social transition without medical intervention. This is especially common for those who are non-binary.

If this is the case for you, and you are happy with your body as it is, you should never feel pressured to pursue HRT out of the belief that it is what a trans person “should” do. The goal of transition is for you to be comfortable with your body and identity.

If you are happy with yourself as you are but feel that you need to look a certain way to be taken seriously as your gender, that is a valid concern, but should not be the basis for medical decisions.

Consider speaking about this with a counsellor, or find other ways to influence how others see you – such as through make-up (for trans girls and other transfemmes) or working out (for trans boys and other transmascs), or even explicit indicators like pronoun pins. For trans youths, this – alongside clothing, hairstyles and mannerisms – may be sufficient for you to be perceived as your gender.

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In school

Socially, trans students in Singapore face immense challenges within the school system and are unlikely to be accommodated on school uniform and toilet access issues. If you are presently enrolled in a local school, you may wish to consider options like withholding your transition until after graduation, living as your gender only among friends or outside of school, or going on HRT without full social transition if your dysphoria is too severe.

Some schools are willing to make accommodations to allow transgender students to wear PE uniforms in place of the usual school uniform.

If you legally change your name, you can update your name in your school records and be addressed as such. Schools and other educational institutions would otherwise continue to refer to you by your legal name, which would also be the name that appears in your transcripts and certificates.

International schools are known to be more accommodating or even strongly supportive of transgender students. This nonetheless differs from school to school.

You can read more about navigating the school system here.

Managing stress

Transitioning is often deeply stressful, especially in Singapore and especially for youths, all the more if you do not have a supportive environment. If you are already undergoing considerable stress in other areas of your life, do take that into account when considering when and how to transition.

If you have severe gender dysphoria, the relief from transition may help you better cope with stresses in other areas of your life, even alongside the new challenges that will come from transitioning.

However, if your gender dysphoria is minimal, the relief you get from transitioning may not be enough to overcome those additional stresses and challenges. In that case, you may wish to wait until you are older, since transitioning as an adult is much easier in many ways and also gives you more control over your own transition. This is especially important if you desire a less typical transition, such going on low-dose HRT or pursuing surgeries without HRT.