Singapore has two options for medical transition: public and private.

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If you’re a private GP that is able to provide some form of HRT-related care for those between 18 and 21, we encourage you to email us so we can include you in our database.

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Gender-affirming care for minors

  • When you arrive, the receptionist may ask what you are seeing the GP for. If you are unwilling to out yourself to the receptionist, you can say that you’re there for depression or anxiety. Their main concern here is that you are not undergoing a medical emergency or are contagious (e.g. with COVID-19).
  • Inform the GP you are transgender and ask for a referral to a psychiatrist for gender dysphoria. A psychiatric evaluation is needed before HRT can be prescribed.
    • If you already have a diagnosis from a private psychiatrist OR have been on HRT for a considerable amount of time (e.g. more than 1-2 years), you can ask for a referral to an endocrinologist instead.
    • Indicate whether you have been on HRT, and for how long. This will help in determining how urgent an endocrinologist appointment will be.

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    OpenStreetMaps

  • Depending on the polyclinic and healthcare cluster, you should ask for a referral to the following hospitals:
    • Khoo Teck Puat Hospital (KTPH) if you live in the Central region, close to a National Healthcare Group polyclinic.
    • National University Hospital (NUH) or Ng Teng Fong General Hospital (NTFGH) if you live in the West, close to a National University Health System polyclinic.
    • Changi General Hospital (CGH) or Sengkang General Hospital (SKH) if you live in the East, close to a SingHealth polyclinic. (CGH requires that you see the endocrinologist for an initial evaluation, and may also require you to see a psychiatrist before HRT can be prescribed.)
    • You can check which cluster each polyclinic belongs to on the polyclinic appointment website.
  • The GP will then refer you to a psychiatrist or endocrinologist at that hospital. They will not be evaluating you for gender dysphoria, but may ask some short questions for their referral notes.
    • If you are not comfortable outing yourself to the polyclinic GP, you can ask for a general referral to a psychological medicine department citing depression or anxiety. However, do note that this may require more appointments and prolong the time before you can access HRT. Many trans people have gone through the polyclinic system, so most GPs are familiar with the process.

  • The psychiatrist will ask you some questions about your gender dysphoria and trans identity, as well as your plans for transition.
    • This may include questions about your life, when you realised you were transgender, and perhaps more stereotypical questions like what sort of toys you played with as a child. Depending on the psych, be prepared that some questions may be sexual in nature, though this is rarer these days.
  • It is possible to be approved for HRT after just one appointment, but it is common to have two or more sessions if you are young or the psychiatrist deems you unsure about the transition steps you wish to take. Additional appointments may also be needed if you have additional mental health or personal considerations that could impact your transition, e.g. severe depression or lack of support system.
  • When the evaluation is complete, the psychiatrist will give you a memo with a formal diagnosis of gender dysphoria based on their assessment, and refer you to an endocrinologist if you wish to pursue HRT.
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  • Bring along your transition-related documentation such as psychiatrist memos, any overseas psychiatrist evaluations, private HRT prescriptions.
  • The endocrinologist will do a preliminary evaluation for related health risks from HRT, based on your personal and family medical histories.
    • The endocrinologist may ask you some questions relating to your gender dysphoria, and may refer you to their psychiatrist for a fuller evaluation if you have not been evaluated
  • The endocrinologist will send you for baseline blood tests to check your sex hormone levels and liver and kidney function. This is very important, as it will help determine if any future medical abnormalities are due to HRT or pre-existing medical conditions. Some hospitals additionally require bone density scans.
  • You can also ask for additional referrals to a speech therapist or a psychologist.
    • Any additional referrals should be registered for you 2-3 working days from the end of your first visit.