While HRT leads to some facial feminisation, this is often affected by age and genetics. Facial feminisation surgery — including various feminising cosmetic surgeries — can be done on top of these changes to achieve your desired look.

FFS includes various feminising cosmetic surgeries, such as a tracheal shave (reducing one’s Adam’s apple), rhinoplasty (nose correction), blepharoplasty (eyelid rejuvenation), facial bone reduction and face-lifts. Hair-related surgeries such as hairline advancement and transplants are also part of FFS.

As these are mostly cosmetic surgeries, prices for these procedures, if done in Singapore, will not be subsidised. Prices range from SGD 5,000 and above, depending on number of surgeries required.

This surgical procedure raises the pitch of your speaking voice by shortening the length of vocal cords. Voice training is required prior to surgery.

As this surgery may be risky on your vocal cords, speech therapy is often recommended as an alternative.

You will not be able to speak for a week after surgery as you will need to rest your vocal cords, but you may start increasing speech as the month progresses.

Breast augmentation surgery may help you increase the size of your breasts through breast implants or fat grafting, if you are unsatisfied with your current size. This surgery can be done regardless of whether one is on feminising HRT or not.

The surgical procedure for breast augmentation is the same for cis women, trans women, and transfeminine people. Infections and other complications are rare.

Breast augmentation is widely available in Singapore and overseas (Thailand, Malaysia, etc.), via both the public and private route. It costs anywhere from SGD 8,000 - 18,000.

The average recovery time of breast augmentation is anywhere from 4 to 8 weeks, dependent on factors like physical health, or type of surgery done (fat transfer or implants).

Liposuction may help to feminise your waistline. This procedure is available in Singapore.

Prices vary on the amount of fat removed. Spot reduction costs around SGD $1,500 - 4,000, while full reduction starts from SGD 12,000.

Approximately two to four weeks of recovery is required for this procedure, depending on the amount of fat removed.

Orchiectomy is a surgical procedure that involves the removal of the testicles (testes). This typically leads to reduced testosterone levels.

After this procedure, trans women and transfeminine people usually no longer need to take anti-androgens, and they may be able to lower their estrogen does.

Orchidectomy is available in Singapore, and trans people can usually obtain an referral through their endocrinologist.

Thailand is another option for orchidectomy, and the price for these ranges from anywhere between SGD 3,500 - 7,000.

The average recovery time for orchidectomy is about 2-4 weeks, though you can be discharged on the same day if the surgery is done in Singapore.

Penectomy is the removal of one’s penis. This is usually done in conjunction with a vaginoplasty and vulvoplasty, which is the creation of a vagina that has sexual sensation, mainly in the clitoris.

A vaginoplasty involves the creation of a vaginal canal, clitoris, labia majora and labia minora with existing tissue. A vulvoplasty involves the creation of the outer vagina.

Often, trans women and transfeminine people will need to remove their pubic hair permanently through electrolysis before undergoing vaginoplasty or vulvoplasty, so they do not experience complications. This can cost up to $3,000 to complete.

People who have done orchidectomy can also qualify for vaginoplasty.

Vaginoplasty, vulvoplasty and penectomy for transfeminine individuals is unavailable in Singapore, and many go to Thailand instead. Thai surgeons charge about SGD 10,000 - 15,000 and above.

Vaginoplasty requires a minimum of three months for recovery. People who have undergone vaginoplasty may find issues with self-lubrication and the tightness of the inner vaginal structure, which will require daily post-operative maintenance care such as dilation.

Top surgery or double mastectomy involves removing breast tissue and re-sculpting the chest into a more masculine appearance. There are a multitude of surgical and incision techniques, dependent on the texture, size and amount of tissue removed.

Top surgery can be done with or without transmasculine HRT. If you are planning to take HRT, some local doctors suggest going for top surgery two years after you begin, as you may qualify for other procedures and have better results. Testosterone shrinks breast tissue and redistributes fat, so surgeons will also have an easier time finding the contour of the pectoral muscle to do their incisions.

Depending on the type of top surgery you undergo, you may need anywhere from one week of recovery time to 3 weeks of recovery time. You may not be able to lift your arm overhead during this period, and you may require a caregiver to help you wash your hair or reach for objects in high places. It is recommended to wear button-up shirts, as you may struggle putting on a T-shirt.

In Singapore, top surgery costs anywhere from SGD 3,000 - 14,000, depending on subsidies, insurance and incision type. Costs may increase if liposuction is needed or if axillary breast tissue needs to be removed.

Most transmasculine people go overseas for cheaper rates. Top surgery in Malaysia is approximately SGD 3,000 - 5,000, while Thailand offers competitive rates of SGD 2,000 - 6,000.

A hysterectomy refers to the removal of one’s uterus, while an oophorectomy refers to the removal of one’s ovaries, and a vaginectomy refers to the removal of one’s vagina.

A hysterectomy and oophorectomy can be done on their own, with one another, or together with a vaginectomy or phalloplasty.

Hysterectomy and/or oophorectomy may be necessary, and also subsidised, if a transmasculine person has fibroids, endometriosis, or growths due to cancer. Removal of these organs can also be a preventative measure against cancer.

These procedures are available in Singapore, with subsidised rates from SGD 8,000 (with malignant conditions such as cancer or tumour), to SGD 20,000. In Thailand, procedures cost anywhere from SGD 6,000 - $9,000.

Hysterectomy and vaginectomy requires about 6 to 8 weeks of recovery time. Oophorectomy requires 4 to 6 weeks of recovery time; you may be able to reduce your testosterone dosage as estrogen levels will decrease.

Metoidioplasty is a form of genital reconstruction surgery that reconstructs a testosterone-enlarged clitoris and some surrounding tissue into a small penis. This is one form of penile reconstruction surgery, which retains full sensation, allowing for the penis to become erect on its own.

This surgical procedure is often done on top of a vaginectomy, but this is not always the case. If done with a urethroplasty (moving the urethral opening to the tip of the penis), you will be able to urinate standing up.

Metoidioplasty is not available in Singapore presently, and most people go to Thailand for this procedure. In Thailand, costs range from SGD 6,000 - 14,000.

These procedures take approximately six weeks in total for recovery, especially if done together.

Phalloplasty is another form of genital reconstruction surgery, which forms a penis that is closer the appearance and size of a typical male penis.

It is a highly invasive, complicated and expensive procedure. Phalloplasty often occurs in multiple steps, and requires multiple surgeries to fully craft a functioning penis. The full procedure may take years to complete as recovery time is needed between each stage.

There are several types of phalloplasty, dependent on the donor site. As nerves are required for blood flow to the reconstructed penis, donor sites usually are the forearm, back, thigh, abdomen. There will be large and obvious scarring on the donor sites.

Erotic and tactile sensation may be limited, but may also increase over time. People with phalloplasties may not be able to have erections, but this can be remedied with penile implants, which are also used by people with erectile dysfunction to get an erection.

Urethroplasty, vaginectomy, and hysterectomy are often done on top of phalloplasty, but not always.

Phalloplasty is available in Singapore, but many people go to the US or Thailand to undergo these procedures. Costs range anywhere from at least SGD 12,000 - 30,000 and above.

Scrotoplasty is the reconstruction of scrotum by reshaping the surrounding tissue, and the creation of testes via silicon or saline implants. It is usually done alongside phalloplasty, metoidioplasty.

Scrotoplasty may require a change of implants every decade or two, depending on the type of implant used.

This surgical procedure is available in Singapore, but most people head to Thailand for it. Prices range from SGD 2,000 - 6,000 for scrotoplasty in Thailand.

Recovery takes anywhere from three weeks to a few months, depending on the complexity of surgery done.