Vanishing act
Singapore's new, cautious treatment guidelines have mysteriously gone offline
Lost connection
Singapore’s new and restrictive guidelines for youth gender dysphoria have disappeared from government webpages.
A Ministry of Health (MOH) circular, with two separate treatment guidelines for children and adolescents attached, was uploaded last week to official, public webpages, including the Healthcare Services Act (HCSA) site.
Now the guidelines, which advise doctors against any hormonal or surgical interventions with gender dysphoric patients under 18, have been taken down.
Web searches did not turn up any public explanation by the MOH, nor any local media coverage of this unusual development.
On Singaporean LGBT social media, one poster said it was unclear whether or not the disappearance of the guidelines represented “a reversal of policy or just a cover-up”.
Last week, this person had claimed cross-sex hormones were “life-saving” and urged the local “queer community” to share the news that the government was “cracking down on trans healthcare”.
At the time of writing, the circular and both guidelines were available as archived files on the Wayback Machine.
Doctors and hospitals in the conservative Republic of Singapore would have been directly notified of the circular via the MOH Alert system.
One Australian-trained endocrinologist offering “gender-affirming hormone therapy” in Singapore has already updated her webpage to reflect the new advice from the MOH.
As recently as May 6, the day after the circular was issued, Minister for Health Ong Ye Kung was served up a question in Parliament enabling him to summarise the new guidelines.
“Psychological support should be the first line of treatment, and hormonal and surgical treatment should not be offered for children and adolescents under 18 years old,” he said.
“For adolescents aged 18 to 20 years old, hormonal therapy (excluding pubertal suppression) may only be offered in exceptional circumstances, with clear evidence of benefit, multidisciplinary team agreement, and informed consent from the adolescent and their parents.”
GCN put questions to Mr Ong and the MOH but there were no replies at the time of writing. GCN’s May 6 article on the contents of the new guidelines was based on PDF copies of the documents sent by a contact.
Although the circular that announced the guidelines was dated 5 May 2026, the guidelines themselves were dated July 2025. The reason for this delay in publishing the guidelines is unknown.
The key adolescent guidelines were drafted by a 20-strong workgroup, most members being clinicians. Although restricting the medicalisation of young people with gender dysphoria, the guidelines also use some gender-affirming language.
The incidence of gender dysphoria in Singaporean patients aged 6 to 19 years old increased from 2.17 per 10,000 population in 2017 to 5.85 per 10,000 population in 2021, according to a Q&A session hosted last year by the NUS School of Medicine.
A February 2026 letter to Annals, the journal of Singapore’s Academy of Medicine, urged the adoption of “specific education modules on gender care and sensitivity” in medical school curriculums.
The letter, signed by five members of the Department of Psychiatry at Sengkang General Hospital, cited a study identifying “significant gaps in LGBTQI+-related knowledge and preparedness among clinical-year medical students, suggesting that insufficient training may play a role in the stigma observed in healthcare”.
“Given our local cultural context, social transitioning can carry significant risks, including potential rejection, discrimination and alienation from family and community,” they wrote.
“While gender-affirming hormone therapy is comparatively accessible locally, most providers seem more comfortable with a prior psychiatric assessment, following a mental health assessment model rather than an informed consent approach. This process can often be time-consuming.”1
Presumably the letter writers are referring to adult patients. The “informed consent” model is a fast-track pathway to gender medicalisation.