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hsts in Singapore

by Gogo Yee

In Singapore and most of SE Asia where I'm from... transgirls like myself mostly start off as gay boys first... and then later branch away from the gay community to transition as women. It is loosely termed as the sisterhood here because the girls here hang out together a lot, both for guidance from older sisters and friendship. Most of us are young transitioners, starting even as young as 12 or 13, though the average seems to be 15-16 and later but not usually beyond mid twenties. (The year of discharge from our army liability normally marks the latest age range of transition).

Transition is mostly DIY because shrinks are unaffordable and or not very well informed on gender issues. Very few shrinks deal with GID and few of us seek psychiatric treatment when the national gender clinic closed down. It is mostly concerned parents who bring their children for psychiatric treatment when the signs of GID manifest themselves, usually at the cusp of puberty. Our estrogen hormones are obtained from older sisters who go to buy hormones in bulk in Thailand or from thai markets which normally smuggle in hormones, most commonly used is Diane 35, which is cheap and effective. Due to street wisdom, overdose is common and might be the reason why the use of anti androgens is never practised. The only available drug prescribed for anti androgenic purposes, cyperterone acetate, is very expensive, 100 dollars for a months supply.

At 18, some may start to see a doctor for estrogen injections which cost about 7 to 14 USD per shot. The normal dosage is about 4 to 6 shots (estradiol valerate + progesterone unijab), and some doctors are willing to give up to 8 shots. The threshold is normally dictated by the pain tolerance (those injections hurt like hell!), some girls are quite hardcore on this and the prevailing street wisdom endorses more is better. Premarin can be also purchased from the doctor, but these are expensive as well. Many girls go over the limit with regard to hormone dosage, but I have not heard of any ill effects which are preached of often in the West.

Unfortunately, transgirls are looked down upon and are seen as an aversion to social norms. The main reason is that the general publicœs view is that transgirls are simply gay men who dress up to sleep with straight men, hence the initial homophobic umbrella shrouds transgirls as well. Ejection from the family unit at a young age is highly common and this is probably the main determining factor for the dive into prostitution and this social hireachy stagnates the girls into the profession permanently, due to the lack of education (when kicked out early from home) Substance abuse is common with transgirls back home, mostly due to job stress and peer influence. The media uses the term transvestite rather than transsexual, but transvestites in the true sense of the word are hardly seen in public. This is a vicious cycle and I lament this situation a lot.

The oldest son who transitions is also seen to be a loss, because male children are valued over females, because they are given the responsibility to carry on the family line and surname.

We are seen as prostitutes, gay men who dress up as women who crave for sex with men and earn money at the same time. Ironical thing is that many guys who flame or verbally abuse TS girls here seek their services in the dead of the night. The reason is that most transgirls back home look more stunning than the average GG, especially with regard to height. Many also obtain plastic surgery from Thailand or Malaysia to enhance their looks, but unfortunately some succumb to bad jobs due to cheap, irresponsible surgeons. It is sad that the shelf life of work normally doesn't exceed 20 years, and most transgirls are delegated to stereotypical jobs in hairdressing, fashion and beauty. Some lucky ones manage to finish school and some might find a rich accepting foreigner to marry them (usually men from Sweden and Holland I have heard of). SRS is obtained normally if the girl can find alternatives to prostitution. Some never get it done due to the reliance on the relatively higher money from prostitution but many of us desire straight men and want to be seen as women.

I believe there are minorities among Singapore transsexuals who are late transitioners though I haven't seen one myself. Its just that the social stigma and financial burden here for late transitioners is probably too great that most of them just abandon any thoughts on transition. Family is held in high regard here and abandonment of the family to transition is viewed on very abhorrently. Divorce is already greatly frowned upon here. Moreover, the impression here in Singapore is that TS = gay or TS is subset of gay. Most of these older men who dress up mainly identify as crossdressers or transvestites.

I do not know any lesbian or older transitioners in real life in Singapore but they do exist, but rarely are given the go ahead to transtion.


Data from medical sources.

Some data from Dr. Tsoi Wing Foo who ran a gender clinic back when it was still open and talks about the TS scene in Singapore:

Dr Tsoi Wing Foo's article titled "Male and Female Transsexuals: A Comparison" that was published in the Singapore Medical Journal in 1992.

There were some findings were very interesting. His study was on 320 males and 120 females who sought sex change surgery from the period 1972 to 1988 at the University Department of Obstetrics and Gynaecology.

24% of MTF were prostitutes. 18% were doing stereotypical female jobs while 8% were doing female entertainment jobs. He mentions later in the article that 38% of MTF had a history of prostitution.

For MTF, the average age when they started feeling that they were of the opposite sex was 8.71 years old.

87% of MTF's were sexually active (with men) and 13% were not sexually active (asexual). Among the sexually active ones, most of them started getting interested in other boys at 13.42 years of age (average), started petting about a year later and started having sex at 16.24 years of age (average).

Tsoi desribed the typical Singaporean transsexual as going through a "homosexual phase" where they became interested in other boys before they started to cross dress. They finally progressed into the "transsexual phase" where they sought SRS.

According to him, anal sex was the most popular, followed by oral sex and the least popular was doing a handjob.

There was no mention of how many of the MTF's eventually had SRS.

There were no married men seeking SRS and not a single MTF reported ever having heterosexual sex.

The only book about transsexualism in Singapore and it was published in 1991. It was written by the doctors in the sex change team. They include the late Professor S S Ratnam (who did the first SRS in Singapore), Dr Tsoi and Dr Victor Goh (the endocrinologist).

The book is now out of print and Longman does not even have it on their computerized records. It is available as a reference book in the National Library branches.

In Chapter 1, page 7 (written by Dr Victor Goh) "It is known that some effeminate homosexuals, in order to enhance their sexual performance would be on female hormone therapy and subject themselves to surgery to enlarge their breasts".

The interesting facts and figures that Dr Tsoi mentioned in his chapter were:

The team treated 282 MtF transsexuals. ( There was a total of 413 TS's, 282 MtF, 131 FtM)

Age: 15 - 43 Average: 23.5, 50% < 25
50% worked normal hours, 30% at night
Suicide rate: low due to availability of SRS
They were all mentally healthy
Onset of TS feelings averaged 8.8 years
Started petting at 15, anal sex at 16
By 18, 64% cross-dressed in public
By 21, 59% were living full time as women and by 24, 60% were doing so
59% were in a Female social role at 21; 60% at 24
The absolute criteria that had to be fulfilled before they were allowed to have their sex change were:

Sastisfy American Psychiatric Association criteria
Becoming a member of the opposite sex should be primary motivation
On hormones, cross dress and cross live for 6 months
Free from psychotic and psychopathic personality disorders
However, ideally the team felt that their patients should also be:

age: 21 - 40
average intelligence
good physical and mental health
economically and emotionally independent
good educational, occupational and social relationships
good family understanding and support
no history of heterosexual practice
have appearance and body-build appropriate for the opposite sex
feel comfortable living the life of the opposite sex
The books states that:

Total of 110 MtF (of 282 patients the team saw) had SRS.
45 of 110 were followed up for 2 - 8 years. 14 (32%) got married post-op. None were married pre-op.
Post-operatively 62% said life better than before, 38% said their life was fair (same as before).


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