Singapore Sets Up Review Panels for Youth Gender Dysphoria Treatment

Singapore's Ministry of Health (MOH) has introduced new guidelines for treating children and teens with gender dysphoria (GD). Gender dysphoria is a condition where a person feels deep distress because their inner sense of gender does not match the sex they were born with. Health Minister Ong Ye Kung announced the changes in a parliamentary reply on August 5, saying that review panels will soon be set up to look at each young patient's case. Until those panels are ready, children currently receiving treatment will continue to see their existing doctors so their care is not suddenly cut off.

Under the new guidelines, introduced on May 5, psychological support must be the first step in treating young people with GD. This means that before any other treatment begins, a young person must first receive help from mental health professionals. Puberty blockers, which are medicines that pause the body's development during puberty, are no longer allowed under the new rules. Instead, each young patient must be assessed and cared for by a team of specialists from different fields.

The review panels being set up will include a wide range of experts. These will include the psychologist, counsellor, and social worker already involved in the patient's care. An independent psychiatrist, an endocrinologist or paediatrician, and a surgeon — if surgery is needed — will also be part of the panel. One additional medical specialist who is not directly treating the patient will also join the panel to provide an outside view.

Minister Ong said the goal of these panels is to make sure every young patient gets the right diagnosis and the right treatment. He described GD as a serious psychiatric condition that needs careful and well-rounded care, especially for young people who are still going through big physical and emotional changes. He stressed that patients with GD deserve empathy, acceptance, and support from both their families and the wider community. "It enables us to better support young people with GD, while avoiding putting those without GD on a painful and irreversible path," he said.

Singapore's Institute of Mental Health diagnoses about 65 patients under the age of 18 with GD each year, based on figures from 2021 to 2025. MOH admits it does not have full numbers, since some patients may seek care privately and GD does not have to be officially reported. Ong explained that the risks of getting treatment wrong are very serious in both directions. If a young person truly has GD but gets no treatment, the harm can be severe — but if someone without GD receives irreversible treatment, the consequences are also very severe.

MOH developed the new guidelines by setting up expert groups to study published research and international reviews on GD treatment in children and teens. The guidelines were then endorsed, or officially approved, by the Academy of Medicine, Singapore. They are in line with guidelines published by the National Health Service in England in March 2024, and similar positions have been taken by health authorities in New Zealand, Sweden, Norway, Denmark, and Finland. This shows that Singapore's approach follows a growing global trend in how doctors manage GD in young people.

Some LGBTQ+ advocacy groups have raised concerns that the new guidelines could create barriers to treatment and cause more distress for young people with GD. Minister Ong said MOH is working with both public hospitals and private providers to develop clear care pathways under the new rules. He noted that so far, MOH has not heard of any existing patients who were unable to continue their current treatment. The ministry says it is committed to balancing care for those who truly have GD while protecting those who may have been misdiagnosed.