Singapore bans hormonal and surgical treatment for gender dysphoria in minors

Singapore has joined a growing group of countries imposing stricter conditions on the medical treatment of gender dysphoria in young people. On May 5, 2026, the Ministry of Health sent healthcare providers a circular containing the first official treatment guidelines for gender dysphoria in children and adolescents. The key decision: no hormonal or surgical treatments may be offered to anyone under 18.

What the guidelines specifically regulate

The circular, signed by Director-General of Health Professor Kenneth Mak, states that young people under 18 diagnosed with gender dysphoria may not be offered hormonal or surgical treatment. Cross-sex hormones remain prohibited until the age at which a person is legally considered an adult in Singapore: 21. For those aged 18 to 21, an exception is possible, but only with approval from a special review panel, the Treatment Review Panel. The guidelines do not recommend puberty blockers, citing a lack of evidence regarding their long-term safety and effectiveness. Psychological counseling is designated as the first and primary treatment option, with a diagnostic process that, according to the guidelines, may take twelve to eighteen months before further steps are considered.

The ministry's rationale

The ministry justifies the decision by referring to the well-known figures on the development of gender dysphoria in children: according to historical research, eighty to ninety-five percent of prepubertal children with gender dysphoria outgrow it when no medical intervention takes place. The guidelines also warn that puberty blockers may actually 'lock in' a young person's gender-related distress instead of providing time for reflection—the opposite of the so-called 'pause button' argument typically used to defend these drugs. In doing so, Singapore aligns itself with the conclusions of the 2024 British Cass Review, which described the evidence base for puberty blockers in minors as notably weak.

Part of a broader international trend

With these guidelines, Singapore joins a series of countries that have reconsidered the early medicalization model in recent years. The United Kingdom stopped the routine provision of puberty blockers outside research settings, Sweden restricted treatment to strictly controlled research settings through Karolinska University Hospital, and Finland chose psychosocial treatment as the first step through the COHERE guidelines. Singapore is therefore the first Asian country to legally establish a similarly explicit, cautious approach. The decision could set a precedent for the region: neighboring countries that have so far lacked their own guidelines may draw on the Singaporean model when developing them.

What this means for young people and parents

For Singaporean families, the guidelines primarily mean that the path to medical transition for minors is now formally closed, and that the emphasis is legally placed on psychological counseling. Supporters of the guidelines point to uncertainty about the long-term effects on fertility and brain development as a reason for caution. Critics of this approach generally argue that a strict ban could make it more difficult for young people with persistent gender dysphoria to access care. As in Europe, this debate is also taking place in Singapore against the backdrop of a growing number of countries judging the scientific basis for early medical transition to be too weak.

Source:

• Bernard Lane, Gender Clinic News (May 2026). Singapore joins the cautious club.

Edward Jansen

Genderinfo.nl