New MOH Guidelines for Youths with Gender Dysphoria

[Tree]

Video sources: Ministry of Health's Guidelines for Youths with Gender Dysphoria​

by Heckin’ Unicorn | Updated on May 11, 2026



Watch the original video on Instagram / TikTok

1. Singapore’s health ministry (MOH) released Circular 44 on 5 May 2026, addressed to all registered medical practitioners, which informs them of the national treatment guidelines for children and adolescents with gender dysphoria (GD). You can download the guidelines here: For Children | For Adolescents
2. The new national guidelines effectively ban medical treatments for those with gender dysphoria but are below 18 years old. Details:
   1. Medical interventions should not be carried out in children with GD (Children Guidelines, pg 5). MOH defines "children" as people between infancy and puberty, i.e. prepubertal persons (Children Guidelines, pg 7).
   2. Puberty suppression (a.k.a. puberty blockers) is not recommended for adolescents (Adolescent Guidelines, pg 5). MOH defines "adolescents" as people who have reached puberty but are less than 21 years old, the age of majority in Singapore (Adolescent Guidelines, pg 5).
   3. Initiation of gender-affirming hormone therapy may only take place post puberty, once the individual has reached 18 years of age (Adolescent Guidelines, pg 19).
3. The new national guidelines give these requirements for people between 18 to 21 with gender dysphoria to qualify for hormone therapy:
   1. Informed consent is required from parents (both parents / one parent / legal guardians) (Adolescent Guidelines, pg 5).
   2. A Treatment Review Panel (TRP) must agree that there are "exceptional circumstances" that warrant hormone therapy. MOH describes "exceptional circumstances" as cases where there is clear evidence of benefit or harm reduction. (Adolescent Guidelines, pg 5)
   3. The TRP should comprise a minimum of 4 medical specialists: (Adolescent Guidelines, pg 7)
      1. An attending psychiatrist, and
      2. Attending psychologists, counsellors or social workers (as many as were involved), and
      3. An attending endocrinologist or paediatrician, and
      4. One more non-treating medical specialist from any of the above groups
   4. The TRP needs to convene an actual meeting to reach a consensus on the treatment to be offered. Each medical specialist in the TRP needs to assess the patient in their area of expertise before the meeting. All medical factors should be presented at the meeting. The trans patient and their parents should be invited to the meeting. (Adolescent Guidelines, pg 8). These guidelines imply that all members of the TRP need to attend the meeting, and that the meeting needs to be held synchronously. In other words, all members of the TRP, the trans patient, and their parents need to find a date and time to have a meeting together.
4. MOH's guidelines stress that "a high priority should be placed on avoidance of risks of long-term hormonal treatment because of the risks of side effects and irreversible consequences associated with medical therapy" (Adolescent Guidelines, pg 5).
5. MOH's guidelines for children includes this snippet in the introduction segment: "De Vries and colleagues (2011) observed from a follow-up study on 70 prepubertal candidates that the high subscription for puberty suppression in children could be self-fulfilling in nature to encourage a young child with gender dysphoria to socially impersonate the opposite sex (social affirmation). This might inadvertently set in place the inevitable outcome of transgender identification, when normally 80-95% of prepubertal youth do not persist in their gender dysphoria (American College of Pediatricians, 2017)." (Children Guidelines, pg 4)
6. De Vries' 2011 study, titled "Puberty Suppression in Adolescents With Gender Identity Disorder: A Prospective Follow-Up Study" (full text here), does not discuss the idea that puberty suppression for young children with gender dysphoria encourages social transitioning. In fact, the study concludes that "puberty suppression may be considered a valuable contribution in the clinical management of gender dysphoria in adolescents" (pg 1).
7. The American College of Pediatricians (ACPeds) is a designated hate group, a status held also by the KKK. The ACPeds is described as a "religious advocacy group" that is anti-vaccine and pro-conversion-therapy (Wikipedia). Though it sounds official, ACPeds is not the leading organisation for U.S. pediatricians; That designation goes to the 67,000-member American Academy of Pediatrics (AAP) (SPLC).
8. The ACPed's claim that 80-95% of children with gender dysphoria outgrow it has been debunked by TransgenderSG in 2021.
9. In the section of MOH's guidelines that details gender-affirming hormone therapy, they cited 6 papers (Achille et al., 2020; Claahsen-van der Grinten et al., 2021; Cohen-Kettenis, Steensma, et al., 2011; Coleman et al., 2022; Hembree et al., 2017; Khatchadourian et al., 2014). MOH doesn't specify which paper contributed to which of their sentences or opinions within that section (i.e. the papers were cited generically as sources for that entire section). One of the sentences include the guideline that hormone therapy may only take place after 18 years of age. (Adolescent Guidelines, pg 19)
10. The 6 papers that were cited by MOH do not appear to directly support or endorse the hard age limit imposed by MOH's guidelines:
    1. Achille et al., 2020: "Longitudinal impact of gender-affirming endocrine intervention on the mental health and well-being of transgender youths: preliminary results" (full text here)
       1. The study looked at 50 participants (mean age 16.2) and noted that depression scores and suicidal ideation decreased over time while mean quality of life scores improved over time after medical endocrine intervention. The study doesn't appear to suggest any hard age limits for hormone therapy, especially since their participants began treatment at the mean age of 16.2.
    2. Claahsen-van der Grinten et al., 2021: "Gender incongruence and gender dysphoria in childhood and adolescence-current insights in diagnostics, management, and follow-up" (full text here)
       1. The paper generally describes existing practices surrounding medical treatments for children and adolescents with gender dysphoria. No age limit recommendation appear to be given.
    3. Cohen-Kettenis, Steensma, et al., 2011: "Puberty Suppression in a Gender-Dysphoric Adolescent: A 22-Year Follow-Up" (full text here)
       1. This is a case report on a specific transgender person, with a 22-year follow-up. This person was treated with puberty blockers at 13 years of age and considered eligible for androgen treatment at age 17, and who had gender reassignment surgery at 20 and 22 years of age. At follow-up, he indicated no regrets about his treatment.
    4. Coleman et al., 2022: "Standards of Care for the Health of Transgender
       and Gender Diverse People, Version 8" (full text here)
       1. The Standards of Care (SOC) is a set of internationally-accepted medical guidelines for transgender healthcare, published by the World Professional Association for Transgender Health (WPATH). This specific version is their latest, version 8.
       2. Under their chapter for adolescents, SOC-8 generally moves away from hard age limits and towards a more holistic assessment of the adolescent's capacity to give informed consent on treatments.
       3. SOC-8 also mentions: "Previous guidelines regarding gender-affirming
          treatment of adolescents recommended partially reversible GAHT could be initiated at approximately 16 years of age (Coleman et al., 2012; Hembree et al., 2009). More recent guidelines suggest there may be compelling reasons to initiate GAHT prior to the age of 16...". A hard age limit of 18 years thus appears to possibly contradict SOC-8.
    5. Hembree et al., 2017: "Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline" (full text here)
       1. This set of guidelines specifically mentions: Clinicians may add gender-affirming hormones after a multidisciplinary team has confirmed the persistence of gender dysphoria/gender incongruence and sufficient mental capacity to give informed consent to this partially irreversible treatment. Most adolescents have this capacity by age 16 years old.
    6. Khatchadourian et al., 2014: "Clinical management of youth with gender dysphoria in Vancouver" (read here)
       1. The study concludes that treatment with puberty blockers or hormone therapy is an intervention that appears to be appropriate in carefully selected youth with gender dysphoria.

 

[bobby]

Similanjiao is “Gender Dysphoria“ ?

Or should I say Similanjiao/cheebye is “Gender Dysphoria“ ?

 

[Tree]

Similanjiao is “Gender Dysphoria“ ?

Or should I say Similanjiao/cheebye is “Gender Dysphoria“ ?

It is lanjiao want to be cheebye or cheebye want to be lanjiao syndrome

 

[rocket]

It is lanjiao want to be cheebye or cheebye want to be lanjiao syndrome

I know 1 also like this. He came from a dysfunctional family. His mother beat up his father. Former acs primary child