This is a reproduction of a chapter in the publication "LGBTQ Policy Journal at the Harvard Kennedy School, Volume VI, 2015-2016. Trans* Rights: The Time Is Now"

The Forced Sterilization of Transgender and Gender Non-Conforming People in Singapore

By Vanessa Ho, Sherry Sherqueshaa, and Darius Zheng

ABSTRACT[]

Singapore’s current gender recognition law allows trans people to change the sex marker on their identification cards, only on the condition of full removal of reproductive organs. While some people are relatively satisfied, there are many trans and gender non-conforming people who feel frustrated, as they do not want or cannot afford to undergo a full sex reassignment surgery. This means they are left in a state where their identity documents are not aligned with their gender identity and expression. This paper intends to tease out the specific barriers and challenges that transgender and gender non-conforming people face in Singapore in relation to gender recognition.

TERMS AND DEFINITIONS[]

For the sole purpose of this paper, we define the terms below as such. The definitions presented apply here, and are limited to this report.

Sex reassignment surgery (SRS): Surgical procedures that change one’s body to better reflect a person’s gender identity. This may include different procedures, but for the purposes of conceptual tidiness, we define SRS in this paper to the surgeries that one undergoes to qualify to change the sex markers on their identification cards in Singapore. For an individual who is assigned male at birth, SRS means removal of the penis and reconstruction of a vagina. For an individual who is assigned female at birth, SRS means removal of the uterus.

Transgender people / Trans people: A term for people whose gender identity, expression, or behavior is different from those typically associated with their assigned sex at birth. “Trans” is shorthand for “transgender.”

Trans man: An individual who was assigned female at birth, but whose gender identity is male.

Trans woman: An individual who was assigned male at birth, but whose gender identity is female.

Gender non-conforming people: Individuals whose gender identities and expressions are different from societal expectations related to gender. For the purposes of this paper, we exclude people who identify as trans men and trans women in this category. Gender non-conforming individuals include genderqueer, genderfluid, non-binary, agender, and others. The list of categories here are not exhaustive—they are determined based on what respondents indicated in their survey forms.

Pre-operative people: Individuals who identify as trans men, trans women, or gender non-conforming, and have not undergone SRS at the point of the data collection for this paper. However, these individuals have also indicated their desires to go through SRS in due time.

Post-operative people: Individuals who identify as trans men, trans women, or gender non-conforming, and have undergone SRS at the point of the data collection for this paper.

Non-operative people: Individuals who identify as trans men, trans women, or gender non-conforming, and have not undergone SRS at the point of the data collection for this paper. These individuals have also indicated that they would not be going through SRS.

INTRODUCTION[]

“Though the movement is sometimes referred to colloquially as LGBT, I excluded transsexual and transgender individuals from my study. They deal with different laws and issues in Singapore, and gay activists also do not address their concerns or do so more as an afterthought.” —Lynette Chua

“Every persons self-def ned sexual orientation and gender identity is integral to their personality, and is one of the most basic aspects of self-determination, dignity, and freedom. No one should be forced to undergo medical procedures, including sex reassignment surgery, sterilization, or hormonal therapy, as a requirement for legal recognition of their gender identity. No status, such as marriage or parenthood, may be invoked as such to prevent the legal recognition of a person’s gender identity.” —Yogyakarta Principles

“Because as a person of southeast Asian heritage, 1 want to honor the third gender status that is culturally normative to our societies and cultures before British colonialism. For example, the Bugis people had a five gender system. ” -Thirty-year-old non-binary genderqueer survey respondent.

On 30 July 1971, Professor S.S. Ratnam, Associate Professor Khew Khoon Shin, and R. Sundarason conducted the first male-to-female sex reassignment surgery (SRS) in Singapore.2 A total of 413 sex reassignment surgeries were conducted in Singapore from 1971 to 1990, and because of this, Singapore was known internationally for being one of the leading countries for such operations.

In 1973, Singapore allowed post-operative transgender people to change the sex marker on their National Registration Identity Card (NR1C), a card that is used in many day-to-day activities including going to the bank and signing up for the gym.4 This policy change was considered a progressive move, especially considering this was not possible in any other country in the southeast Asian region.5

In 1991, a landmark court case, Lim Ying v. Hiok Kian Ming Eric, gave the transgender and gender non-con-forming communities a reality check as Hiok’s marriage was nullified due to his identity as a transgender man. Even though he had undergone the required surgeries and had changed the sex marker on his NR1C, his birth certificate still stated he was female. Birth certificates cannot be changed, and as such the judge ruled that “the personal particulars on a person’s identity card when it was considered alone were not conclusive evidence of the sex of that person for the purposes of marriage.”6 However, despite this setback, in 1996, the Women’s Charter was amended to recognize the (heterosexual) marriage rights of a post-operative transgender person. The Women’s Charter is a legislative act that was passed in 1961 and was meant to govern matters relating to marriage, divorce, sex work, sex trafficking, and the rights of the child. The relevant section of the statute reads (emphasis added):

Avoidance of marriages between persons of same sex

12. (1) A marriage solemnized in Singapore or elsewhere between persons who, at the date of the marriage, are not respectively male and female shall be void.

(2) It is hereby declared that, subject to sections 5, 9,10,11 and 22, a marriage solemnized in Singapore or elsewhere between a person who has undergone a sex re-assignment procedure and any person of the opposite sex is and shall be deemed always to have been a valid marriage.

(3) For the purpose of this section-

in) the sex of any party to a marriage as stated at the time of the marriage in his or her identity card issued under the National Registration Act (Cap. 201) shall be prima facie evidence of the sex of the party; and

(b) a person who has undergone a sex re-assignment procedure shall be identified as being of the sex to which the person has been re-assigned.7 Some respondents to our interviews, who have undergone sex reassignment surgery (SRS), indicated that they are satisfied with this law, as it allows them to be who they are, thus resolving their gender identity dysphoria. Furthermore, this seems to be a rather progressive piece of legislation, especially when compared to neighboring country Malaysia, where after a high-profile four-year legal battle that ended in 2014, cross-dressing is still considered illegal.8

However, many transgender and gender non-conforming people cannot afford or choose not to undergo SRS for a variety of reasons that will be explored in this paper. As their gender identity and expression do not match their legal documents, this poses many problems including homelessness, unemployment, discrimination, and violence. Sex work also remains a reality for many trans women, and while it is somewhat tolerated in Singapore, prejudice and violence persists in the industry.9

As such, this paper seeks to examine the impact of the current gender recognition laws on the lives of transgender and gender non-conforming people in Singapore. In particular, we aim to better understand the impact of being able to change one’s sex marker on their NR1C only on the condition of SRS and the inability to change one’s birth certificate. We do this firstly by presenting findings from our survey that illustrate the diversity of the trans and gender non-conforming communities in Singapore, as well as their opinions on the current gender recognition laws. We then move on to analyzing the barriers to SRS for people who want to undergo the procedure, and the difficulties that people who do not wish to undergo SRS face. We conclude by presenting our thoughts for a more inclusive future.

METHODOLOGY[]

Survey[]

The team conducted a survey from 4 to 22 of December 2015 to find out the views of the transgender and gender non-conforming communities. This was a follow-up to the pilot, which was previously circulated by Project X in May 2015. The more significant survey questions center on respondents’ gender identities, whether they have gone for SRS, what sex marker they would prefer to be stated on their identity cards and birth certificates, and a remark column to elaborate on the reasons. There were a total of seven questions in the survey. For each of the questions, participants were allowed to fill in their responses in the open-ended column if any of the options did not accurately reflect their identities and opinions.

The survey was a Google form, which was distributed online via LGBTQ community organizations, as well as personal contacts. The decision to use the Google form was based on the ease of distribution, but more importantly, it allowed survey respondents the option to remain anonymous, thus reassuring individuals who may be worried about being outed. Many community organizations shared a link to the survey through their online platforms. Assistance was rendered to individuals who approached us and were not well-versed in technology.

The team also organized eight focus group discussions from the 14 to 23 December 2015 to follow up with survey respondents on their answers. Twenty-one individuals participated in the focus groups, and each of them were given an option to have their real names published in this report, remain anonymous, or adopt a pseudo-name to attribute to what they have shared. A final follow up was conducted via email and Whatsapp in February 2016 with the focus group respondents, and twelve individuals responded.

Results[]

The survey received an initial total of 283 responses. Inclusively, 249 valid survey responses were compiled and used for the analysis below—thirty-four of the responses were invalid for multiple reasons, which included incomplete information and foreign participation. Out of the valid survey responses, 51.6 percent of the respondents were individuals aged twenty-five and below.

The survey results below are classified according to their current status in relation to SRS, whether they are pre-oper-ative, post-operative, non-operative, or undecided. Four of these charts reflect the choices made for their preferred sex markers on their identity cards, while the remaining four reflect their preferred sex markers on their birth certificates. There are seven different groups of individuals in each chart: trans men, trans women, genderqueer, non-binary, agender, genderfluid, and all others (see Table 1). Within these groups, for the purpose of this report, the choices of individuals for their preferred sex markers are also categorized into “self-identified” (preferred sex marker as opposite of their assigned sex at birth, strictly either male or female), “assigned at birth” (preferred sex marker is the same their assigned sex at birth, strictly either male or female), “no sex marker required,” “third gender,” and x.

TABLE1 Gender Identity Number of Respondents Percentage of total Respondents Transgender Trans Woman 93 37-4% Trans Man 80 32.2% Gender non-conforming Genderqueer 20 8.0% Genderfluid 13 5.2% Non-binary 12 4.8% Agender 7 2.8% Others 24 9.6% Total 249 100%

On a macro level, responses are fairly concentrated into two main subgroups, namely trans men and trans women. In these two subgroups 23.1 percent are non-operative, 49.7 percent are pre-op-erative, 4.1 percent are undecided, and 23.1 percent are post-operative. In the rest of the subgroups (genderqueer, non-binary, genderfluid, agender, and others)—with the exception of one individual who has undergone SRS—the rest of the respondents have all not gone through with the surgery. Although responses as to whether they will go through SRS are mixed, 81.1 percent of the individuals in these subgroups have expressed they have no plans to go through SRS. This is something we will discuss later.

SURVEY FINDINGS[]

In summary, a clear majority exists among the transgender and gender non-conforming communities who would like to be able to self-identify on their identification documents. That said, as can be seen in Figures la and ib, there are more individuals who would like to self-identify on their identification card (65.6 percent), as opposed to on their birth certificate (50.8 percent). Additionally, 18.2 percent of total respondents indicated they would like to have third gender on their identification card and 27.4 percent of total respondents said they would like to have their sex assigned at birth on their birth certificate. The charts on the following pages will break down these results according to the various subgroups in order to tease out the specificities of each community.

FIGURE 1A Identification Card u Self Identify hl Assigned at birth U No sex marker hl Third Gender JX FIGURE IB Birth Certificate M Self Identify Assigned at birth No sex marker hi Third Gender □ X

Preferred Sex Markers on Identity Cards

Every Singaporean owns an identification card (1C) from the age of twelve. Cards are used for numerous things, such as registering for school, applying for a job, reporting to the police, signing up for loyalty card, and so on. As such, it is of utmost importance that one is comfortable with the way they are represented on their 1C. The charts that follow illustrate the desires of the different groups with regard to what sex marker they would like on their 1C. FIGURE 2.1 Post-operative Transgender and Gender Non-conforming Individuals If can be changed, what would you like to be stated on your Identity Card? M Self Identified ^Assigned At Birth J No Sex Marker u Third Gender jX woman Post-op Category N = 40

From Figure 2.1, we can see that out of all the respondents, 20 percent of trans men and 23.7 percent of trans women have undergone SRS. There was just one person who identified as “others” who has undergone SRS. Of all post-operative individuals, 95 percent reflected they would like to be able to self-iden-tify on their 1C. To explain their choice, a thirty-seven-year-old trans woman wrote, “1 do not wish to raise eyebrows if people see you are a female and your NR1C is stated male. It will have administrative problems, and lead to discrimination in job hunting.”10 Another respondent, a thirty-two-year-old trans man highlighted that “1 do not want to be singled out by my gender marker on my 1C or birth certificate. 1 would like to have the option of‘coming out’ when fm comfortable to.”11

FIGURE 2.2 Pre-operative Transgender and Gender Non-conforming Individual If can be changed, what would you like to be stated on your Identity Card? □ Self Identified Assigned At Birth -J No Sex Marker Third Gender Trans man Trans Genderqueer Non-Binary Agender Genderfluid Others woman Pre-op Category N = 97 From Figure 2.2, we can see that of all the respondents, 50 percent of trans men, 47.3 percent of trans women, and 7.8 percent among all others are pre-op-erative. Pre-operative individuals make up the majority of respondents in this survey, and 80.4 percent of them chose “self-identified” as their preferred sex markers on their identification cards. In the next section, we will spend more time exploring the views of pre-operative individuals; however, suffice it to say now that being unable to have one’s gender identity reflected on official documents can have dire consequences. “When 1 was admitted into 1MH on the grounds of suicide risk (due to distress over gender dysphoria), 1 was placed into the women’s ward and treated as a woman, despite the hospital staff having been informed of my male gender identity. The entire ordeal was tailor-made to worsen my dysphoria, and yet the staff asserted they were jus tified in their actions because my legal documents still stated “female.” If 1 were not yet ready to commit suicide ... 1 would have jumped off the tallest story of my HDB [Housing Development Board] building the moment 1 got home. 1 was given neither help nor support.” —Twenty-two-year-old pre-operative trans man12 Of the pre-operative individuals, 11.3 percent would like to have third gender, 5.2 percent would like to have their sex assigned at birth, and 3.1 percent would like to have no sex markers on their identification cards. Here are some quotes from people who chose third gender:

“I choose third gender because 1 feel that I’m different in [a] unique way, so 1 should be addressed as how 1 feel 1 am.” —Twenty-four-year-old pre-operative trans woman13

“It’s easier to fight for a ruling of third gender than to change our gender on the NR1C without having to go through surgery.” -Thirty-one-year-old pre-operative trans woman14

FIGURE 23A Non-operative Transgender and Gender Non-conforming Individuals If can be changed, what would you like to be stated on your Identity Card? Non-op Category N = 97 FIGURE 23B Non-op Category (Identity Card) 4% □ Self Identified □ Assigned at birth -i No Sex marker u Third gender MX

Of all the respondents, 30 percent of trans men, 29 percent of trans women, and 90.9 percent of all others are non-operative. In other words, they have no plans to undergo SRS. From Figure 2.3a, we can see that for this particular group of individuals, there are a variety of choices made across the seven available categories. That said, there is still a clear majority, as can be seen from Figure 2.3b—43 percent of non-opera-tive individuals would like to self-iden-tify for the sex marker on their IC:

“1 want to be a female because 1 wanna be my own true identity.

1 don’t want to lie to the society, my family and friends.” —Nine-teen-year-old trans woman15

“Because 1 identify as a man.” — Twenty-year-old trans man16

The second-most popular choice made was to have “third gender” on their 1C (29.8 percent). An interesting thing to note is that all agender individuals surveyed have no plans to undergo surgery, thus the lack of response as shown in Figures 2.1, 2.2, and 2.4.17 This is something we will explore further in the “Limitation 5” section.

FIGURE 2.4

Individuals who were still undecided on whether to go for SRS If can be changed, what would you like to be stated on your Identity Card? woman Undecided Category N = 19 This category was made for respondents who have not undergone SRS and are undecided due to various limitations, which will be elaborated on in the next section. They make up 7.6 percent of the total number of respondents surveyed. Of the individuals who are undecided, 26.3 percent of them are trans women, 15.8 percent are trans men, and 57.9 percent are gender non-conforming individuals (see Figure 2.4). Preferred Sex Markers on Birth Certificates Birth certificates, while used less than ICs in day-to-day activities, are still important in occasions like applying for an 1C, marriage, having or adopting a child, and immigration. It is important that one is comfortable presenting such documents when required to. The right to amend one’s birth certificate should not be seen as less important and as such, we dedicated equal weight to the following questions.18

FIGURE 3.1 Post-operative Transgender and Gender Non-conforming Individuals If can be changed, what would you like to be stated on your Birth Certificate? woman Post-op Category N = 41 Of all post-operative transgender individuals, 65.9 percent would like to self-identify for the sex marker on their birth certificates (see Figure 3.1). “It will definitely make me feel equal to the other people, and showing my birth certificate would not be an issue.” —Twenty-five-year-old trans woman19 “1 feel that Singapore still has gender identity discrimination. If someone were to see that my documents do not match the gender 1 represent and identify with, 1 will be discriminated against, whether verbally in public or in private. 1 feel it would affect my workplace standing and other’s opinions of me. If this were not the case in Singapore, then 1 wouldn’t mind that my birth cert[ificate] still states female as a way to celebrate my identity as a transmale and my journey through transition.” —Twenty-two-year-old trans man20 This is significant, as according to Figure 2.1, 95 percent of post-operative transgender people would like to be self-identified on their identification cards. In other words, fewer post-operative trans individuals want to self-iden-tify for the sex marker on their birth certificates. Of transgender and gender non-con-forming individuals, 24.4 percent would like to have their sex assigned at birth reflected. One twenty-three-year-old post-operative trans man shared that “1 since technically that’s what 1 was born don’t need to change birth certificate[s] as.”21

FIGURE 3.2 Pre-operative Transgender and Gender Non-conforming Individuals If can be changed, what would you like to be stated on your Birth Certificate? woman Pre-op Category N = 96 From Figure 3.2, we can see that 66.7 percent of the pre-operative transgender and gender non-conforming community prefer to self-identify for their sex markers on their birth certificates, while 19.8 percent would like to keep their sex assigned at birth indicated on their birth certificates. This is a marked difference from what they prefer to have on their ICs (see Figure 2.2), with a 13.7 percentage point drop in respondents who would like to be self-identified on their identification cards. “[My] birth certificate can remain as it is (male), just a memory of who 1 was.” —Thirty-five-year-old trans woman22 “1 can’t change my past, but 1 can change my future . . . That by accepting ourselves, one day others will accept us too, for who we are.” —Sixteen-year-old trans man23

FIGURE 3.3A Non-operative Transgender and Gender Non-conforming Individuals If can be changed, what would you like to be stated on your Birth Certificate? Self Identified ^Assigned At Birth -JNo Sex Marker h^Third Gender woman Non-op Category N = 95 FIGURE 3.3B Non-op Category (Birth Certificate) □ Self identified u Assigned at birth •J No Sex marker UThird gender □ X Similar to Figures 2.3a and 2.3b, non-op-erative transgender people vary widely in their opinions as to what should be stated in their birth certificates (see Figure 3.3a). From Figure 3.3b, we can see that most people would like their birth certificate to reflect their sex assigned at birth (35 percent), but those who would like to self-identify came in a close second (32 percent). The least number of people chose to have “X” as the sex marker on their birth certificate (2 percent). VOLUME VI 2015-2016 65 FIGURE 3.4 Individuals who were still undecided whether to go for SRS If can be changed, what would you like to be stated on your Birth Certificate? woman Undecided Op Category N = 20 Finally, as can be seen in Figure 3.4, except for agender individuals (none of whom falls under this category), the other six categories of transgender and gender non-conforming individuals made their choices between self-identified (35 percent), assigned at birth (35 percent), and third gender” (25 percent). There was one person who opted for “X” as their sex marker.

ANALYSIS[]

It is clear from the survey results that even while there are distinctive majorities, there are still many differing opinions in the community. There are a variety of views, all of which should be respected. From our findings, it is clear that it is important for transgender and gender non-conforming individuals to be able to self-identify on their documents. Self-identify not just in the sense of how we have been using the term, but also in the sense they would like to be able to define themselves from a broad spectrum of possibilities. For some, the current gender recognition law is sufficient. “1 did SRS to change my gender marker on my identity card. Of course, doing SRS is also to reduce inconveniences such as binding, and awkward situations such as having to go swimming. Wearing clothes are also much easier now. It’s a great relief.” — Kieran, a thirty-three-year-old post-operative trans man24

“Yes, 1 would still go through SRS [even if there is no requirement to do so]. It is more than just a documentation record. It is the life and body 1 want to live in.” —Benson, a thirty-one-year-old pre-operative trans man25

“The operation [SRS] wasn’t a means to an end. If that is what it takes to be a woman, 1 want to go through it. 1 would still go for SRS even if [my] 1C can be changed without SRS. Physicality has to match up for legality.” —Natalyn, a forty-seven-year-old post-operative trans woman26

However, this raises the question as to the availability and accessibility of trans-specific healthcare, as well as the obstacles one has to face in order to undergo SRS. For many transgender individuals, the decision to undergo SRS or not lies more than just in a change of sex marker on their identity cards—it ultimately boils down to other factors, such as family, religion, and surgical fears. These factors may severely impede both abilities, and desires, of individuals to undergo SRS. Here we narrow down and focus on five limitations to SRS that transgender and gender non-conforming people face.

Limitation 1: Financial Concerns[]

Many of those surveyed or interviewed identified financial considerations as one of their topmost concerns when deciding to go through SRS. “1 just really don’t like the idea of paying a few thousand dollars to remove healthy internal organs that are part of the regular functioning and upkeep of my body.” —Twenty-six-year-old trans man, undecided on whether or not to go through SRS27 “Can’t afford. Unsupportive family. Still studying. Can’t even use my hard-earned CPF (Central Provident Fund) or Medisave.” —Twenty-four-year-old pre-operative trans woman28

“Pending [a] money drop from sky.”—Thirty-five-year old pre-operative genderfluid individual29 “As the cost for bottom surgery can involve a huge amount of money, it’s good to be able to change the identity card before bottom surgery. However, 1 will still do it after 1 feel that my financial situation allows me to do so. Because it’s awesome to have the transition completed fully.” —Nat, a twenty-one-year-old pre-operative trans man30

Nat raises an important point, which is that SRS is a long-term goal for some transgender people. According to the Asia Pacific Transgender Network, “If legal gender recognition requires such medical steps, trans people can be forced to spend many years, or all of their lives, with no legal verification of their gender identity.”31

Another overarching theme reflected in the data is that of family dependency, where it is a norm in Singapore for younger members of the family to be economically dependent on older members of the family. This is usually the case until younger members of the family graduate, get married, and buy their own house. For twenty-five-year-old post-operative trans woman Jenn, the hefty cost of SRS is compounded if the threat of being kicked out of her parent’s place becomes real. Renting a room is rare, as it is a huge cost given the high standard of living in Singapore. Secondly, the current policies in Singapore only permit single individuals to purchase their own flats from the age of thirty-five, unless they buy with their

parents, or if they are orphaned.32 In other words, only married heterosexual couples are eligible to buy built-to-order (BTO) government housing regardless of age, so long as they are registered with the Registry of Marriages (ROM) in Singapore.

Another topic touched upon by one of the respondents is the use of the Central Provident Fund (CPF) and Me-disave to pay for SRS. The CPF is a social security savings plan for Singapore citizens, where a certain percentage of each individual’s salary is deducted from the gross monthly salary and put into a special government account, with similar contribution from the individual’s employer. Part of this money is channeled into Medisave, a medical savings scheme which helps individuals put aside part of their income to meet their future personal or immediate family’s hospitalization, day surgery, and certain outpatient expenses. The savings can be withdrawn to pay hospital bills of the account holder and their immediate family members. However, the Medisave account is unable to be used to pay for fees for SRS. Furthermore, Medisave is only for hospitalization costs accrued in Singapore.

Limitation 2: Concerns from People Around Transgender Individuals[]

Another important concern affecting individuals’ decisions to have SRS is the possible negative responses from immediate and extended family members, friends, schoolmates, colleagues, and even spouses. This discovery is not surprising, but warrants some reflection, given what we have talked about in the previous section about younger family members being economically dependent on older family members and having to bear the consequences if anything unfavorable happens. Some, like twenty-fiveyear-old pre-operative trans woman Jason, have previously been threatened by parents that she will get chased out of the house if she goes through SRS. For Jason, this fear is very real. In fact, it constituted her top-most consideration in her decision-making process of whether or not to go through SRS.33

In the workplace, individuals who are considering undergoing SRS are also at a disadvantage, both in terms of getting a job and surviving in the workplace environment. Many respondents were concerned and feared disclosing their trans identities to coworkers and bosses alike. For Vittorio, she feels that it is difficult to gain coworkers’ acceptance for her decision to go through with SRS, even if her superior gives her permission to do so. According to Vittorio, her coworkers have already started to “see her as a freak” and have even gossiped and formulated untrue assumptions about her—all based on her looks due to her ongoing hormonal therapy.34 For others, like twenty-three-year-old non-operative trans man Tiky, being bound to the public service sector means his career could be in jeopardy if he undergoes SRS. Tiky does not feel the public service favors, in any way, transgender individuals—and that may affect his chances of a promotion, as well as increase the risk of paying for liquidated damages should the scholarship be revoked.35 Thus, for these individuals, declaring their desires to go through SRS may have very devastating effects on their lives.

For others, like trans man Kieran, ithe nfluence of people around him is so great that considerations to go through SRS only began to materialize after his mother—who opposed his decision-passed away. To add on, Kieran’s ex-girl-friend broke up with him because of this very desire to undergo SRS.36

Other consequences that transgender individuals have to face, include possible counter-proposals. One such account given was by nineteen-year-old pre-operative trans woman Jaclyn, whose father—while telling her to “wait for ten years before deciding whether to transition”—simultaneously brought her around to different psychiatrists to determine if anything was mentally wrong with his child.37 Similarly, Cass, an eighteen-year-old genderfluid individual was asked to go see a “bomoh,” or a Malay shaman, for exorcism when they tried to come out as gay to their parents.38 Parents’ influence can never and should not be undermined. Jason’s parents were similarly insistent that Jason’s desire to undergo SRS is merely “a phase,” causing Jason to also not attend family gatherings the past several years for fear of being pressured into a cis-heterosexual marriage.39 In the words of a twenty-four-year-old non-operative trans man, “1 really think that any change should start from the family level. If parents or siblings could be more understanding of this situation, it would help so much.”40

For others, like thirty-year-old pre-operative trans woman Amanda, there is also a fear of violence—as the closest friends she currently has are also those who call transgender individual names, as well as intend to inflict harm onto them. Amanda has not come out to them yet.41

Limitation 3: Fears Related to Surgery[]

According to the World Professional Association for Transgender Health (WPATH), “Transsexual, transgender, and gender-nonconforming people need health care throughout their ives.”42 However, the full range of resources required is not readily available in Singapore since the only SRS-specific facility in one of the local hospitals was shut down in 2001. Many who have intentions to go through SRS have expressed the most reliable and inexpensive venue to undergo the surgery would be in Thailand. Some, however, would have preferred to do the surgery in Singapore—comparing the health care systems between both countries. For some, like a thirty-nine-year-old trans man, the shutdown of the facility led him to decide to not undergo SRS, because of the precise lack of such healthcare facilities in Singapore.43 One respondent made a connection between the lack of resources with the current gender recognition laws:

“Trans care in Singapore is lacking in many, many ways, [and] this is among one of them. Especially when any form of actual medical care is so difficult for many trans people to obtain in Singapore, the requirements for changing gender in official documents are made even more ridiculous.” —Twenty-three-year-old non-operative trans man44

There are also some others, like one twenty-two-year-old trans woman who is undecided on whether to go through SRS because she “do[es] not agree with the idea that one must go through so much pain, in body, and emotionally for the rest of your life just to be who you want to be.”45

Limitation 4: Faith Community[]

One of the greatest oppositions to the decriminalization of homosexuality comes from Christian and Islamic groups. Of significance lately is the WearWhite Campaign, which “is an informal grassroots movement” with the purpose of “reminding Muslims not to participate in” Pink Dot, Singapore’s annual LGBTQ event.46 Numerous churches in Singapore have also encouraged their members to wear white on Pink Dot, an event where participants turn up in pink.47

Religion, or one’s faith community, has a strong presence in Singapore. One’s faith can have a role affecting decisions to undergo SRS. For example, a forty-two-year-old pre-operative trans woman who indicated that she would like her sex assigned at birth on her birth certificate explained that “1 believe 1 should not forget how 1 was born, and as a Muslim 1 would want to be buried as a man following my religious practice.”48 It is a practice where they are to be buried without modifications to their bodies.49 Furthermore, there is anecdotal evidence of trans people being turned away from burial services, leaving them discriminated even in death.50

Another factor could be social pressure stemming from coworkers’, families’, and spouses’ religious affiliations indirectly affecting a transgender individuals’ choices to undergo SRS. For instance, for nineteen-year-old pre-operative trans man Alex, his entire family (including Alex) identifies as Buddhists. Even though, according to Alex, nothing in Buddhist scripture talks about opposing the idea of SRS, his mom speaks to him about “attaching himself to his gender” all the time. This idea of non-at-tachment forms a foundation of the Buddhist faith, though, interestingly, one of the Buddhist deities Guan Yin, or the Goddess of Mercy, is sometimes thought of as androgynous or transgender.51

Limitation 5: Non-binary/Fluid Identities[]

Of all respondents, 30.4 percent identify as genderqueer, genderfluid, agen-der, non-binary, and others (excluding trans men and trans women communities). Of this group, 90.9 percent of individuals have also indicated they are non-operative. Many gender non-con-forming individuals feel that gender in itself is a social construct and defined by humans ourselves. To be “agender,” for instance, is to be “without gender.” As such, participants may not feel the need to undergo SRS, as that means adopting either gender for themselves.

“1 do not like to be placed in a specific gender and 1 don’t feel like I’m fully a girl or a boy. And sometimes 1 feel like I’m a girl, and at times a boy. Most days 1 feel gender neutral/non-bi-nary and 1 hope that 1 could be accepted as myself and not be forced into the gender binary because gender is a spectrum.” —Sixteen-year-old non-opera-tive genderfluid individual52

For others, they desire physically altering their bodies, but also express there isn’t a strong desire for them to choose to undergo SRS. Responses for many in these groups of individuals as to their desired gender identities on their ICs are mixed, with some preferring to be able to self-identify on their documents and others being comfortable with their sex assigned at birth. It is of interest to note the emergence of a “third gender” or the request for removal of sex markers—of which this option appears more for such groups of individuals who are gender non-conforming, as opposed to the trans men and trans women communities. For these groups of individuals, it is unfair to request them to go through SRS to indicate their preferred gender identity on their cards.

“It is how 1 identify my gender identity to be and has no relationship to any surgery.” —Forty-year-old non-operative trans man53

“1 have no plans for any surgery because 1 am not exactly youn, and besides, it is just a glorified plastic surgery procedure because it is not going to give me a womb or the capacity to bear children.” —Fifty-eight-year-old non-operative trans woman54

“1 do not think having a penis makes me any less of a woman.” —Jaclyn, a nineteen-year-old non-operative trans woman55

“1 don’t see SRS as important. It’s true that there was a time 1 considered SRS—1 thought that it was the only way to be complete. But SRS is essentially the reconstruction of something fake, which is not necessary, especially when my life is about living out the truth and 1 recognize that 1 will always be a trans woman, and not a woman.” —Tricia, a sixty-year-old non-operative trans woman56

There were also individuals who had stronger feelings about this and feel that SRS is in some ways, unnecessary and a form of state coercion. “1 do not want to undergo forced sterilisation just to have the gender marker on my official documents changed.” —Twen-ty-three-year-old non-operative trans man57

CONCLUSION[]

For many, changing the sex marker on their ICs means more than mere administrative ease. To have control over how one is represented gives many a sense of security, affirmation, and acknowledgement. This would also create greater ease in other areas of their lives, such as job applications, visitations to hospitals, and the checking of travel documents at airport departure gates. For some, there would be an added level of psychological security, as they would be free to be who they are without contradictions and without judgement.

It is heartening that the Singapore government allows individuals to change the sex markers on their identity cards, though only on the condition they have undergone SRS. However, as shown in the above sections, not only are there material limitations and challenges to go through the operation itself, for some who don’t identify as one gender, the idea of SRS does not apply. The government needs to take this into account when drafting such future policies. This is a complex topic of which there exists a vast diversity of views, even within the communities itself. As one twenty-six-year-old pre-operative trans woman wrote, “At the end of the day, if people don’t accept trans people, the discrimination and violence will happen even if our 1C states F, M, or X.”58 On the other hand, a seventeen-year-old genderfluid individual wrote that “Unless it is formally recognized, gender non-conformity and trans people will be taken as a joke.”59 Both views reflect the need to have more platforms and discussions in society and with policymakers in order to ensure that such laws of forced sterilization can be amended, and more importantly, that Singaporeans, no matter who they are, have a voice and have the space to be who they want to be.

Vanessa Ho is the project director of Project X, a local non-governmental organization that advocates for the rights of sex workers of all sexual orientations and gender identities. This is a full-time position she has held since 2011, and one where she is responsible for documenting and reporting on the various human rights abuses sex workers face. She has written and spoken on sex work, human trafficking, rape culture, and LGBTQ rights in Singapore.

Previously, Ho was part of Sayoni, a gueer women’s organization, and was a volunteer for its Convention for the Elimination of all forms of Discrimination against Women (CEDAW) reporting team. As part of her assignment, she traveled to the United Nations (UN) in New York to present a shadow report on queer womens issues for Singapore’s session.

Ho was also one of the key organizers of SlutWalk Singapore, a movement that aimed to raise awareness about rape culture, victim blaming, and slut shaming. Simultaneously, she was a curator at Post-Museum, where she organized a series of talks and events to examine sex, gender, and sexuality in Singapore. Ho was awarded the Young Activist Award by the Association of Women for Action and Research (AWARE) in 2014 for her work on various human rights issues.

Ho graduated with a bachelor of science in economics from the University of Warwick, and a master of arts in gender, society, and representation from University College London. She is also a part-time associate lecturer at the Singapore Institute of Management University (UniSIM), teaching modules in film, and gender theories. Ho holds the view that if people can speak about sex, gender, and sexuality in open and in non-judgmental ways, society will become a safer place for everyone.

Sherry Sherqueshaa is a former transgender sex worker turned activist. As a Muslim, she also aims to inspire the transgender community. She joined local non-governmental organization Project X initially as a youth program coordinator, working closely with trans women via events and workshops in the community center. Having found deep interest through her involvement in plenaries, interviews, and interactions with academics and others, Sherqueshaa then moved on to be the organizations researcher and writer, championing and advocating for the rights of sex workers in Singapore.

Sherqueshaa is currently with the National University of Singapore (NUS) as a research facilitator and consultant, assigned to be a peer leader. Her role is to execute a campaign called the Project Stiletto and a survey that address issues concerning transgender sex workers’ health, sex reassignment, insurance, and social support.

A year and still counting, being with Project X has taught and allowed Sherqueshaa to educate and advocate for changes in Singapore’s marginalized community. Being frequently exposed to the issues and concerns of sex workers not only motivates her but also pushes her to be optimistic. Sherqueshaa has attended human rights conferences and seminars in Chiang Mai, Taipei, and Kuala Lumpur, where she gained experiences and learned various advocacy strategies. She believes that with small steps, effort and perseverance, hope will translate into reality. Sherqueshaa also feels that if one cannot accept transgender people and sex workers, the least they can do is give respect like they would to any other person.

Darius Zheng is an LGBTQ activist, whose work started in 2012 when joining the steering committee of Pink Dot SG, organizing the nation’s annual de facto LGBTQ rally (27,000 supporters attended in its seventh year in 2015), where the LGBTQ community and allies gather at a park dressed in pink. In his three years with Pink Dot SG, he has worked with numerous community groups, students and youths, media, corporate and individual sponsors, event ambassadors, performers, and commercial partners.

Since late 2013, Zheng has moved on to look at intra-community issues. He is currently a volunteer para-counselor under Action for AIDS Singapore’s Pink Carpet Initiative to advise high-risk young men-who-have-sex-with-men on the importance of safe sex. As part of the initiative, he is also responsible for outreach efforts to gay bars and clubs. As a journalist, Zheng regularly contributes to one of Asia’s leading LGBTQ publications, including Element Magazine, and currently works for international LGBTQ media company GayStarNews as its Asia-Pacifc correspondent.

Zheng is similarly active in transgender advocacy work. As part of Free Community Church, Singapore’s only LGBTQ-inclu-sive church, he helms a team to organize monthly donation drives for the T Project, Singapore’s only transgender shelter. This collaboration with Project X’s Vanessa Ho and Sherry Sherqueshaa for the LGBTQ Policy journal is also in part to raise awareness for transgender issues on a global scale.

Zheng is also a personal advocate for LGBTQ rights. In 2013, he was awarded a grant by Manila-based B-Change Foundation, supported by the UN Development Program, to produce his own coming-out film, which was subsequently featured on local and international media outlets. He was also invited by the Beijing LGBT Center and the Human Rights Campaign (HRC) to talk about the work he has done.

Zheng was also involved in the HRC’s global advocacy efforts as a global equality innovator, speaking at the organization’s first Global Innovative Advocacy Summit held in Washington, DC, in March 2016. Zheng graduated with a bachelor of communication studies from Singapore’s Nanyang Technological University, specializing in journalism, and will be embarking on a master of arts in a human rights studies program at Columbia University in August 2016.

ENDNOTES[]

1. Non-binary genderqueer, interview with authors, 31 May 2015.
2. Chan Meng Choo, “First Sex Change Surgery,” Singapore Infopedia, 8 April 2011.
3. “Singapore Hospital Closes Last Sex Change Clinic,” Fridae, 30 May 2001.
4. Soon after the independence of Singapore in 1965, a National Registration Act was established and took effect in 1966.

VOLUME VI 2015-2016 73 This act required all Singaporeans above twelve years of age to register for an identification card; “National Registration for Singapore Identity Cards Begins.” National Library Board, n.d.

5. “Legal Gender Recognition—Change of Gender,” Transrespect Versus Transphobia Worldwide, 2016.
6. Patrick Jiang “Legislating for Transgender People: A Comparative Study of the Change of Legal Gender in Hong Kong, Singapore, Japan and the United Kingdom,” Hong Kong Journal of Legal Studies Vol. 7 (Hong Kong: University of Hong Kong Press, 2013): 31-73.
7. “Women’s Charter PART 111: Solemnization of Marriages,” Singapore Statutes Online, 1 January 2015; It is interesting to note the wording in paragraph I2(3)(a). The initial words proposed were “conclusive evidence” instead of “prima facie evidence,” but the latter was used as concerns were raised that the former “would be too rigid and problematic”; Parliament of Singapore,” Official Reports—Parliamentary Debates,” 27 August 1996.
8. “Malaysia: Court Ruling Sets Back Transgender Rights,” Human Rights Watch, 8 October 2015.
9. Allard K. Lowenstein, International Human Rights Clinic, Yale Law School, and Project X, “’They Only Do This To Transgender Girls’: Abuses of Trasgender Sex Workers in Singapore,” Project X, 19 November 2015.
10. Anonymous, interview with authors, 25 July 2015.
11. Anonymous, interview with authors, 30 May 2015.
12. Pre-operative trans man, interview with authors, 3 June 2015; the HDB is the government statutory board responsible for public housing.
13. Pre-operative trans woman, interview with authors, 29 May 2015.
14. Nadia Rzeya, interview with authors, 11 December 2015.
15. Halinadii, interview with authors, 7 December 2015.
16. Trans man, interview with authors, 30 May 2015.
17. The definition of “agender” is to be “without gender.” As such, participants may not feel the need to undergo SRS, as that will be to adopt a gender. However, as none of the participants who identified as agender volunteered for the focus group discussions, we were unable to explore this further.
18. In 2008, the UN Human Rights Committee urged Ireland to “recognize the right of transgender persons to a change of gender by permitting the issuance of new birth certificates,” citing the rights to “privacy, equality, and recognition before the law”; “License to be Yourself: Laws and Advocacy for Legal Gender Recognition of Trans People,” Open Society Foundations, 2014.
19. Trans woman, interview with authors, 4 December 2015.
20. Trans man, interview with authors, 3 June 2015.
21. Anonymous, interview with authors, 6 December 2015.
22. Candy, interview with authors, 21 December 2015.
23. Trans man, interview with authors, 18 July 2015.
24. Kieran, focus group interview with authors, 17 December 2015.
25. Benson, e-mail interview with authors, 10 February 2016.
26. Natalyn, focus group interview with authors, 17 December 2015.
27. Trans man, focus group interview with authors, 17 December 2015.
28. Pre-operative trans woman, interview with authors, 30 May 2015.
29. Pre-operative genderfluid individual, interview with authors, 22 July 2015.
30. Nat, e-mail interview with authors, 11 February 2016.
31. Health Policy Project, Asia Pacific Transgender Network, and United Nations Development Progamme, Blueprint for the Provision of Comprehensive Care for Trans People and Trans Communities in Asia and the Pacific (Washington, DC: Futures Group, Health Policy Project, 2015); APTN adds that “this is particularly true for trans man, as creating male genitals involves multiple stages of surgery; frequent technical difficulties and post-operative complications mean only a small minority of trans men have such operations.”
32. More information about the eligibility criteria for buying public housing—in particular, the “Singles Scheme” and “Public Scheme”—can be found at hdb.gov.
33. Jason, focus group interview with authors, 22 December 2015.
34. Vittorio, focus group interview with authors, 15 December 2015.
35. Tiky, focus group interview with authors, 23 December 2015.
36. Kieran, focus group interview with authors.
37. Jaclyn, focus group interview with authors, 18 December 2015.
38. Cass, focus group interview with authors, 18 December 2015.
39. Jason, focus group interview with authors.
40. Anonymous, interview with authors.
41. Amanda, focus group interview with authors, 23 December 2015.
42. “Standards of Care for the Health of Transsexual, Transgender, and Gen-der-Non-conforming People,” World Professional Association for Transgender Health, 2012.
43. Trans man, interview with authors, 9 December 2015.
44. Non-operative trans man, interview with authors, 30 May 2015.
45. Trans woman, interview with authors, 3 July 2015.
46. “#wearWHlTE,” Wear White, n.d.
47. “Christians to Don White for Services as Hong Lim Park Hosts Pink Dot,” The Straits Times, 23 June 2015.
48. Pre-operative trans woman, interview with authors, 29 May 2015.
49. According to Teh, on the situation of transgender women in Malaysia, “Muslim burial rites state that only a female can bathe the body of another female—this would not include the mak nyahs even though they may had undergone the sex change operation. Mak nyahs with the sex-changed female organ could also not be bathed by a male”; Yik Koon Teh, “Mak Nyahs (Male Transsexuals) in Malaysia: The Influence of Culture and Religion on their Identity,” The International Journal of Transgenderism Vol. 5, No. 3 (Abington, England: Taylor and Francis, 2001).
50 Sherry Sherqueshaa, “Reflections on Mr. Imran’s Talk on Religious Issues Relating to Sex Workers and the Transgender Community,” Project X, 23 July 2015.
51 James S. Fu, Mythic and Comic Aspects of The Quest: Hsi-yu chi as Seen Through Don Quixote and Huckleberry Finn (Singapore: Singapore University Press, 1977); Barbara E. Reed, “The Gender Symbolism of Kuan-yin Bodhisattva,” Buddhism, Sexuality, and Gender, ed. Jose 1. Cabezon (Albany: State University of New York Press, 1992): 159-180; Alex, focus group interview with authors, 18 December 2015.
52 Non-operative genderfluid, individual, interview with authors, 14 December 2015.
53 Non-operative trans man, interview with authors, 30 May 2015.
54 Non-operative trans woman, interview with authors, 18 July 2015.
55 Jaclyn, focus group interview with authors.
56 Tricia, focus group interview with authors, 22 December 2015.
57 Non-operative trans man, interview with authors, 29 May 2015.
58 Pre-operative trans man, interview with authors, 3 July 2015.
59 Genderfluid individual, interview with authors, 6 December 2015.

Archive of "The Forced Sterilization of Transgender and Gender Non-Conforming People in Singapore", LGBTQ Policy Journal, 2015-2016

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