Torn over Transgender Therapy for Teens

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Photo Credit: Kyle|Unsplash

Is Reddit a new way to make headlines in Singapore on culturally sensitive issues? The US-based social media platform has been around for about 15 years. It sees discussions on all kinds of topics, from people sharing fat stories to experiences in the Singapore commando unit. As a creature of the internet that fiercely protects user privacy and has over 300,000 users in its Singapore subreddit, it’s now made an inroad into mainstream media by catching the eye of a government agency.

The Ministry of Education (MOE) and Institute of Mental Health have issued a joint statement saying that decisions on hormone therapy rest with clinicians and their patients, according to today’s media reports. This is in response to online controversy that broke out a few days ago, when mainstream media reported on a story that had originally exploded on an SGExams subreddit. MOE had allegedly intervened to deny a transgender student’s hormone therapy. The news sites led with a credible news source: a Facebook response by the Education Ministry debunking the claim.

It seems that resourceful journalists managed to put a name to the anonymous Redditor – and Ashlee shared more details on what went down, including how hormone therapy was withheld under instruction from MOE.

This move by the mainstream media is groundbreaking for transgender activists in Singapore on one point – hormone therapy for those under 18 – and it’s a big step in Ashlee’s favour.

With their reportage, the average Singaporean is now confronted with the following questions:

  1. Did MOE really intervene with Ashlee’s hormone therapy? While it denied intervention, Ashlee’s account contradicts this. What is the truth?
  2. If MOE really intervened, why did they do so?

It was also unusual in another way – reliance on rather scant sources to build a story. News reports typically feature multiple voices and viewpoints, for fairness and balance. Yet, there were only two sources – one verified, one anonymous. This isn’t to say journalists shouldn’t chase down one source to build a story. It’s been done before, where Mr Seow Ban Yam almost single-handedly upended health policies for elderly patients (with the help of the Straits Times’ Senior Health Correspondent Selma Khalik). However, if Ashlee’s doctor had been contacted to clarify, and if mainstream media told us whether they had pressed the Education Ministry for more information, the initial story might have been more credible. This also raises questions for anonymous activism moving forward – does this unintentionally set a precedent, where those with compelling stories might be encouraged to post them to social media with little fear of accountability, and hope for the chance to make the headlines to further their cause?

Nonetheless, the path ahead seems fraught with challenges for Ashlee, MOE, and Singapore in general. Are there are internal government policies against allowing students below a certain age to transition? If so, Ashlee is unlikely to receive therapy. However, today’s Joint Statement suggests that it’s up to the family to decide. (We note that Ashlee had mentioned transferring to a polytechnic; it was unclear whether gender transition would still be a problem there. If not, might the issue have been about pre-university institutions enforcing gender-based regulations on hairstyles and uniforms, rather than the school being against hormone therapy per se? Would MOE prevent polytechnic students transitioning?)  

As for MOE, it will have to fend off an increasingly condescending online mob, as seen from the hundreds of comments denouncing it for “misgendering” Ashlee. It will likely also have to formulate (or publish) policies touching on this sensitive issue.

The reports also raise a tough question for Singaporeans: should those under 18 be allowed to undergo hormone therapy, even with parental consent?

With the mainstream media throwing a spotlight on this issue, public conversations will likely have to take place, if they aren’t already. It’ll be yet another divisive topic. Transgender rights have been a flashpoint for division in societies globally, with debates on trans-inclusivity in bathrooms and sporting events.

Most online comments take Ashlee’s side. However, it will be as important to hear opposing viewpoints, including ones held by those more typically excluded from the digital space. Even those who venture a different opinion online are swiftly silenced. A commenter was banned by Facebook after fighting against accusations of misgendering. Mr Renson Seow argued that MOE wasn’t wrong to use the gender stated on Ashlee’s NRIC. Without a robust discussion, it may be difficult to make decisions and formulate policies that appear even-handed.

Zooming in on the specific issue of the young and hormone therapy, the UK’s Health Ministry has recently seen legal pronouncements over transgender issues. A recent High Court ruled in favour of 23 year old “de-transitioner” Keira Bell that under 16s were unlikely to be able to consent to puberty blockers; an appeal is pending. There is a separate lawsuit by a 14 year old against the Health Ministry over alleged hormonal treatment delays.

These are complex issues which must be unpacked and dealt with moving forward. Singapore will have to find a way to be compassionate to the very real struggles of transgender teens, acknowledge the complex realities of “de-transitioners”, handle the medical and societal implications of hormone therapy, and hold space for civil and meaningful discussions around these and other controversial issues.

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