SINGAPORE: Final decisions on the use of hormonal therapy "rest with clinicians and their patients", said the Ministry of Education (MOE) and Institute of Mental Health (IMH) in a joint statement on Thursday (Jan 21).
This comes after an 18-year-old student said in a Reddit post on Jan 14 that the Education Ministry had intervened with her treatment, preventing her from obtaining a doctor's referral letter to begin hormone therapy.
MOE denied these claims two days later, saying that it was "not true" that it interfered with the student’s hormonal treatment, and invited the student to approach the school to "clarify and discuss how the school can support his schooling better".
The Education Ministry and IMH wrote in the joint statement on Thursday: "In treating individuals who are diagnosed with gender dysphoria, IMH clinicians will typically seek inputs from a wide range of stakeholders.
"The final medical treatment decisions involving the use of hormonal therapy rest with clinicians and their patients. Such treatments also require the written consent from parents (where minors are concerned)."
In the school setting, the schools work closely with IMH and the students' parents to support them and "maintain a conducive learning environment", the statement read.
DOCTOR TOLD TO CONSULT MINISTRY BEFORE TREATMENT: STUDENT
Speaking to TODAY last week, the student, who wanted to be known only as Ashlee, said that MOE’s initial response did not address any of the issues laid out in the Reddit post.
Ashlee had asked that the school not be named for fear of repercussions for speaking with the media, and requested to be referred to by she/her pronouns.
She was diagnosed with gender dysphoria in 2019, she said, adding that the situation with MOE and the school started around February last year.
Ashlee had notified the school's management of her diagnosis in March last year, and was asked to confirm this via a letter from the IMH psychiatrist, she told TODAY. The letter was reportedly given to the school and MOE the same month.
MOE told her through the school that it would work with her to understand her diagnosis and make school conducive for her, she said.
The school's year head and counsellor had also sat in for at least one of her appointments with the psychiatrist, said Ashlee, adding that some school rules were relaxed during the time, citing the example of being allowed to use the wheelchair toilet.
But when she was to proceed with hormone replacement therapy in August, she was informed by the psychiatrist that MOE had told the doctor to consult the ministry before any decision could be made regarding treatments for transgender students, Ashlee told TODAY.
Because of this, she has not received the letter to begin hormone replacement therapy, she said.
Ashlee also told TODAY that during a meeting in October involving her father and the school management, she was told that she would have to continue wearing the uniform for boys.
If hormone replacement therapy resulted in physiological changes that prevent her from doing so, she would be expelled from school, she said.
According to Ashlee, the school's principal also requested to work personally with the endocrinologist to limit the dose of hormones so that expulsion was unlikely to happen.
Addressing this case, MOE and IMH said in Thursday's joint statement that the school is "committed to providing the education support the student needs to graduate", including via home-based learning.
"The school will continue to work with the parents and IMH medical professionals to support the student's education journey and well-being," the statement read.
"We urge all parties to respect the privacy of the family, so that the parents can have the space to decide what is in their child’s best interest."