July 2005

Singapore: a woman with a past




At the First International Conference of Asian Queer Studies, 7 9 July 2005, held in Bangkok, one of the keynote speakers, Prof Vitit Muntarbhorn, Professor of Law at Chulalongkorn University, mentioned in his address that till now, no country in Asia has permitted the change of sex to be reflected in personal identity documents after sex-change surgery. This puts transgenders in a legal limbo and does not completely resolve their dilemma.

Vitit didn't seem to be aware that Singapore has recorded the change in status for over 30 years, and recognises marriages of sex-changed persons as well.


As my friend Russell Heng remarked, "Even when Singapore does something right, nobody knows, and they don't get any credit for it."

I suspect the Singapore government doesn't want anyone to know. They may think it embarrassing that there was ever a time when they were liberal-minded. In these days when the government takes pride in their homophobia, this stain on their past behaviour is best hidden away. Just like a woman with a past.

Singapore's transgender and sex-change history is quite interesting, and I'll give a short account of it here. On the face of it, Singapore will appear quite progressive and even ahead of its time, but there can be another interpretation, which a remark by Prof Douglas Sanders, Prof Emeritus of Law, University of British Columbia, indicates.

He said, at one of the panel sessions at the above-mentioned conference, that perhaps the Singapore government's obsession with orderliness explains the situation better. "If you're going to go around looking like a woman, then the papers should jolly well say you're a woman!"

* * * * *

For decades, Singapore had a world-famous tourist attraction (the loss of which we are now desperately trying to make up for, after losing tourism market share for years). It was Bugis Street [1], a narrow street of outdoor bars and rat-infested drains. Its claim to fame came from the transvestites who sashayed up and down the street looking to hook half-drunk sailors, American GIs and other foreigners on R&R, for an hour of profitable intimacy.

Not only would these clients get the thrill of sex with an exotic oriental, there would be the added spice of transgressing gender boundaries in a seamy hovel.

By the late 1970s however, a determined campaign was in force to rid Singapore of such yellow culture. Whole blocks of crumbling shophouses would be razed in our attempt to create a "modern" city. Our drains, canals and rivers would flushed clean, rats exterminated and other undesirables (read: transvestite prostitutes) chased off the streets.

Was it a coincidence, I wonder, that Singapore's first sex-change operation took place in July 1971? Was it the surgical complement to the clean-up campaign?

Imagine the logic: what better way to eradicate prostitution than to have these ah kuas remade into real, legit women, so they can find proper jobs assembling components in a semi-conductor factory, 9 hours a day, thus helping Singapore's economy? Their employers cannot know their sexual history, otherwise they can't get jobs, so make sure the papers say they are female.

* * * * *

Professor S S Ratnam was born in Ceylon (now Sri Lanka) in 1928, but by 1970, he was Head of the Department of Obstetrics and Gynaecology in the former University of Singapore. He practised at Kandang Kerbau Hospital, which was then the teaching hospital for O&G.

According to this website,

He had been visited by an "attractive female" patient who shocked him by disclosing her true sex and begged him to transform her into a woman. Although hesitant, Prof Ratnam eventually relented. As part of his research, he would spent hours in front of a mirror, naked, looking at his genitals to see how they could be removed with minimal trauma to the rest of the body.

Thus a milestone event took place in Singapore in July 1971, when Asia's first sex re-assignment surgery (SRS) was performed. (The world's first sex-change operation was performed in 1952 by Danish doctors on George later Christine -- Jorgensen.) Ratnam was to remain the leading figure in Singapore's SRS Clinic until his retirement in 1995. In that period, about 500 SRS operations were performed, not only male-to-female but also female-to-male, a more complex procedure.

Ratnam was famous internationally for his work.

More interestingly, the government looked kindly on the procedure. As reported by Asiaweek magazine, March 1996, in the story titled, "Women in Distress: Are Police Needed to Protect Battered Wives?"

In 1973, Singapore legalized sex-change operations and permitted transsexuals to wed.

Thus, quite soon after the first operations were performed, a policy was put in place that post-operative patients could get their sex changed on their identity cards and other documents that flowed from that.

I searched our laws for a specific provision allowing the Registrar to do this, but I couldn't find any. Probably, it exists only at the level of a policy directive. However, for over 20 years, this policy seemed to have operated smoothly.

Then in 1991 a case came up before the High Court. A woman asked the court to rule her marriage null and void because she realised only after marriage that her husband had been born a female, and was sex-changed into a male (before marriage). I shall quote from this website:

In Lim Ying v Hiok Kian Ming Eric, the petitioner married the respondent at the Singapore Marriage Registry under the provisions of the Women's Charter. The petitioner later discovered that the respondent was born a female and had undergone a sex-change operation. The petitioner prayed for a declaration that there had never been a marriage between the parties because the respondent was a female, and alternatively, for an annulment of the marriage on the basis that it was not consummated owing to the incapacity of the respondent.

In a landmark decision, three important points were decided. First, that marriages under the Women's Charter between parties of the same sex are not permitted; secondly, following the English case of Corbett v Corbett, that the determination of sex was to be by use of biological criteria (chromosomal, gonadal, and genital tests), ignoring any operative intervention; and thirdly, that breach of this requirement renders the marriage void ab initio even though it is not one of the grounds listed in the former section 99 of the Women's Charter.

The Women's Charter is the law governing civil marriage in Singapore. At that point in time, it did not specifically state that marriages can only take place between people of opposite sex, but the judges interpreted it to be so in the above-mentioned case.

Judicial Commissioner KS Rajah said "The [Women's] Charter introduced the traditional marriage or the voluntary union of one man and one woman for all Singaporeans except Muslims..."

He equated "marriage" with that of one man and one woman. Rajah added the word "traditional" in his judgment when that word wasn't in the Act, and when marriage wasn't "traditionally" a matter of one man and one woman. Not in this part of the world, at least. Diverse forms of customary marriage involving more than 2 persons would be well known to anyone living in Asia even in the 1990s.

That being said, same-sex marriage was unheard-of to the general public at the time, so the chances of the judges interpreting the Women's Charter to permit a female marrying another female were remote. That is, provided they found that Eric Hiok, the husband, was female.

They did. The judges ruled that in a dispute such as this one, reference should be made to the birth certificate, in determining a person's sex. In the case of the respondent, Eric Hiok, his birth certificate noted he was female, as the policy since 1973 was that only the ID card would be amended to record the new sex. The intention was that the birth certificate should continue to reflect the historical fact that he was female at the time of birth.

On this basis, referring to the birth certificate, the court ruled the marriage null and void. Some lawyers criticised this interpretation whereby the birth certificate would be the deciding reference.

Somehow, the government was energised into corrective action. It would have been very easy for them to just let the court decision lie, though that would have meant invalidating all marriages of transitioned transgenders up to that time.

In 1996, a bill was put before Parliament and the Women's Charter amended. The minister moving the bill argued that all along the intention was for sex-changed persons to a life according to their new sex, including the right to marry. Through an oversight, the law relating to marriage had not been re-aligned neatly with the official policy to recognise sex-reassignment surgery. Now that the court had illuminated this inconsistency, it was necessary to amend the Women's Charter to ensure that the original intention was not undercut.

For the exact transcript of what the minister said, see Marriage for sex-changed persons


Shiite Iran

Did you know that about 40 years ago, Ayatollah Khomeini, the theocratic founder of Islamic Iran, issued a fatwa that said that transgenderism is a disorder akin to an illness, and therefore medical and surgical intervention is allowed? 

Hojatuleslam Kariminia, another cleric, said to BBC [3] that the right of transsexuals to change their sex is a fundamental human right.

The leading sex-change surgeon in Iran is Prof Dr Bahram Mirjalali. He has done over 320 operations in the last 12 years.

However, Iran is no paradise. At a social level, there is still extreme prejudice.

Unlike transgenderism, homosexual orientation is not considered an illness, but ruled an evil.




With the amendments passed, the relevant portion of the Women's Charter currently reads thus:

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. [30/96]

(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. [30/96]

(3) For the purpose of this section

(a) 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. [30/96]

(4) Nothing in subsection (2) shall validate any such marriage which had been declared by the High Court before 1st May 1997 to be null and void on the ground that the parties were of the same sex.

For transsexuals, this is as good as it should be. With the 1996 amendment, it is expressly stated that the sex as shown on the identity card at the time of solemnisation should suffice, with the implication that the sex at birth should be immaterial.

But it is also worth noting that with this 1996 amendment of the law, it is now expressly stated that marriage in Singapore is only between a male and a female. It is no longer open to judicial interpretation whether two persons of the same sex can marry.

One door opens, another is closed.

* * * * *

For a little while after Ratnam retired, the SRS Clinic carried on under the leadership of Dr Anandakumar, who happened to be Ratnam's nephew. Then in 2001, the clinic quietly closed.

The official explanation was that the surgeon in charge had left for private practice, and without him, the clinic did not have the skills to perform the operations.



But the chill wind had been blowing as early as 1987.

... in 1987, the Health Ministry asked hospitals to stop doing such operations on foreigners. It also discouraged them on Singaporeans. It said 'the increased danger of Aids with such patients poses unnecessary risk to hospital staff'.

Source http://www.ftmaustralia.org/media/03/0608.html

8 June 2003


The homophobia from the knee-jerk equations (Transsexual = homosexual;  Homosexual = AIDS) had kicked in.

Another knee-jerk reaction could also be seen in the blanket ban on doing such operations on foreigners. AIDS was seen as an external disease that could come into Singapore if foreign homos  -- trannies are homos, aren't they? -- were not discouraged from entering Singapore.

Anyway, in 2001 when the SRS Clinic closed, the online newspaper Project Eyeball carried out a poll, the results of which I found here:

June 2001 
Project Eyeball survey

Should sex-change operations be resumed in Singapore?

39% - Yes, they are people with valid medical needs, like infertile couples. 

35% - Why not? It is legal here, as are transsexual marriages. 

9% - No, they can go abroad. 

8% - No, society here is not open enough for it. 

8% - Eventually maybe, but it's not a life-or-death issue.

Based on 158 responses to our online poll.

You can see from the above that Singaporeans are generally quite supportive.

Two years later in 2003, the clinic re-opened again, with no fanfare. Dr Ilancheran was now in charge. However, by now, Bangkok had become the chief centre for sex-change surgery. To begin with, it was much cheaper than Singapore, but concerns have been expressed about the quality of work and sometimes, the lack of psychological profiling and counselling prior to confirming the decision to operate. The latter is very important, as the surgery is irreversible and patients must be very sure they want what they say they want.

Yet, with the re-opening of the SRS Clinic so hush-hush, it appears that Singapore is reluctant to pursue and develop this branch of cosmetic surgery.

Why? We can only speculate.

* * * * *

The first thought that comes to mind is that the economic argument may not be there. Why should we go out of way to do this if there is no macro-economic benefit? the authorities might say.

This is very plausible as many Singaporeans have observed that social justice and other non-economic concerns have little weightage in the government's calculations compared to economic goals. Chris Tan, for example argued that tolerance for gay civil servants was just another "survivalist strategy", and not the result of any enlightenment [2]

However, there seems to be a downplaying of SRS services even compared to the past. To what can we ascribe this cooling off?

It may be a reaction to the rise of the gay argument. In the 1970s when there was no gay issue, being trannie-friendly would not be seen as any concession to the (non-existent) gay lobby. In any case, it was very easy to argue that providing sex-change operations resolved a social problem by de-fringing a fringe group that had no other means of survival except prostitution, bringing them into the mainstream as respectable heterosexuals. Allowing sex-change was a pro-heterosexual move.

30 years on, the terrain is very different. It is a sign of how the gay issue has become an issue, that the government cannot even concede as much to transgenders today as they did in the 1970s. Someone somewhere would raise difficult questions about how they treat gays and lesbians compared to the legal provisions they have made for transgenders. At the same time, the religious extremists (inspired by the Christian fundamentalists of the USA) might rain fire and brimstone on the ministers for being kind to non-heterosexuals. In this age, spotlighting sex-change would be a pro-queer position, not a pro-heterosexual one. In view of such risk, perhaps the government felt they couldn't highlight the re-opened SRS Clinic nor really support this branch of surgery.

Yet, Singapore is trying hard to be a leader in medical services. It has identified this as one of the ways for Singapore to stay economically ahead of the curve as our manufacturing sector succumbs to the Chinese juggernaut.

In two articles on 11 July 2005, the Straits Times reported that the half-empty Kandang Kerbau hospital (KKH), formerly a maternity hospital, is being revamped to cater to "women's needs", including cosmetic surgery. 

KKH is now a third empty most of the time. And this is despite the fact that it is using only about 740 of its 900 beds, the rest having been mothballed since those new wards were built.

Quoting from the Straits Times,11 July 2005,

KK Women's and Children's Hospital is now offering tummy tucks, facelifts and cellulite reduction, as part of a move to offer services for women in areas other than obstetrics and gynaecology.


Over the next few months, it will add or expand services, starting with orthopaedic, breast, ear, nose and throat, psychiatric and aesthetic services this year.

It will also have an eye department and start a clinic catering to teenagers' special needs soon after.

Is sex reconstruction included under this ambitious plan? If so, why the coyness in not mentioning it? If not, why not?

Yawning Bread 




  1. For a gay take on Bugis Street, see the article The sailor's birthday present by "Bob from Australia" 
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  2. Chris Tan Kok Kee presented his paper, Pinking the Lion City: Interrogating Singapore's Gay Civil Servant Statement, at the 1st International conference of Asian Queer Studies, Bangkok, 7-9 July 2005. See the article Gay civil servants redux
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  3. See BBC article Iran's sex-change operations, 5 Jan 2005 at http://news.bbc.co.uk/2/hi/programmes/newsnight/4115535.stm  
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