First sex change surgery


The first sex change surgery in Singapore was successfully performed on 30 July 1971 at the Kandang Kerbau Hospital (now known as the KK Women’s and Children’s Hospital). The operation involved a 24-year-old man and was the first procedure of its kind carried out in Singapore. There had been previous “sex change” operations done in Singapore, but these mostly involved patients who had both male and female genitalia (hermaphrodites) and the removal of one set of genitalia.1 The 1971 operation was regarded as a first because it involved a surgical conversion aimed at functionally changing a person’s sex and appearance.2

Patient and diagnosis
The patient was a 24-year-old Chinese Singaporean. Her name was kept secret, but her background was later made public in a book. The eldest son in a family of five with two younger sisters, her father was a dentist who was often physically violent with his wife, which caused the patient psychological trauma. As a child, the patient was raised by her grandmother, who dressed her as a female. In her teenage years, she associated with other cross-dressers before frequenting the transsexual and transvestite scene at Bugis Street as an adult.3

From the age of 16, she worked as a sales assistant, a housemaid, in a bank and as a public relations officer in a hotel. She later won second prize in a beauty contest and became a model. While working as a part-time model, she joined a cabaret in 1968 and was known as “Mama Chan”. She also ran a social escort service.4

Having lived as a woman for some time, in 1969 she first consulted Professor S. S. Ratnam, a senior lecturer in the University of Singapore’s Department of Obstetrics and Gynaecology. She had been suffering sexual and emotional problems, which had led to two suicide attempts. Ratnam explained to her that he had no experience in sex change surgery, but she continued to visit his clinic weekly. After researching the subject of transsexualism and sex reassignment surgeries, Ratnam familiarised himself with the surgical techniques by practising on cadavers.5

The patient underwent a psychological analysis by a team of psychiatrists who confirmed that she was a transsexual who required surgery.6 A diagnosis of transsexualism requires that the patient possesses a continuous sense of inappropriateness about his or her anatomic sex, a desire to discard his or her genitalia and live as a member of the opposite sex, and the absence of physical intersex symptoms or genetic abnormalities. As well, his or her gender confusion (gender dysphoria) must not be caused by other disorders such as schizophrenia.7 The patient was also cautioned that the surgery would be irreversible, potentially involved a number of complications and required a prolonged follow-up period.8 A total of six to nine months of medical and psychiatric tests have to be carried out before patients are passed for the operation.9

Legal clearance for the operation was then sought from the Ministry of Health and granted. After consideration of the patient’s psychological profile and the medical expertise involved, with the approval of the ministry, the decision was taken to proceed with the operation.10 

Operation and impact

The operation was performed by Ratnam and two other surgeons from the University of Singapore’s Department of Obstetrics and Gynaecology, Associate Professor Khew Khoon Shin and plastic surgeon R. Sundarason.11 Photography of the operation was not permitted. Ratnam later described the three-hour operation as a success, with an uneventful post-surgery recovery.12  

After her successful operation, the patient went on hormone treatments13 and was functionally a woman, though she could not conceive or menstruate.14 She later married a French man and owned a travel agency in Paris, before moving to England.15

The July 1971 operation paved the way for sex change surgeries in Singapore and in the region. Singapore’s first sex change operation on a woman took place three years later. It was carried out in three stages between August 1974 and October 1977.16 Female-to-male conversions are more complex and involve several surgical stages.17 In the 1970s and ’80s, hospitals in Singapore accepted numerous sex change patients from abroad, with foreigners making up around half of all surgeries performed, while the rest were locals and Malaysians.18 

In the years following the operation, a number of legal issues arose for transsexuals who had undergone a sex change. The Registry of Marriages implicitly recognised marriages involving a sex change patient, as it required only an identity card to prove the different genders of the couple.19 In 1991, however, a marriage between a sex-change transsexual man and a woman was declared void from the beginning by the High Court, officially making such marriages illegal in Singapore.20 It was only in 1996 that the government amended the Women’s Charter to allow transsexuals to marry legally.21



Author

Chan Meng Choo



References
1. Yeo, J. (1971, July 31). First sex change surgery in S’pore. The Straits Times, p. 17; Tan, W. L. (1971, August 25). Sex change patient has marriage plans. The Straits Times, p. 8. Retrieved from NewspaperSG.
2. Tan, W. L. (1971, November 11). They’re still ‘misters’ despite sex changeThe Straits Times, p. 8. Retrieved from NewspaperSG.
3. Ratnam, S. S., Goh, V. H. H., & Tsoi, W. F. (1991). Cries from within: Transsexualism, gender confusion & sex change. Singapore: Longman Singapore, pp. 25–26. (Call no.: RSING 616.8583 RAT)
4. Ratnam, S. S., Goh, V. H. H., & Tsoi, W. F. (1991). Cries from within: Transsexualism, gender confusion & sex change. Singapore: Longman Singapore, pp. 25–26. (Call no.: RSING 616.8583 RAT)
5. Ratnam, S. S., Goh, V. H. H., & Tsoi, W. F. (1991). Cries from within: Transsexualism, gender confusion & sex change. Singapore: Longman Singapore, pp. 25–26. (Call no.: RSING 616.8583 RAT)
6. Yeo, J. (1971, July 31). First sex change surgery in S’pore. The Straits Times, p. 17, Tan, W. L. (1971, August 25). Sex change patient has marriage plans. The Straits Times, p. 8. Retrieved from NewspaperSG.
7. Ratnam, S. S., Goh, V. H. H., & Tsoi, W. F. (1991). Cries from within: Transsexualism, gender confusion & sex change. Singapore: Longman Singapore, p. 4. (Call no.: RSING 616.8583 RAT)
8. Chua, M. (1974, November 7). Who really needs a sex-change? The Straits Times, p. 10. Retrieved from NewspaperSG.
9. Lim, S. (1990, May 20). Legal poser over sex-change transsexuals who get hitched. The Straits Times, p. 21. Retrieved from NewspaperSG.
10. Tan, W. L. (1971, November 11). They’re still ‘misters’ despite sex changeThe Straits Times, p. 8. Retrieved from NewspaperSG.
11. Tan, W. L. (1971, August 25). Sex change patient has marriage plans. The Straits Times, p. 8. Retrieved from NewspaperSG.
12. Yeo, J. (1971, July 31). First sex change surgery in S’poreThe Straits Times, p. 17. Retrieved from NewspaperSG.
13. Second sex change operation in S’pore. (1971, November 5). The Straits Times, p. 15. Retrieved from NewspaperSG.
14. Why sex-change patients set up homes overseas. (1975, August 10). The Straits Times, p. 5. Retrieved from NewspaperSG.
15. Ratnam, S. S., Goh, V. H. H., & Tsoi, W. F. (1991). Cries from within: Transsexualism, gender confusion & sex change. Singapore: Longman Singapore, p. 26. (Call no.: RSING 616.8583 RAT); She tried to commit suicide. (1992, January 18). The New Paper, p. 20. Retrieved from NewspaperSG.
16. Kwee, M. (1974, October 20). S’pore’s first sex change woman. The Straits Times, p. 1. Retrieved from NewspaperSG.
17. Why sex-change patients set up homes overseas. (1975, August 10). The Straits Times, p. 5. Retrieved from NewspaperSG.
18. Chong, G. P. (1986, November 3). Sex-change cases can get new ICs. The Straits Times, p. 13. Retrieved from NewspaperSG.
19. Lim, S. (1990, May 20). Legal poser over sex-change transsexuals who get hitched. The Straits Times, p. 21. Retrieved from NewspaperSG.
20. Sex-change pairs can’t marry. (1991, September 26). The New Paper, p. 11. Retrieved from NewspaperSG.
21. Goh. T. T. (1996, January 26). They were allowed to wed before. The New Paper, p. 9; Gwee, E. (1996, 30 August). ‘I do’ – and no need to state gender at birth. The Straits Times, p. 6. Retrieved from NewspaperSG.



Further resources
Cheow, X. Y., & Fung, E. (2007, March 7). Born in the wrong bodyThe Straits Times, p. 114. Retrieved from NewspaperSG.


Chong, G.P. (1986, November 3). Sex-change cases can get new ICs. The Straits Times, p. 13. Retrieved from NewspaperSG.

Fifth sex-change operation a success. (1972, September 11). The Straits Times, p. 6. Retrieved from NewspaperSG.

Sex change man signs statutory declaration affirming that he is now a woman. (1972, April 16). The Straits Times, p. 6. Retrieved from NewspaperSG.

Tan, K. H., & Tay, E. H. (Eds.). (2003). The History of Obstetrics and Gynaecology in Singapore. Singapore: Obstetrical & Gynaecological Society of Singapore: National Heritage Board.
(Call no.: RSING q618.095957 HIS)

Tan, W. L. (1971, August 31). Man-made woman may not get marriage licenceThe Straits Times, p. 6. Retrieved from NewspaperSG.



The information in this article is valid as at 2016 and correct as far as we are able to ascertain from our sources. It is not intended to be an exhaustive or complete history of the subject. Please contact the Library for further reading materials on the topic.

 

Subject
Sex change--Singapore
Public health
Health and medicine>>Medical science>>Surgery
Politics and Government>>Health