A psychiatric investigation on 56 cases of male transsexuals in Singapore revealed a prevalence of I in 25,000. Eighty-two per cent were prostitutes and 83 per cent had completed secondary education. All were unmarried, and 35 per cent were co-habiting with men. Fifty-eight per cent had felt they were females before the age of 5, 65 per cent cross-dressed before the age of 10, and by the age of 20, 57 per cent were completely cross-dressed of whom 73 per cent were receiving female sex hormones. Their mean IQ was 105. Thirty-two (58 per cent) underwent sexual reassignment surgery. There was no report of psychiatric complications. It was concluded that transsexualism as described by different authors may not refer to the same condition. Aetiologically, these cases did not appear to be determined by early childhood experience.

Twenty female transsexuals were assessed for sexual reassignment surgery in Singapore. This gives a prevalence of 1 in 36,000 for females aged 15 and above. The age ranged from 18 to 31 with the mean at 24.9 years. Fifteen had received secondary education and 19 were employed. There was no history of serious anti-social behaviour. They were closer to their mothers, some of whom encouraged their cross dressing behaviour during childhood. Their behaviour became more masculine as they grew older. All were unmarried. Eighteen had girl friends and 10 indulged in sexual activities with their girl friends. They sought the sex change operation because they wanted to live as males so that they could marry their girl friends. Eight are at present undergoing the multi-stage operation.