Talk by Prof Lee Kok Onn, Professor and Consultant in Endocrinology, National University of Singapore

Increasingly otherwise healthy people with gender uncertainties look to the medical profession for reliable information and medications. Endocrinologists are generally proficient in the physiological use of hormones and diffident in the use/misuse of hormones in non-physiological indications and doses. There are also hurdles in the legal and ethical milieu in Singapore which differ from America and Europe, and their guidelines, even when clear, may not be applicable or appropriate. What should a reasonable endocrinologist do? The information about hormonal preparations available from traditional and non-traditional sources can confuse, and information from the internet may be difficult to assess. There are creams and gels, tablets, pellets and injections for male and female hormones. Surprisingly there are no rectal preparations, or testosterone pessaries – even in Europe. The non-medical and medical aspects of giving advice and hormones in these situations were also discussed.