When Ms Amanda Wee, 31, met The Straits Times last Wednesday, she was in a black shift dress, flat pumps and make-up. But at home, she wears what she calls "boy clothes".

Her parents know she identifies herself as a woman and intends to live her life that way - Ms Wee was born male - but they disapprove. Her younger sister and friends are supportive, but she has not come out to her Catholic community.

"I would like to express myself the way I am now all the time. But I can't and have to hide," said the software designer, whose struggles with accepting herself had, at times, led to her contemplating suicide.

By letting this newspaper publish her picture, she risks their ire, but she is hopeful her coming out can help other transgender people.

Because for transgender women like her, depression and thoughts of suicide are alarmingly common. A new survey of 41 transgender women here found that nearly half have thought of suicide. About 15 per cent acted on such thoughts and tried to kill themselves in the past year.

The poll, by transgender shelter T Project and social enterprise B-Change, also found that 78 per cent of respondents felt depressed in the past year.

DEBILITATING BUT TREATABLE Depression and suicidal tendencies are conditions that can be debilitating and yet treatable at the same time. There needs to be more public dialogue and education, involving both the public and the professional community, on transgender issues. DR KENG SHIAN-LING, assistant professor at the department of psychology at the National University of Singapore.

Ms Wee said: "I hope, even if this story generates pushback, that people will think about the issues we face and be kinder. And transpeople who are struggling with suicide will seek help."

There could be some 34,000 transgender Singaporeans, based on international studies that estimate that 1 per cent of any population is transgender - meaning they identify with a gender different from the one they were born as.

The summary report was available on the organisers' websites from yesterday - which was Transgender Remembrance Day, dedicated to those murdered due to transphobia.

Ms Cassandra Thng, 19, is one transgender woman who contemplated suicide. She held two fingers half a centimetre apart: "I came this close this year. I had a fully fleshed out plan."

The mental health issues are, said transgender woman Jolene Tan, 19, "part and parcel" of being transgender. Family pressure also adds to their struggle with accepting themselves.

Helplines •Samaritans of Singapore (24-hour hotline): 1800-221-4444 •Tinkle Friend: 1800-274-4788 •Singapore Association for Mental Health: 1800-283-7019 •Care Corner Counselling Centre (in Mandarin): 1800-353-5800 •Mental Health Helpline: 6389-2222 •Aware helpline: 1800-774-5935 •Oogachaga hotline: 6226-2002 WhatsApp: 8592-0609

Ms Wee said: "I felt unclean and defective, that I was meant to be a boy so I should try harder."

While the three of them have told their parents about their gender identity, the parents are in varying degrees of acceptance and, sometimes, do not know what to say.

Ms Thng's mother, for instance, told her daughter that her physique was "too masculine" for hormone replacement therapy to help - an offhand comment that contributed to her suicidal thoughts.

"For some reason, I wanted her acceptance a lot," said Ms Thng. Fortunately, a friend urged her to try hormone replacement therapy and she is now happier.

Ms Tan, who is waiting to study computer science at the National University of Singapore (NUS) next year, had a run-in with her father recently, during which he said in anger: "Which parent wants his child to be a chao ah gua (a Hokkien pejorative for effeminate men)?"

Yet, these three transgender women - who live with their parents, have access to university education and the support of friends - have it better than some survey respondents. Others cited employment issues, financial difficulties, and a lack of social support and romantic relationships as causes for their unhappiness.

Nine in 10 surveyed did not seek help for depression or suicidal thoughts - something experts say needs tackling.

"Depression and suicidal tendencies are conditions that can be debilitating and yet treatable at the same time," said Dr Keng Shian-Ling, assistant professor at the department of psychology at NUS. "There needs to be more public dialogue and education, involving both the public and the professional community, on transgender issues."

Mr Leow Yangfa, executive director of lesbian, gay, bisexual and transgender counselling group Oogachaga, thought social and healthcare workers should all have suicide prevention training.

The three transgender women said it will help if healthcare staff used the preferred names and gender pronouns of transgender people, instead of publicly addressing them as "mister", which would elicit stares and whispers.

They also said that having more transgender people talking about their experiences and representing the group as public figures can help to reduce the stigma.

"But I don't want to risk making my situation unsafe," said Ms Thng, fearing the general public may not be as accepting as her friends.