The price of change and the right to be a woman in Thailand
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The price of change and the right to be a woman in Thailand

With a culture of tolerance and affordable surgery, Thailand remains a leading light for transgender rights, writes James Austin Farrell

MY brother was my sister from as early as I can remember. He was born with a boy’s name, but now we call her Angel. On a recent trip to England Angel and I met; we went for a walk around the Yorkshire town where we grew up, and later sat in a pub for Sunday lunch (or dinner as they call it in northern England). When you walk down the street, or eat, with Angel, people look at you. Is that a boy or a girl, man or woman, their expressions seem to say. Some people look awkward and curious, some people smirk, some people remain inscrutable, as strangers do when they look at someone they deem ‘normal’ like me. Growing up, Angel was often harassed, sometimes beaten, for being different; or for, wrongly, being gay, or for simply being, rightly, girly. Why the majority of people back home had a hard time accepting that my brother was more feminine than masculine was perplexing, and maddening, and sad; and I was just a bystander.

I told Angel I was writing a story on transgenderism in Thailand, discrimination towards transgender people, and sexual reassignment surgery. While Thailand is often called tolerant concerning what is sometimes called the third sex, England, from what I remember was still locked into a cultural dark age apropos acceptance of transgender people. Angel told me last week, “Times are changing, slowly, despite the uninformed comments of certain high profile academics. Trans people are the last bastion of acceptable prejudice currently being addressed.”

While it might be true that tolerance is granted towards transgender people, discrimination exists in some form in Thailand. The kratoey, or ladyboy in English, might be expected to act in a certain way, as if being transgender is a role one might play, filling an expected narrative. In older times that role may have been to act as spiritual medium, while in modern times the ladyboy might still have a difficult time becoming a bank manager. However, in terms of being accepted into the community, not being laughed at or bullied, Thailand is progressive compared with much of the world. Support for transgender people is now widely available, while if someone does decide they would like to reassign their sexual organs, as well have other man-to-woman surgeries, Thailand has far less restrictions than many western countries. These restrictions could be conceived as good practice, but it seems that it’s often not the case for the people they are supposedly protecting.

“I didn’t want to be a cross-dresser.”

Dania A. McClendon, who was born in Oakland, California, and is now living in Chiang Mai, came to Thailand to have surgery after realizing it would be impossible for her to do it in America. From an early age McClendon met with intolerance concerning her femininity. At her house in Chiang Mai she explained that her parents had tried to change the way she was by giving her “testosterone shots from the age of 5 to make me more aggressive.”

Prior to sex reassignment surgery in Bangkok she had lived in Hawaii and had had an 18 year relationship as a man, with a gay man, in spite of the fact that from an early age she had related to being a woman. “I couldn’t wait for my private time,” she said, explaining that when alone she would dress as a woman. This eventually led to a break-up of her relationship as her gay lover did not want her to be female.

After some research she came to Bangkok in April 2012 to have the surgery. “In the US you have to live one year in women’s clothes before you can have the operation,” she said, adding that that was not something she felt she could do. “I didn’t want to be a cross-dresser,” she explained, and an option, she realized, was to come to Thailand. McClendon says that the amount of obstacles in the US makes it extremely hard to have the surgery, while in Thailand she was able to take all the requisite tests in the morning and be in the operating theatre by 3pm.

Five days later she was in the shower in her hotel looking at her changed body, somewhat distressed by the swelling, but she says it was, “A relief, a total relief.” The surgery, as well as the outpatient care, she said was impeccable. She was relieved, and somewhat shocked she said when for the first time she understood, “what the clitoris was all about,” after the doctor had touched her new, transformed erogenous zone. She has since left a position of authority at her workplace and retired in Chiang Mai. Content with a body she feels comfortable with, she says one setback is that “it’s tough to get a date.”

“If I wanted a job I would dress as a boy in the interview.”

After Naeree Songsilijid left her job to travel around the world for a year she said that she came across transgender people who she said looked up to Thailand for its progressive views concerning transgenderism. Naeree, who has had sex reassignment surgery herself, told me that she began to realize the difficulties people face in other countries around the world if they want surgery.

“Hormones, surgery, can cost up to $30,000 in the US, and only $8,000 in Thailand,” she said. Mirroring McClendon’s remarks she explained, “For the first few months before surgery you have to see a therapist, and also walk around in public dressed as a woman.”

SEE ALSO: Thai university introduces mandatory class on transgender issues

She had believed prior to travelling that the West was more accepting, but on realizing how difficult it was to have the surgery in some countries she opened an agency in Thailand, catering to foreigners, that helps people to make the change.

She told me about one of her clients who was shocked at the fact no one was staring at her when she arrived in Thailand. “In Russia,” said Naeree, “she couldn’t enter certain restaurants.” There are people trying so hard to have the surgery, said Naeree, but because of finances, and conditions set prior to surgery, they just can’t make that happen.

Naeree does accept that some amount of discrimination exists in Thailand, and could hinder your chances of getting a certain job. “In Thailand there are no laws to protect us from discrimination,” she said. “If I wanted a job I would dress as a boy in the interview. Once I had signed the contract I would tell them.”

“I always wanted to be a girl. I have a girl’s mind.”

I asked her about the matter of what label she prefers, or dislikes, only because in an interview this year I had been chastised by an interviewee for calling her transgender and not female, while ‘ladyboy and definitely ‘shemale’ could be taken by some as derogatory terms. “You can call me what you want,“ Naeree replied, but says she is happy to be recognized not as a woman, but as transgender.

Her agency in Bangkok, NaereeM2F, helps bring people to Thailand wanting to have male-to-female surgery, while offering them guidance, lists of surgeons, booking hotels, etc. “I want to help people from around the world. I know how hard it can be in other countries to change from a man to a woman,” said Naree.

Jan, a cabaret performer in Pattaya had the surgery two years after saving around 150,000 baht (US$4,155) for the male-to-female operation(s), which she says was the best money she has ever spent. “I always wanted to be a girl,” said Jan, “I have a girl’s mind.” When asked how much pre-surgery counseling she received she explained that the doctor only gave her sleeping pills before the operation and told her not to take hormones due to the possibility of more blood loss.

“It was very, very painful,” explained Jan, but said that post-op she was happy. “Everyone can accept me as a girl. In society people look at me like I am a girl.” She has a boyfriend, who she says has no hang-ups about her being transgender. “He sees my mind. I’m a good person, and the mind is the most important thing.”

“We still have a way to go.”

Justine Sass, a UNESCO Asia-Pacific HIV and Health Education advisor, has been working on a report looking at issues such as bullying and discrimination of LBGTI people in schools in more than 40 countries in the region. Sass told me that not only was the report focused on the types of experiences in classrooms, but also how schools prevent and respond to this.

“We are not just looking at emotional, verbal violence, but also institutional violence,” said Sass, explaining that discrimination could manifest as content in textbooks, uniform policies in schools, or even how transgender people may have to adhere to gender-specific haircut rules in school. “Research suggests that many people don’t use the toilet,” she says, because a transgender person may not feel comfortable using a certain toilet. This could lead to pupils missing classes, and also impact lifelong employment and benefits, said Sass. She believes that schools could adopt a policy of creating inclusive spaces to prevent this from happening.

“We still have a way to go,” said Sass, relating to discrimination of LGBTI people in the region, explaining that LGBTI people will still suffer from some form bullying in schools at least once every 30 days. She also explained that transgender persons are still directed towards certain studies, discouraged from teaching, or even from psychology, as in Thailand being transgender is still stated to be a psychological abnormality. It is regarded as a sexual abnormality along with masochism, exhibitionism, necrophilia, paedophilia, incest and rape, as was written in the Bangkok Post in a story on the definitions of transgender in school textbooks.

“This is an immense step for Thailand and the region.”

Australia, Sass explained, has an excellent policy relating to transgender rights in schools. “Australia has become a model concerning privacy, protection, pushing schools to enable students’ choices, the correct use of pronouns, helping young people transition. For me this is quite exemplary.”

The Tangerine Community Health Center in Bangkok, opened this month by the Thai Red Cross AIDS Research Centre and U.S. development partners, is also exemplary, reported to be, “The first transgender-specific center in Asia.” Run by transgender people and medical professionals sensitive to transgender issues, it offers counselling and hormone administration, as well as other health services.


Tangerine Community Health Centre opened in Bangkok last month.

In a press release the Red Cross said that current social, economic, cultural, and legal frameworks, as well as health policies, inadequately address gender sensitivity and transgender identity. The health disparities faced by transgender people lead to issues such as misuse of hormones for gender-affirmation, vulnerability to HIV and other sexually transmitted infections, and stigma and discrimination.

“This is an immense step for Thailand and the region regarding the mobilization and advocacy for transgender health,” said Ms. Nicha Rongram, communications director at the Thai Transgender Alliance for Human Rights.

“Does not make any sense and violates human rights.”

Rena Janamnuaysook, program coordinator at the Thai Red Cross AIDS Research Centre (TRCARC), responsible for the Tangerine Community Health Center, sent me this report by TGEU (Transgender Europe) in which she had collaborated with other researchers on the Thailand chapter. For the most part transgender interviewees in Thailand expressed that they had received emotional support, both familial and from outside. Although one stand-out negative was that almost all participants said that they had not been able to receive identification of their self-defined gender. The report states, “The difficulties are a consequence of the fact that there is no gender-recognition legislation and of prejudice towards and discrimination against trans people in public administration.”

The report also states that 48 percent of participants said that they have not received counselling from medical doctors, endocrinologists, surgeons or other medical professions in regard to sex reassignment/trans health-care, while 32 per cent have received such counselling once or a few times. Half the participants didn’t feel they needed councelling, and a small group said they couldn’t afford it or didn’t know where to get it.

In regards to restrictions in some Western countries before one can have sex reassignment surgery, Rena said in an email: “I would say that the requirement of living as a preferred gender for a certain period of time does not make any sense and violates human rights.” However, she added, this still happens in many countries. “The ultimate goal of hormone support and sexual reassignment surgery is to affirm gender identity. It should not be used to legally recognise a gender marker. Healthcare providers have to provide psychosocial counselling to transgender clients, not a counselling for illness treatment,” Rena said.

SEE ALSO: Did Thai university reject transgender lecturer because of an Instagram post?

Angel, who has not had any kind of surgery, explained to me why she made that choice, but also how that choice never seemed attainable. “I think at the ages 13/14 I was aware that you could have transition surgery and certainly talked about it with friends as an option,” she said, “However, the lack of familial understanding and support made it difficult for me to discuss this with our parents. There was no Internet and no real way of researching. I just dealt with being transgendered by living in my imagination, reading and listening to music. I think if I’d had support at this stage I would have gone through with the transition.”

When she was 16 she says she went to a gay youth group. Initially she says she thought she’d found likeminded people, but then realized how different it was to be transgendered to being gay. “There were a few transsexuals who had transitioned on the scene, and although they were ‘accepted’ they were still often ridiculed,” she told me. “I was always open about being transgendered and continued to wear and dress like I wanted to. I guess this jaded me with transitioning somewhat.”

However she said that she continued to think about surgery, wanting her body and mind to be in sync. “The rebellious part of me always used to think: ‘Why can’t I be female in a male body?’ ‘What is society’s problem and why should I let them define me?’ Clothing and ideas of gender are social constructs, so why should it matter? However, this always was questioned by me when I had an attraction or frisson with some man: I wanted to have a heterosexual relationship. I am a product of society myself!”

“The true key to happiness in being transgendered is being proud of the fact.”

She explains that if she was to go through surgery she would want to feel, “Truly emancipated, liberated from this limbo of being transgendered.” To look in the mirror and see a woman’s body before her, her woman’s body. “In short, over intellectualizing, I thought that it would not be the panacea to all my woes and so I continued to live as being transgendered because I thought that deep down I would still not be the woman I am in my mind by transitioning.”

Being transgendered can be a very lonely life, she said, explaining that she had read how lonely people were after transitioning and how they often felt suicidal as it hadn’t solved their dichotomy. However, she says, as she has gotten older she has realized that the true key to happiness in being transgendered is being proud of the fact, which she says she most certainly is.

“I wish in some ways that I had this wisdom at a younger age because I could have had surgery and possibly been happy and less lonely as a transsexual woman, rather than seeking to be a biological woman – although I believe we transsexuals are the gender biologically in our minds. I have been just as lonely by not transitioning, so maybe it would have been better to have transitioned and taken the gamble. Basically, I spent too long thinking about it rather than living it.”

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