January 2, 2016

Ladyboys”: Trans women in Thailand

People often ask me what I think about ladyboys’ in relation to transgender/transsexual/gender issues. I will attempt to explain below.

The term Ladyboy’

I find the term ladyboy’ an odd one. It’s a constructed word in English that is sort of the correlate of Kathoey’ in Thai, a term which refers to both effeminate gay men and trans women. It’s not really accurate, especially because most trans women in Thailand refer to themselves as women, or a few as phuying praphet song (a second kind of woman’)1 which would be best translated as trans woman’.

When people refer to ladyboys’, they usually mean Thai trans women who are also sex workers. Certainly this is the stereotype. The stereotype also can include the rather odd notion that they have had hormones and surgery in the way of breast augmentation or genital sex reassignment surgery in order to pursue their chosen career rather than actually being transgender. As sex work is taboo in many countries with few people understanding why anyone would become a sex worker without coercion, the general attitudes towards ladyboys can be pretty negative.

In summary, because they are Asian, female, sex workers and have had sex altering surgery, the presumption (that stems largely from a lack of knowledge rather than ill will as such) is that they are a completely different kettle of fish from trans women in the West, a difficult to understand group of people who have chosen’ to do what they do rather inexplicably.

However, this is based on assumptions that I will debunk below.

Who are Ladyboys’?

Research shows that of Thai trans women, including that large proportion working in the entertainment industry (not just as sex workers), almost all self-identify as women’ rather than as Kathoey’, have had a female gender identity since a young age and many have started medical and/or transition as teenagers or young adults2.

In other words, ladyboys’ are simply Thai trans women.

Why do they undergo hormone treatment and sex reassignment surgery (SRS)?

For the same reasons that trans people overseas do: it is unbearable to remain in one’s current situation pretending to be a gender you are not. Psychological distress and complications decrease significantly post-transition3. It would make no sense for someone who is not transgender to undergo hormone therapy or SRS, and the fact that ladyboys’ are in fact Thai trans women is borne out by the evidence4.

Why are some sex workers?

It is not uncommon for there to be significant discrimination in finding work. In addition, surgical transition is very expensive in almost every part of the world and although much cheaper than in the West, Thailand is no exception5. Genital operations can cost US$20,000 when performed in the US6, and breast augmentation can cost $10,000. Facial feminisation surgery can be far more expensive than either. The cost is around half when performed in Thailand but remember that incomes are much, much lower.

Not all trans women in Thailand or elsewhere work as sex workers, however sex work can be regular, stable, well-paid, less discriminatory in terms of work opportunity and allow for saving money for medical care and financial support for their families. However it is criminalised and sex workers, especially transgender ones, face negative community attitudes, harassment from the police and criminal behaviour from clients7.

Sex work is an understandable rational choice under these financial and social circumstances.

Do ladyboys’ harm the transgender cause?

Trans women in Thailand are just going about their everyday business and trying to survive. Many are trying to campaign for greater legal rights for themselves and other transgender people. They exist, and the idea that by existing they are harming the cause’ for transgender people in the West is wrong-headed. If anything, they are helping the transgender cause’ by fighting for their own rights.

Also consider that until very recently there was close to zero trans representation in the mainstream media. If transgender people (usually trans women) were presented on the screen it was usually to show them as weirdos and freaks. A particularly egregious example is the show There’s something about Miriam”8 in which Miriam was revealed to be a man all along’. Except she isn’t. She is a woman and has always been female.

Faced with the incredible harm that mainstream media and transphobic people make in the general public on a day-to-day basis I am afraid I must conclude that the trans women of Thailand are in fact helping the cause and that the people harming the cause are not trans women or sex workers but in fact some members of general public, the news industry, the entertainment industry and governments.

The focus on Thai women trans women by the media is problematic. The attention is framed as one in which we point and laugh at an Asian culture that is actually more accepting of transgender people than Western culture, for being more accepting. We laugh at sex workers for being sex workers. In actual fact, yes, we should be talking about Thai trans women but we should be talking about them as people to be celebrated, not laughed at.

What lessons does this teach us for what we should do in society?


  1. Winter, Sam. Thai transgenders in focus: Demographics, transitions and identities.” International Journal of Transgenderism 9.1 (2006): 15-27.


  3. Murad, M. H., Elamin, M. B., Garcia, M. Z., Mullan, R. J., Murad, A., Erwin, P. J. and Montori, V. M. (2010), Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes. Clinical Endocrinology, 72: 214–231. doi:10.1111/j.1365-2265.2009.03625.x


  5. ‘A Ladyboy Paradise:’ Gender Reassignment Surgery in Thailand.” Khaosod English.

  6. Male to Female Price List.” The Philadephia Centre for Transgender Surgery

  7. Thailand’s trans sex workers seek empowerment, not pity.” Asian Correspondent

  8. There’s Something About Miriam.” Wikipedia

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