Research and discussion paper

Why are there so many kathoey in Thailand?

Sam Winter, Division of Learning, Development and Diversity, Faculty of Education, University of Hong Kong, Hong Kong

Copyright Sam Winter to whom requests for reproduction and dissemination falling under copyright laws must be made

Note: The  word 'kathoey' has long been a controversial one. While transwomen in Thailand often use the term, it can also be seen as offensive when used disparagingly by outsiders. When I wrote this paper in 2002 my intention was to use the term 'kathoey' with great respect. In the last ten years members of the transcomunity have popularised , and in some cases invented, new terms that do not carry pejorative implications; terms like 'phuying khaam phet' ('women who have crossed sex/gender') etc. I have retained the use of the term 'kathoey' through various minor revisions of this paper over the years. The term is still used with respect. 

Contact author

uploaded 10/5/2002, revised 14/6/2002, minor revision 27/9/2010 

A little girl, Miss Moon, was once given a crushed paper flower by a passing man of magic. He told her that if she took care of it it would grow into a beautiful tree of blossoms. She planted it and took care of it for years, ignoring the villagers who laughed at her telling her that her flower was just made of paper. And yet nothing happened. Some years later she woke up to find that the flower had grown into the most beautiful tree imaginable: full of sweet blossom. Everyone from miles around came to admire it.

But some villagers still laughed, saying that it was just a paper tree, and wasn’t real at all. The young girl smiled, answering that she knew it was not real, but she didn’t care, for her tree was the most beautiful tree that she had ever seen

(a traditional Thai folk story)


Thailand probably boasts one of the highest incidences of transgender world-wide. No one knows for sure how many there are, but I have seen or heard figures ranging from 10,000 to 300,000. Even the lowest of these figures would put the incidence way above Western countries. And note my own research, in an adjacent paper on this site ('counting Kathoey'), that supports a figure roughly between these two estimates - a figure of around 180,000.

Notwithstanding that they occupy a somewhat marginalised role in Thai society (Jackson, 1995) they nevertheless appear to enjoy a degree of prominence and acceptance unknown in most other places. They even have an international profile. As Matzner (2001) notes, ‘One of Thailand’s more sensational exports is news about transgendered males’ (p71).

The common term for transgendered males in Thailand is 'kathoey'. The term originally encompassed gays and effeminate males, but is nowadays more often used specifically for male-to-female transgender. Many kathoey present outwardly, from their teenage years onwards, as entirely female – in terms of hair (often long), dress, cosmetics, manner, gait, gestures, voice, stereotyped personality traits and interests (including vocational). When they speak they employ a female tone and vocabulary, employing Thai word-forms normally restricted to females. Some kathoey appear indistinguishable from women. Those who can be ‘read’ may find themselves in that position only because of minor cues: height, width of shoulders, 'adam's apple', stereotypically exaggerated female manner, size of hands or feet, minor facial features or soprano voice.

Kathoey have become entirely common place in Thai society. In Bangkok and other urban centres they go about their daily affairs – shopping, meeting friends, going to the cinema, eating and drinking in cafes, using public transport, visiting the temple. One may be served by a kathoey at a café, market stall, or boutique. The guide leading the tourists around may be one. Nor is the kathoey an exclusively urban or adult phenomenon. Taywaditep et al. (1997) remark that that children and adults can often identify at least one kathoey in every school or village.

In short, it seems that, compared to elsewhere, a large number of genetic males in Thailand early on in life decide to make a gender transition that is substantial (indeed, for some as complete as it can get), long-term (apparently for life) and full-time. Whether these numbers reflect a higher incidence of those feelings we call in the West ‘gender dysphoria’ or simply a greater willingness to act on them, is a moot point. As you will see, I take the view that it is both.

Let’s assume for the purpose of this essay that the incidence of TG in Thailand is higher than in some better researched cultures of the West. Why might that be? While I suppose biological differences cannot be entirely ruled out, it seems to me that the answer likely lies elsewhere – in religion, culture, society and psychology.

I will divide my thoughts into three broad topics: spiritual beliefs (about man's origins, life and death); social attitudes (towards people in general, as well as towards minority groups like TGs); and developmental pathways for the kathoey (aspects of Thai society that facilitate the kathoey’s gender transition).

Thai spiritual beliefs

Archaic Thai beliefs and Buddhist dogma have a lot to say about gender.

In the West sex and gender are defined above all in terms of anatomy; males have a penis, and women do not. In contrast, in Thailand (as in many other non-Western societies) gender is often defined in terms of ones social role (what role, male or female, one plays in the house and in the community), and sexual role (what you do with your anatomy during the sexual act; specifically, acting as the inserter or as the insertee in sex (Jackson, 1998). If you don’t conform to the stereotype of sexual inserter you have foregone your claim to maleness, and may be allocated to other gender categories (Jackson, 1995, p.219-220; 1998). More of this later.

Interestingly, ideas about multiple genders are found in ancient Northern Thai creation myths which speak of three genders – male, female and mixed - at the beginning of the world (Matzner, undated). These beliefs apparently persisted until the mid-twentieth century (Nanda, 2000). Archaic Thai beliefs link transgender to special shamanistic abilities; a tradition that persists today (Matzner, 2002; Taywaditep et al., 1997). In short then, multiple genders have long formed part of the Thai worldview.

Just as genders are perceived as multiple, so too i wonder if they are perceived in Thailand (more readily than in the West) as transient genders; in the sense that Buddhist teachings on impermanence, re-birth across lives, and karmic fate may all serve to encourage a person to act on a desire for gender transition. For if all things are transient (even our souls) then why should gender be immutable within a lifetime, especially when the means to alter it are so clearly available today? Buddhist teachings hold that, until such time as we achieve enlightenment, we are all doomed to re-birth. If we are to re-born in a future life, perhaps as someone quite different, why not be re-born in this life?

Buddhist teachings hold that the circumstances in which we live today are the product (karmic consequence) of the ways in which we lived our previous lives. For many onlookers the condition in which the kathoey lives is karma; specifically, the consequence of some sexual misdemeanour in an earlier life or lives (Taywaditep et al., 1997; Jackson, 1998). That she is a kathoey is not ideal. Nevertheless her condition is understandable (Jackson, 1998). Incidentally, the kathoey is likely to explain her transgender in these ways. In recent (as yet unpublished) research conducted with Kim, Lertsubin and Udomsak, we have found that 47% of kathoeys explain their transgender in terms of karma.

As Jackson (1998) notes, some Buddhist teachers have argued from this that we have all been kathoey at least once in previous lives, and will be again in future ones. For this reason if not for others, they argue, the kathoey should be treated with compassion. As for the kathoey herself, Buddhism dictates she must accept her fate. Importantly, the act of changing sex does not itself produce further bad karma (Jackson, 1998). By contrast, to fight against one’s condition would incur further bad karma.

Thai social attitudes

It seems to me that Thais display attitudes that can only serve to facilitate a decision to make a gender transition; indeed, may even facilitate the initial development of gender dysphoric feelings. These attitudes revolve around females, and sexual and gender minority groups.

Attitudes towards females

Like other societies, Thai ascribes to males and females a range of stereotypic personal characteristics. However, in Thailand the differentiation between males and females in terms of those characteristics is smaller than in many other countries (Williams and Best, 1990). In short, males and females are seen by Thais as far more similar (each to the other) than in other cultures. This raises the intriguing possibility that, however great the step towards womanhood may be chemically and anatomically, it is, in Thailand compared to other cultures, a relatively small psychological step.

But would any Thai man want to be a woman? We might here answer ‘yes’ more readily than for many other societies; Asian or otherwise. Thai women occupy a more advantageous position in Thai society than elsewhere in Asia (Ford and Kittisuksathit, 1994; Taywaditep et al., 1997). These last authors remark that Thai males tend to revere females, referring to them as the ‘peht mae’ (gender of mothers). Conversely, all things worthy of reverence are conceived of as feminine; for example a great river is called mae-nam (‘mother-water’). Traditionally, a man’s family has paid a bride price upon a son marrying, while property inheritance has traditionally been through the daughter. Nowadays, as females move out from home and the motherhood role (Ford and Kittisuksathit, 1994), more women are to be seen working full-time, contributing to society at all levels. Within an overarching context of what is acceptable behaviour for the female, young girls feel able to flirt, and even make allusions to sex or proposals of marriage (Taywaditep et al., 1997). Interestingly, these authors remark that the status of Thai women is higher than in any other Asian society with the exception of Singapore.

It may be that the changing nature of womanhood has helped kathoey in efforts to be accepted as female. As the birth rate falls and femaleness is defined less in terms of motherhood than it used to be, other roles now open up for women. Women may go out to work and earn salaries. With divorce rates rising they may find themselves supporting their families. They may become somewhat more assertive and dominant in their dealings with people. Kathoey, often retaining some assertive and dominant traits stereotypic of their original gender (Winter and Udomsak, 2002), find that they can fill some of these female roles quite well, competing with women on their own turf. Traditionally the village kathoey might have been asked to arrange the flowers or prepare food for festivities (Taywaditep et al., 1997). In the modern city they have become stall holders, shop assistants, tour guides, hairdressers, beauticians and performers in shows for tourists.

In these stereotypically female activities kathoey have demonstrated an uncanny ability to beat females at their own game, living lives as females (to the extent that society allows them to), unencumbered by the raising of children, and becoming materially independent. Some indeed, have become benefactors to young men (Taywaditep et al., 1997). All this has generated a degree of admiration (albeit sometimes grudging) in Thai society (Matzner, 2001). As Taywaditep et al (1997) remark: ‘the image of kathoey as a resourceful member of the community and a benefactor of young men is remarkably more positive than the Western images that most cross-gendered individuals are street transsexuals who live marginalised lives in the underworld of drugs and prostitution’.

However, the kathoey community has not entirely avoided sex work, indeed becoming best known internationally for its involvement in this industry. More of this later.

Attitudes towards sexual and gender minorities

Thai culture is one of overall tolerance, albeit a conditional tolerance, to all groups – religious, ethnic, gender and sexual. Just as the position of women is relatively privileged, so, compared to many other societies, is the position of those who do conform to the male stereotype.

Homosexuals are a case in point. Thailand is a markedly non-homophobic society. Buddhism has a broadly neutral view on homosexuality, seeing it as resulting from bad karma (Taywaditep et al., 1997). There is high social acceptance of male-male sex (Jackson, 1995; Ford and Kittisuksathit, 1994), allowing homosexuals the freedom to pursue their lifestyle. Indeed, male-male marriages are still common upcountry (Jackson, 1995). However, many homosexuals often pursue their life style discretely. As Taywaditep et al. (1997) remark, same-gender sex is less stigmatised than disclosing it. Notwithstanding all this, the incidence of male-male sexual experience seems to be no higher in Thailand than in many Western societies (Jackson, 1999).

The conditional tolerance extended to homosexuals also extends to kathoey. In the recent research with Kim, Lertsubin and Udomsak I mentioned earlier we found that around 40% of our kathoey believed that, as a general statement, Thai society was encouraging or accepting of kathoey. Another 27% felt that it tolerated them. Only 15% believed it rejected them.

Within the family, acceptance of the kathoey can be even higher. Forty per cent of our sample said their fathers were either encouraging or accepting when they first made it known that they were kathoey, while 66% said their mothers were. I cannot imagine any Western research that would generate findings of this sort. Indeed, around 30% of our sample believed that they were kathoey at least partly because of their parents’ influence. Another 30% said the same thing about sibling influence.

This acceptance of the kathoey seems to be rooted in a wide range of attitudes and social conditions. First, as we have already seen, kathoeys are commonly believed to be the victims of karmic consequence; consequences that may befall any of us in other lives. They deserve our understanding.

Second, a traditional belief persists that the role of kathoey is the only acceptable role for a male exclusively attracted to the passive sex role. As we have seen, in failing to make use of his male organs (indeed, placing himself in the role of insertee) he has sacrificed his right to be regarded as a male (Jackson, 1995). Instead the kathoey is seen as belonging to a third gender, if not as a female. It is not surprising that (in the context of traditional Thai views of what is proper behaviour for a female) the kathoey has traditionally provided a sexual outlet for males (Jackson, 1995,p195). Interestingly, males who have sex with a kathoey often regard their own behaviour in these encounters as heterosexual. Since the kathoey herself also thinks of herself as a female or third sex, so she also sees her own behaviour and that of her partner as heterosexual (Jackson, 1995; ten Brummelhuis, 1999). To that extent the kathoey may see the act of sex as in some way re-affirming her gender identity.

The picture of acceptance that I have so far painted runs the risk of being over-simplistic. In fact, social acceptance towards the kathoey is somewhat conditional. Matzner (2001) points out that a Thai’s attitude towards a kathoey is likely to depend very much on the demeanour of the kathoey, as well as the nature of the relationship between the two parties. Ideas about acceptance can break down when the relationship is one of employer and job applicant. Many kathoey complain that they have to be better than any of the competition even to get a job interview. Those who are not so capable, and may be poorly educated, find themselves drawn to bar work and prostitution.

Developmental pathways for the kathoey

Once a young boy has become discontented about his gender identity, he finds that modern Thai society opens up for him a clear identity group and a clear developmental path.

On one hand media personalities – TG actresses, singers, models, beauty queens - provide role models to aim for. Nearer at hand an older peer, often a fellow student, may provide first social contact with a kathoey, and a means, through an informal contact, of making contact with many more. Note again Taywaditep et al’s remark that children can often identify at least one kathoey in their school. Those who get to university often be able to identify many.

These older role models can provide the young kathoey with important information; initially regarding hormones, clothes, make-up, beauty contests etc, and perhaps later on extending to information about employment and surgery. Not surprisingly then, our recent research found that over 50% of kathoeys believe that they became a kathoey because of the influence of friends.

Once the kathoey has decided to make a transition she will find it easy to get hormones, entirely by-passing the medical profession in doing so. In the town of Pattaya I recently counted, at a general store selling toiletries, health and beauty products, a total of 23 hormonal preparations, most of them contraceptives, and all available without any doctor’s note and at modest price. A similar situation exists for surgery.

A lot of kathoey never have any surgery done at all. The hormones they take, sometimes from the age of ten, are enough to produce what is for them a satisfactory appearance. However, in the event that they become interested in any kind of surgery (even sex reassignment surgery (SRS)) they need undergo no psychiatric evaluation or counselling. There would be no point. They already know what they want. They simply approach the surgeon and pay the money. Largely because of the domestic demand (from women as well as kathoeys), there is now a very large number of surgeons who provide facial and body cosmetic surgeries in Thailand, including some that are focused on the needs of some kathoey for SRS. These doctors provide services to varying standards and prices. Some of the best (and most expensive) increasingly take clients from overseas.

A word here about economics. A nose operation can cost from US$240. Sex reassignment surgery can cost from US$950. To save even that money one needs a job. Many kathoey find that Thai acceptance of transgender stops at giving them a job. In any case, salaries are low in Thailand. A shop assistant or junior office worker will earn under US$250 a month. The costs of surgery therefore act to draw kathoey to the cabarets and bars for work. The cabarets are often unobjectionable spectacles of dance, music and costume for tourists. While the salaries are small much more might can be earned from tips given by tourists taking photos. The bars, on the other hand, provide a vehicle for prostitution. Both provide a way of earning the kind of money that make surgery possible. Remember here that prostitution does not carry the sort of stigma in Thai society that it does in more puritan Western societies. Taywaditep et al. (1997) remark that it fails even to be considered unconventional.

It’s worth noting here that bar and cabaret work also provide means for re-affirming one’s gender. In one case it is by attracting audience admiration as a stereotype of (relatively) untouchable beauty. In the other it is by exciting, and likely satisfying, the sexual interest of males (some of whom, ten Brummelhuis (1999) notes, may go with a kathoey thinking throughout that he has been with a genetic girl). Bar work may also provide the kathoey, with hope of meeting a Westerner who might take her to his country, where, apart from anything else, she might be able to achieve legal status as a female and marry. ten Brummelhuis calls this the ‘kathoey career’.

A word is needed here on the somewhat different concept of the ‘career kathoey’. The view is often expressed that many if not all kathoey are ‘in it for the money’. According to this view, they have crossed the gender divide so that they can work as prostitutes. As evidence, the proponents of this view cite the number of kathoey selling sex. While many do work in this way, it is important to remember that there are countless others who do not. Many of those who are in the business are there because they need the money for surgery and/or cannot find another job. They would rather be doing something else. And after nearly three years of working in this area I have neither found nor found anybody (kathoey or otherwise) who can name an individual who has become a kathoey for this purpose. The ‘career kathoey’ seems to be rare indeed.

A footnote on the effects of numbers

Two final notes, and they both relate to domino effects that may arise from the numbers of kathoey that are now found in Thailand. First, just as social acceptance provides a catalyst for numbers, so numbers facilitate further acceptance. It seems likely that the very large numbers of kathoey, and their high profile in the media, only serve to weaken whatever residual intolerance exists towards them. They quite simply melt into the social background. Second, just as social acceptance can provide a catalyst for numbers, so too can the increasing numbers themselves. The more kathoey one sees around one (at school, in a café, at the temple, or even in one’s family) the more acceptable may be the idea of becoming one, and the more chance one has of meeting one, and, if one chooses, entering their peer group.

Concluding comments

To summarise, I suggest that many factors - aspects of Thai culture, social attitudes and society itself - play a part in contributing to the kathoey phenomenon.

Writing this most recent revision (27th September 2010), and if asked for my opinion on the most important factor, I would put my money on the role played by the very different views of the relationships between sexual anatomy, gender identity, gender presentation, social role, and sexual role, in a place like Thailand. In the West we expect a concordance between sexual anatomy and gender identity / presentation. Beyond that Western culture (to the extent that there is such a unitary thing) nowadays tolerates a lot of discordance between sexual anatomy and gender on one hand and sexual role and social role on the other. But in places like Thailand (and for that matter in many other places in S.E.Asia and the Pacific) society expects a concordance between social role, sexual role and gender identity/presentation. Beyond that it tolerates a discordance between these things and sexual anatomy. Note that this may explain the common observation that transpeople in these cultures are not quite so much focused on a need to change their sexual anatomy.

Anyway, all other things being equal, individuals growing up in Thailand seem more likely to describe and explain their feelings in terms of being a kathoey ( as compared with individuals in the West describing and explaining their feelings in terms of transgender).What sort of feelings? Well, the answers might be in Williams and Best (1990), whose study investigated what ordinary Thais believe are the stereotypic traits of males and females. Each culture has its own gender-trait stereotypes of course. For Thais, gentleness and mildness, sentimentality and weakness, excitability, emotionality and a tendency to worry are all very strongly female-stereotyped traits.

Now consider a young Thai boy, growing up feeling that he has these characteristics (indeed being told he has them and being treated as if he has them) and knowing that these traits (perhaps like his love of dolls and dressing up in girls clothes) are stereotypically female. He and everyone around him may, rather than being inclined to shrug them off as evidence that here is a boy who does not quite fit in (as might happen in many other societies), instead be more likely in Thailand to see them as evidence that he is indeed not really a boy at all. Another label is close-at-hand. He is a kathoey; a label that is not likely to be seen as the end of the world for the child or the family. As the young kathoey grows up she will meet other kathoey who by their example validate the label given to her, as well as mentoring her along a path towards her new gender. At every step of the journey her choices (regarding what she is, and what she will do about it) have been validated by the cosmology, social attitudes and social context in which she lives.

In another society, maybe the English or Hong Kong Chinese cultures with which I am familiar, a young boy with the same feelings may, together with his parents, siblings and peers, interpret his feelings quite differently, viewing them as evidence that he is a sensitive boy, perhaps an effeminate one, a sissy, but a boy nonetheless. Those around him may press him to do the things other boys do, and be like other boys are; to toughen up a bit. Family doctors, child psychologists and psychiatrists may be called into to help. The end result is that he may live his whole life labelled as a male.

I am not suggesting here which road is right (although the large numbers of late onset TGs gives cause for us to wonder about the Western way). For the present I am just trying to suggest that different roads are offered by different cultures. And different roads are taken.

Acknowledgements: to Fiona Kim, for her comments on an earlier version. 


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