Few figures in Southeast Asia are as globally recognisable—and as persistently misunderstood—as the Thai kathoey. Often flattened into the tourist cliché of the “ladyboy”, kathoey occupy a far more complex space at the crossroads of gender, culture, labour and stigma in Thailand, where visibility does not necessarily translate into equality, and tolerance often masks exclusion.
The word kathoey (กะเทย) itself carries a long and shifting history. Linguists trace it to the Khmer term khteuy, originally used to describe people born with ambiguous sexual characteristics. In premodern Thai usage, kathoey functioned as a broad category for those who did not fit neatly into male or female norms: intersex people, effeminate men, cross-dressers, and what we would now call transgender women. Over the twentieth century, as Western medical and psychological ideas about sex and gender entered Thai society, the term narrowed. Today, kathoey most commonly refers to transfeminine people assigned male at birth, though its boundaries remain culturally fluid.
Unlike the Western notion of a clearly defined “trans woman”, kathoey is a social category shaped as much by gender expression as by identity. It can include women living full-time as female, people who openly identify as sao prathet song (“second-type woman”), as well as feminine-presenting gay men. Many trans women reject the label altogether, preferring to be called phuying—simply “women”—and see kathoey as a third-sex box that denies their womanhood. Yet others embrace the term, reclaiming it as a distinctly Thai gender identity.
Thailand’s reputation as a haven for kathoey stems largely from their high visibility. They are present in comedy shows, pop music, social media, pageants and iconic cabaret performances in Bangkok and Pattaya. Films such as The Iron Ladies helped normalise kathoey characters for mainstream audiences, while beauty contests like Miss Tiffany’s Universe draw national television audiences and serve as glossy showcases for Thailand’s cosmetic surgery and tourism sectors. This visibility, however, coexists with deep structural limits. Thai law still does not allow people to change their legal sex on identity documents, which creates daily barriers in education, employment, travel and military conscription.
Social acceptance is also uneven. The term kathoey itself can swing between playful familiarity and sharp insult, depending on context. Many grow up facing ridicule in schools, pressure from families to “act like a real man”, and discrimination in hiring and promotion. Buddhist interpretations sometimes frame being kathoey as the result of karma from a previous life, a view that may soften overt hostility but reinforces pity and moral judgement rather than equality. Studies consistently link this stigma to higher rates of depression, economic precarity and health vulnerability.
One consequence of these barriers is the strong association between kathoey and Thailand’s entertainment and sex industries. Trans women are overrepresented in hostess bars, cabarets, karaoke venues and sex work, not because these roles are culturally destined, but because other doors are often closed. For some, such work offers income, independence and even glamour; for others it is a last resort shaped by poverty, regional inequality—particularly for migrants from the northeast—and family expectations to remit money home. Globally consumed pornography featuring Thai “ladyboys”, largely produced for foreign audiences, further cements a sexualised stereotype that eclipses ordinary lives.
Medical transition adds another layer of complexity. Thailand is a global hub for gender-affirming surgery, attracting thousands of international patients. Among Thai kathoey, however, full genital surgery is far from universal. Hormone use is common and often begins informally in adolescence, while many opt for breast augmentation or facial surgery without pursuing genital reconstruction at all. Cost, health concerns, medical gatekeeping and personal choice all play a role, and for many, womanhood is not defined by surgical status.
Today, younger generations increasingly use global LGBTQ+ language, sometimes distancing themselves from kathoey as an outdated or stigmatized term, while activists push for legal gender recognition and meaningful enforcement of anti-discrimination laws. The paradox remains: Thailand’s kathoey are among the most visible gender-diverse people in Asia, yet visibility has not freed them from rigid expectations, economic marginalisation or institutional exclusion. To understand kathoey is to see beyond spectacle—to recognise a community navigating respect, survival and self-definition in a society that smiles, watches, but too often refuses to fully include.
I absolutely love my kathoey sisters and brothers. Truly. Some of my closest friends in Thailand sit somewhere along that deliciously messy spectrum people insist on calling “sex fluid,” as if human identity were a liquid you could neatly pour into labelled bottles. Call them kathoey, trans women, queer femmes, soft boys with eyeliner, girls with broad shoulders and sharper tongues than most men in parliament—I don’t care. What I know is this: they are observant, resilient, funny as hell, and usually far more aware of the dangers in the room than the straights are.
Let me be honest, in the way only Auntie can. I find sex-fluid people more interesting. They read between lines. They scan exits. They know who is safe and who is pretending. Years of being stared at, laughed at, desired and dismissed all at once sharpen your instincts. When I walk late at night in Bangkok, Pattaya, or Khon Kaen with my kathoey friends, we watch our backs for each other. Not performatively. Not with hashtags. Quietly. Practically. Survival is a shared language.
Thailand likes to congratulate itself for being “tolerant”, but tolerance is a low bar. Tolerance is smiling while denying paperwork, jobs, promotions, dignity. Tolerance is enjoying cabaret shows while pretending not to see discrimination in schools, hospitals or HR offices. My kathoey friends know this better than any glossy tourism brochure ever will. They are welcomed as spectacle, not always as citizens.
And yes—let’s say it clearly—many end up in entertainment or sex work. Not because of destiny or some exotic urge to seduce foreigners, but because doors close early and often. When your resume triggers laughter, when your ID outs you at every interview, glamour and survival start sharing the same address. Some thrive there, some don’t, and none of them should be reduced to a punchline or a porn tag.
What I admire most is not the makeup skills, the bodies, or the sass—though let’s admit, those can be impressive. It’s the mutual care. Kathoey communities are experts at chosen family. They lend money. They nurse each other through surgery. They warn each other about violent clients, abusive lovers, dodgy cops, fake allies. This is not identity politics; this is lived ethics.
So when people ask me why I “hang out with ladyboys”, I smile sweetly and think: because they notice things you don’t. Because they know the cost of visibility. Because they make the world larger, not smaller. And because when things go wrong—which they often do—it’s good to walk with people who already know how to survive being seen.