Thai transgenders in focus: demographics, transitions and identities



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Thai transgenders in focus: demographics, transitions and identities.

Sam Winter,

University of Hong Kong, Hong Kong
Key words: Thailand, demographics, transition, identity

Abstract

Data was analysed for a sample of 195 Thai transgendered females (i.e. male-to-female (MtF) transgenders) who had completed a questionnaire covering, inter alia, demographics, transition histories and sexual/gender identities. Mean age was 25.4 years.


For demographic data, we found that our participants were often among the youngest in their family, that females played a prominent role in their lives (often rearing them without any male help), and that around one in five brothers (natural or step) were also transgendered.
With regard to transition histories, we found that many participants had transitioned very early in life, beginning to feel different to other males, and identifying as non-male by middle childhood. By adolescence many were living a transgendered life. Many took hormones, beginning to do so by a mean age of 16.3 years, and several from as early as 10 years. Many underwent surgeries of various kinds, on average in the twenties, with one undergoing SRS as early as 15 years.
As to identity, most of our participants thought of themselves simply as phuying (women), with a smaller number thinking of themselves as phuying praphet song (a ‘second kind of woman’). A small number thought of themselves as kathoey (a more general Thai term embracing a variety of gender non-conformities) While most participants would prefer to be a woman, there were a few who seemed comfortable being transgendered. A few foresaw that they would not be living a transgendered life into old age. The vast majority expressed a sexual attraction to men.

Introduction

There appear to be a large number of transgendered females in Thailand. Estimates range from around 1:3000 (Ehrlich, 1996), through around 1: 300 (Totman, 2003) to around 1:180 (Winter, 2002c). All represent a higher incidence than is commonly supposed for their counterparts in the West.


The last ten years have seen the publication of many English language studies of transgender in Thailand. Apart from isolated reports (Beyrer, 1998; Storer, 1999; ten Brummelhuis, 1999; Nanda, 2000, Wong, 2003, Totman, 2003) they come from several sources. First is the work of Peter Jackson, whose interest in transgender connects with an broader interest in gay anthropology and historiography (Jackson 1995, 1996, 1997, 1998, 1999a, b, 2003). The more recent work of Megan Sinnott can be interpreted in a similar light (Sinnott, 2000, 2002, in press). Standing in stark contrast is the work of Andrew Matzner, whose interests are in transgender in its own right (as evidenced by his recent work in Hawai’i (Matzner, 2002a)). Much of his engaging and provocative work is available through his own website (Matzner, no date a-g). Some is also available at the TransgenderASIA website (Matzner, 2002b) or in print (Matzner, 2001).
Most of the work so far cited is of a narrative / qualitative nature. The more recent work of the TransgenderASIA group has tended towards the more quantitative. Aside from more general work (Winter 2002a,b,c,d, 2003), the group has so far focused on how transgenders perceive men and women, as well as how they perceive themselves (Winter and Udomsak, 2002a and b; Winter, accepted for publication).
The present study is the latest in the TransgenderASIA research programme. It is an attempt to present a broad picture of the nature of MtF transgenders in Thailand, focusing on social and family backgrounds, as well as transgenders’ experiences, perceptions and beliefs in regard to their own gender identity and sexuality. Our aim has been to examine participants’ demographics, transition histories, identities (gender and sexual), as well as their beliefs about other people’s attitudes towards their transgender, about the origins of their transgender, and about sexual relationships involving transgender people.
This report concentrates on demographics, transition histories and gender/sexual identities. Other material, focusing on broader perceptions and beliefs, is left to a second report, in preparation.

Instrument

The research instrument was a questionnaire originally developed in draft form in English and then refined and translated into Thai over a period of six months for eventual completion by participants. There were 77 questions. Many questions involved two parts, so that in all 120 items of data were being collected for each participant. Fifty two items involved a multiple-choice format. A total of 41 items also gave opportunities for (or encouraged) open-ended responses.


Six main areas were covered by the questionnaire. These were:
( a ) demographics: place of birth; family ethnicity; parents and siblings; caregivers, living arrangements and socio-economic status during early childhood; educational backgrounds; current occupation, salary, and living arrangements.
( b ) transition histories: as evidenced by developing patterns of gender-specific language, changing hair and clothing styles, use of hormones, and surgical interventions. Current biometric data was also collected.
( c ) identities: including gender identity (as evidenced by perceptions of gender incongruence, perceptions of and preference for cross-gender identity, and expectations for cross-gendered identity later in life); sexual identity (as evidenced by sexual preference); aspects of self-concept.
( d ) perceived attitudes of others towards transgender: initial and current attitudes of father and mother towards the participants’ transgender; societal attitudes towards transgendered females.
( e ) beliefs about the origin of their transgender: in terms of biology, karma, influence of parents, siblings and other relatives, influence of friends, and other reasons.
( f ) beliefs about sexual relationships involving transgendered females: as indicated by labelling of own and others’ sexual preferences.
There were also some miscellaneous items: including a final open-ended item inviting participants to write anything down that they would like us to know about their transgender identity / experience.

This report focuses on findings from Sections (a ) to ( c ). Sections ( d ) to ( f ), concerned with broader perceptions and beliefs, will be the focus of another paper.



A note on terminology

There is no single word for transgender in Thai. Instead Thais use several words, each of which is used at some point in this paper (often following participants’ own usage). Perhaps the commonest word is ‘kathoey’, formerly a very broad term embracing any male who contravened gender role expectations for males (including gays, effeminate males), but nowadays commonly applied to transgendered females. Other terms include the English loan phrase ‘ladyboy’, as well as ‘phuying praphet song’ (literally, ‘second kind of woman’).


For much of the questionnaire we used the phrase ‘phuying praphet song’ for transgendered females, though ‘kathoey’ was sometimes used in addition, for example where it gave us an opportunity to study in finer detail the participants’ own use of the terms.

Participants and procedure

The sample was opportunistic. Between June 2001 and August 2002 198 persons presenting as transgendered females were approached at their place of study or work (n=139), or while waiting for treatment at a surgery providing services for transgendered females (n=59). These two sub-samples were called the community and clinic sub-samples respectively.


For those approached at their work or place of study initial approach was on the basis of apparent gender-presentation, confirmed by enquiry. For all, final confirmation of transgender status rested on participants’ responses to questionnaire items on gender identity. Participants’ questionnaires were only included for analysis if they indicated on those items that they did indeed have a cross-gendered identity. Three participants were rejected based on this criterion, leaving a final data base of 195 participants. Their mean age was 25.4 years, with a range from 15.5 to 47.6 years. Sixteen per cent were teenagers.
All open-ended responses were translated into English, and were tabulated in an Excel file. All other responses were entered and analysed in SPSS PC plus (version 11.0). Analyses were performed for the community and clinic sub-samples separately, as well as for the pooled sample. The results of these analyses were highly similar, and the findings reported in this paper are confined to the pooled sample.

Results

Demographics (see Table 1a, 1b, 1c)



Geographic and ethnic background (Table 1a)
Participants’ birthplaces covered 42 out of 76 provinces of Thailand. However, this does not mean our sample was representative of the nation as a whole. Predictably (given we collected most of our data in and around Bangkok) most participants turned out to have been born in the central region. Much smaller numbers came from the north, north-east or south. Overall, these regions contain 32%, 34%, 20% and 13% of the national population (1998 figures available at College of Population Studies, (no date)). Clearly then, our sample was heavily weighted towards the central provinces.
Our sample also seemed weighted towards an urban background, with over half reporting growing up in cities, compared to only 18% nationally, and only 40% for the relatively urban central region (College of Population studies, op.cit.). In fact, this finding was an artefactual consequence; so many of our participants being born in the Bangkok area. When they were taken out of the analysis the balance for the remaining participants more closely approximated national urbanisation figures.
Our sample was predominantly ethnic Thai, or mixed Thai/Chinese. Around 6% described themselves as exclusively Chinese. A small number checked ‘other’, identifying themselves as Thai mixed with Lao or Vietnamese ethnicity. These figures broadly corresponded with ethnic breakdown for the country as a whole (U.S. Govt., 2002).
Family background (Table 1b)
The vast majority of our participants reported that during their childhoods their family had experienced average affluence. Very small numbers reported more exceptional economic conditions; either poor or rich. One should not read too much into this finding; among other things it begs questions about participants’ understanding of the term ‘average’, ‘rich’ and ‘poor’.
Around one in five participants indicated their father and mother had separated (or else had been separated by force of circumstance) before they had reached the age of ten. In one in six of these cases the separation was before the child’s first birthday. Comparable overall figures for Thailand are difficult to come by, but it is clear that there is nowadays a divorce for every six marriages (1999 figures cited in Government of Thailand, 2003). There must surely be, in addition to those who divorce, many more who simply agree to separate.
Of the reasons given for the separation, 44.4% were framed in terms of a mutual difficulty (e.g. parents arguing or fighting) or event (for example, parents being separated through death). But for those who framed the separation in terms of a particular parent’s behaviour, the vast majority (88%) framed it in terms of something the father had done (in most cases new or additional wives or mistresses), with only 12% making reference to the mother (e.g. running away with another man or going abroad to work).
We now turn to findings on caregivers, examined in terms of the following categories: mother, father, older brothers, older sisters, other relatives outside the immediate family, and others entirely outside the family.
Predictably, most participants reported their caregivers as coming from a number of the above categories. In 22% of cases it was the mother and father. In many others it was another combination, usually the mother in conjunction with their older daughters and/or others inside and outside the extended family (most often grandmothers). In contrast, just under half reported having been raised by one category of person alone; most commonly the mother. In some cases it was someone from a support network of relatives (most commonly the child’s grandmothers, less commonly their aunts) or friends and neighbours.
The upshot was a very strong influence of female caregivers in the lives of our participants. We estimate that overall, around 50% of our participants were raised only by females, performing the task of childrearing either unsupported or with the help of other females. The absence of comparison data for a non-transgendered sample (either in this study or elsewhere) limits interpretation of this finding.

Turning now to natural siblings, we found that 89.2% (174) of our sample had at least one brother or sister. Together these siblings totalled 437. Brothers were as numerous as sisters (52% of siblings versus 49%). But siblings were more likely to be older than younger (62% of siblings versus 38%; p<0.001 on the Wilcoxon Signed-Rank test). This imbalance was evident for both sexes of sibling. Older natural brothers outnumbered younger ones (60% versus 40%; p<0.01). The imbalance was even greater for natural sisters, among whom 64% were older and only 36% were younger (p<0.001).


We also looked at stepsiblings, 327 in all. There were no great imbalances. Again they were as likely to be male as female (52% v 48%). They were also as likely to be older as younger (51% v 49%). The balance between older and younger stepsiblings extended to both sexes.
We found surprisingly high incidences of MtF transgender among brothers, both natural and step. Among older natural brothers the incidence rate was 19.3%. Among younger natural brothers it was 18.9%. Among older and younger stepbrothers the rates were 17.2% and 20.7% respectively.
Once armed with this information, we were able to adjust the sibling arithmetic in terms of presenting gender. Sisters (natal or transgendered) now accounted for 255 of the natural siblings (58%). Of these 63% were older and 37% were younger. There were now only 182 brothers (42% of all siblings), of which 60% were older and 40% younger). Stepsisters (natal or transgendered) now accounted for 190 (58%) of the stepsiblings, equally balanced between older and younger (50%, apiece). There were now only 137 stepbrothers (42% of all stepsiblings), of which 49% were older and 51% were younger.
Taking these findings with the earlier ones on the role of the mother and older siblings in child care, one is left wondering whether a home rich in females, particularly those older than oneself who may be involved in one’s child rearing, might act as a factor (albeit just one) underlying the development of MtF transgender in Thailand.. Unfortunately, we do not have access to comparison data (either from this study or from other researchers) that would enable us to make better sense of this finding.

Education and employment / living conditions (Table 1c)
The vast majority of our sample had completed secondary education. Many had gone on to college or university, with around 53% already graduating. An additional 13% were studying at a vocational college or university at the time of our study, though they had not yet graduated.
Thailand remains a developing country. The mean duration of a child’s education is just 7.8 years (Bangkok Post , 2004). Just over half of the Grade One cohort enter elementary school when they are supposed to, and only 85% get to enroll at any time during their elementary years (UNESCO Institute for Statistics, 2003). Only 80% of those completing primary education go into secondary schools (Government of Thailand, 1996). A massive 70% of the population have received only an elementary education, and only 18% have gone on to secondary or vocational (Government of Thailand, 1997). Seen in the context of these figures, we can see that our sample was a well educated group.
Three out of four participants reported that they were employed. Many were actress-dancers in cabarets popular with tourist groups. Other employment included make-up, costume design and wardrobe work associated with the cabarets, as well as work in beauty salons. Several reported working as dancer-hostesses and prostitutes. Small numbers reported work in restaurants and cafes, at travel and tour agencies, and in offices and general sales. One owned her own small restaurant. Another reported work as a teacher. Among the others, most reported being students. Some reported studying and working in parallel.
Many were now living quite independently. Over half resided outside their family home, residing alone or with boyfriend or friends. Of these they had on average left home in their nineteenth year. Anecdotal reports from our participants suggest that many , whether living with family or not, were helping support family members.

Transition history (see Table 2a and 2b)

On the whole our participants had early in their lives developed a transgendered identity. They felt different from other boys at a mean 8.3 years, felt they had a mind that was not male by a mean 10.9 years, and believed that they were in a fundamental sense something other than male by a mean 11.9 years.


As a whole they had presented early in life in a way that was consistent with that identity. The mean course of transition involved ( a ) feminine language patterns by early- to mid- teens (e.g. using ‘kha’ (instead of the masculine form ‘khrap’) as an affirmative and polite particle, and using ‘noo’, ‘chan’ and ‘dichan’ (instead of the masculine form ‘phom’) to denote the first person pronoun); ( b ) growing long hair, living in female clothes, and taking hormones by mid- to late- teens; ( c ) surgery, for those that underwent it, in their twenties. Around this mean course of development there was much variation. Several participants had started taking hormones around age 10.5. Several had undergone SRS in their teens, one as early as 15.5 years.
At the time of our research substantial numbers had undergone nose operations (39%) or obtained breast implants (40%). Substantial numbers had employed silicone injections to their face or body. Rather smaller numbers (in every case under 30%) had undergone operations of other sorts to their chin or forehead, as well as to their Adam’s Apple or (arguably the ultimate transition) had undergone sex reassignment surgery (SRS).
Many of our younger participants who had not yet had operations reported that they might do so when they were older. The clearest indication of this was in regard to SRS. Two out of three who had not yet had SRS indicated they wanted to do so in the future (i.e. appeared to be ‘pre-op’ transgenders).
However, another 17.0% declared they did not want SRS at all (i.e. appeared to be ‘non-ops’). We looked at these individuals in some detail. We found, compared to others in the sample, that fewer among them identified as women. They were instead more likely to identify as transgenders, either as phuying praphet song (‘a second kind of woman’) or as kathoey (traditionally used to refer to a range of deviances from male norms, but nowadays more often used to denote transgender).
Before leaving this section, we should report some findings on biometrics. Our sample registered a mean height of 1.71m and a mean weight of 55.9kg. How do these figures compare with males and females? A large scale study of weight and height provides a means of comparison. Chavalittamrong, Tarnpradub and Vanprapar’s (1989) study of 4300 18 year olds reported 1.71m and 58kg for males and 1.58m and 47kg for females. Overall then the mean height and weight for our participants appeared to approach that of non-transgendered male compatriots.
Identity (see Table 3a and 3b)
Gender identity (Table 3a)
By virtue of the criteria employed for including data into the study all 195 participants thought of themselves as something other than a man. Beyond this however, their self-identifications varied. While half identified as woman, a significant minority identified as either as a phuying praphet song (connoting a subset of woman) or as a kathoey (connoting something more similar to our notion of transgender). A few had something to add:
Community participant 97: Sometimes I feel like a woman, sometimes I feel like a man.

Community participant 101: My mind is woman,,,only my body is kathoey.

Community participant 52: Before I was 8 or 9 I thought I was a lady, then I realised I was actually a kathoey.

Community participant 72: Actually I didn’t want to accept that I am kathoey, but I had to accept it.

Community participant 137: (doing research on kathoey for a Masters Degree): I liked boys and imagined I was a girl even in primary school. At that time I didn't think about whether I was the same as or different from others. Only at high school did I begin to think I was different from other boys. I called myself ‘kathoey’. I always liked men. I always had "mr" as my title. So people began to call me ‘kathoey’ too.
We asked participants what sort of mind they believed they had. As one might expect, few felt that theirs was that of a male. Instead, around 70% reported a mind of a woman, with a few the mind of a kathoey or phuying praphet song. One commented on our use of the word ‘mind’.
Community participant 137: (following on from earlier quote): I prefer to have a kathoey mind to that of a male or female. In my family, I relate well to all the females e.g. grandmother, aunt, etc. Therefore, my consciousness is female. In fact, I think mind and consciousness are two quite different things.
As we have seen, for many participants these identities had developed early in their lives. On average they felt by their eleventh year that they had a mind that was not male, but instead was that of a woman, or a kathoey or phuying praphet song. On average by their twelfth birthday they were self-identifying as a woman, or as a kathoey or phuying praphet song.
When we asked our participants what they would prefer to be, the vast majority (around three in every four) declared they would prefer to be a woman. By contrast, a small but substantial number expressed satisfaction with being transgender.
Community participant 8:I would like to be a beautiful ladyboy.

Community participant 43: I would like to be the most beautiful kathoey, like a real woman but not a real woman.
Intriguingly, a few (around 5%) indicated that they would prefer to be a man.
These figures were closely echoed in answers to a subsequent question, in which we asked what they wanted for their next life.
A few participants, some apparently with a hint of exasperation, seemed only to wish that they were no longer transgender.
Community participant 137: I prefer to be male. They are more powerful. At least I want to be any normal gender.

Clinic participant 42: Whatever,, but if a man then a proper man, and if a lady, then a proper lady.

Community participant 55: I wish to be real man or woman ,,, either male or female, just a normal gender.

Community participant 95: I just want to be the gender I was born with.

Community participant 110: Any gender, so long as it matches my mind.
Somewhat poignantly, when asked how they would be living by the time they were 50, only around 80% thought they would be living as a woman or as a transgender. Around 20% thought they would be living as a man, would remain a kathoey but dressed as a man, or would fall into some vague ‘other’ group. Quite a few seemed unwilling to predict the future. Some even seemed uncomfortable contemplating it:

Community participant 14: Maybe I'll have a disease.

Community participant 9: I hope I have died already.

Community participant 71: I don't know if I will ever be 50.

Community participant 82: I might already have passed away.


Sexuality and other aspects of identity (Table 3b)
The vast majority of our sample (nearly 98%) were exclusively attracted to men, either straight or male-identifying gays. Only one reported being attracted to women, with another reporting an attraction to other transgendered females.
Our sample reported the onset of feelings of sexual attraction at a mean age of 14.0 years (S.D. 31 months). Interestingly, for most this was after they had begun to develop feelings of cross-gendered identity. For 76% of our sample, a sense of having a non-male mind preceded the onset of sexuality. The two developmental milestones were separated by around 3 years. For 68% of our sample, a sense of actually not being male preceded the onset of sexuality. The developmental lag here was around 2 years.
We turn finally to other miscellaneous aspects of identity. On a seven-point scale 52% of our sample rated themselves as above average in confidence, with corresponding figures of 21% for relaxed attitude, 56% for happiness, 70% for self-esteem, and 33% for attractiveness. All of this indicated a fairly positive self-concept among our sample. Notwithstanding, the results were more disturbing for those who anticipated living a non-transgendered life when they were 50. Among these, there was a significantly lower level of happiness (ANOVA p<0.01), with only 45% rating their happiness as above average.


Discussion

As indicated earlier, we were aware when planning our study that our sample might not be representative of all transgendered females in Thailand. It seems that our sample was heavily weighted towards central Thailand, as well as towards the young, urbanised and educated, and, perhaps for these reasons, towards an unrepresentative range of occupational categories. For all these reasons it is difficult to make confident generalisations from our data. Rather, in collecting information on a relatively large number of transgendered females, we have attempted to portray something of the range of demographics, transition histories and identities that might be found within the population, as well as to draw out findings which suggest possibilities for future research.


The artificial kathoey
It has been suggested that some apparently transgendered females in Thailand are not truly transgendered; rather they undergo a gender change to gain entry into lucrative sex work (ten Brummelhuis, 1999). Our experience, formed through several years of talking with transgenders in Thailand, is that such ‘kathoey thiam’ (‘artificial kathoey) are difficult to find. It is even difficult to find anyone who can point one out. Seen in this context, one of our more striking findings comes not from the questionnaire data itself, but from the number of individuals we were able to include in our sample. Only three persons who initially presented as cross-gendered indicated that they thought of themselves as men (and were therefore dropped from the sample). We therefore are inclined to conclude, within the limits of our sample, that the artificial kathoey is a very rare phenomenon indeed.

Height and weight

In a recent book on transgendered females in Thailand, Totman (2003) has remarked ‘it does not take a statistical survey to reveal that on average kathoey are taller than other Thai males and females’ (p36). He asks why, and draws his readers attention to the fact that males with Klinefelder’s Syndrome (KS) are often taller than their peers. While we are unable to make a comment about the link between KS and transgender in Thailand, we can at least report that, according to our own (self-report) data, transgendered females in Thailand display a height (and indeed a weight) no greater than their male compatriots.


Family and caregiving structure.

Our participants often came from families in which they were one of the youngest, and were brought up exclusively by females. Sometimes it was the mother alone, but sometimes it was female relatives or friends, and occasionally older sisters. Fathers were often absent, sometimes entirely and from the early years. Participants often appeared to blame fathers for the broken home, though one might speculate that those who did so might have been following their mothers’ leads in this regard. These findings are highly suggestive. However, they should be treated with extreme caution. They may not be representative of Thai transgenders overall. Even if they are, they may also be representative of non-transgendered Thais. Third, it should be borne in mind that, no matter how frequently our participants came from broken families, there remained another 23% who had been parented in a way considered ‘traditional’ in the West (i.e. by a mother and father who live together). More research on the family structure of transgendered individuals is needed.


Siblings
Our data suggests that, where (as was the case for nearly 90% of our sample) Thai transgendered females have natural siblings, the majority of those siblings are older rather than younger. These findings echo those of Western studies also identifying a birth order effect (at least for transgenders attracted to the other gender). However, whereas the Western research identifies a birth order effect for brothers, we have identified one for both sexes, with the most significant effect being for sisters. Blanchard (2001) has explained a fraternal birth-order effect in terms of possible immunisation effects upon mothers stemming from antigens linked to Y-chromosomes of their male foetuses. If replicated, our results would somewhat undermine that view.
Around one fifth of our participants’ brothers were themselves apparently transgendered females, a figure that is well above even the highest estimates for overall incidence of transgender in Thailand (Winter, 2002c).

That these siblings were as likely to be older as younger, and were as common among natural siblings as among stepsiblings was intriguing. The findings seem to suggest a family link to transgender, but one that is not based on genetics. It seems likely that MtF transgendered siblings, natural and step, in some way facilitate the development of transgender; modelling or supporting a gender transition in younger siblings.


The processes by which large numbers of Thai children become transgendered has been discussed elsewhere (Winter, 2003). For the moment, it is enough to note the apparent support our findings give to the idea that one’s gender identity, at least under some conditions, might be susceptible to social influence.
Transgender identities
While all of our participants experienced some sort of transgendered identity, the nature of that experience varied greatly across individuals. Around half saw themselves as women pure and simple, around 15% saw themselves as a phuying praphet song (‘second type of woman’), and around 12% saw themselves as a kathoey.
They differed also in the degree to which they had fully embraced their transgender. Around 70% would, if given the chance either now or in their next life, want to be a woman. But some appeared very happy to remain transgendered, both in this life and in the next. Only a small number, apparently less than 10%, expressed a preference to be a man.
While most anticipated living a cross-gendered life into their old age, a few foresaw living as men, or least dressing as men, by the time they were 50. One might conclude that here indeed were the ‘artificial kathoey’ of which we wrote earlier; living a transgender life while their youth and looks could support sex work. However, our analysis revealed otherwise. It was students, rather than other occupational groups, who were more likely to anticipate a male role at 50 (Pearson’s and Kendall’s coefficients 0.321, significant at p<0.01).
Tellingly, those who anticipated later life as a man reported greater depression than the others (Kendall’s tau-b 0.17; significant at p<0.05). In our view, their thoughts about the future were born of a bleak pessimism about living long-term in a society in which, despite a superficial acceptance of transgender, one can never change one’s I.D. or legal status, may have difficulty getting a job or advancing in one’s career, and will unlikely ever be able to marry according to one’s sexual preference.
Transition histories
Most in our sample reported cross-gendered identity and behaviour in early or middle childhood. Many were developing a transgendered identity in middle childhood, were actively presenting themselves as transgendered by their early to mid teens, and were pursuing surgery by their late teens and early twenties. While many Western transgenders report feelings of cross-gendered identity, or at least gender confusion, in early or mid-childhood, few would report living out their identities so early in life (for example see Doorn, Poortinga and Verschoor 1994; Kockott and Fahrner, 1987).
Interestingly, there was some divergence in attitudes towards SRS. Of the seven out of ten who had not undergone SRS, around five said they would like to do it and another one was not sure. That left just one in ten who showed no intention of ever getting SRS and whom we therefore might therefore call non-operational transgenders (‘non-ops’). In the West there appear to be larger numbers who reject the operation (e.g. Kockott and Fahrner, 1987). Seen in this context, the apparently high percentage of people in our sample who were planning SRS is particularly striking. However, we have no way of knowing whether our incidence for non-ops is representative for Thailand overall.
Sexual preferences.
The vast majority of our sample were attracted to men, in most cases to those they saw as heterosexual. This finding, very much consistent with one’s informal observations in Thailand, is quite at variance with much of the Western research (for example Blanchard, Clemmensen and Steiner, 1987) in which transgendered people commonly report being attracted to persons of the same gender identity as themselves.
Our Thai transgendered females’ sexual preference for men is a topic that begs further study. For the present we would limit ourselves to pointing out that around three in ten of our participants saw this sort of attraction as heterosexual. Their view of themselves seems reasonable in view of the fact that all see themselves as being something other than male, with most beginning to identify as such long before they ever became sexually attracted to men.
Their sense of themselves as heterosexual runs counter to the way such the West would view them. Cohen-Kettenis and Pfafflin (2003) note the ‘confusing and unfortunate’ fact that ‘in much of the scientific literature on transsexuals, the terms homosexual and heterosexual are applied to transsexuals exactly as they are to individuals without gender identity dysphoria – to refer to erotic attraction to members of the same or the opposite (chromosomal) sex, respectively’ (p67, their italics). In short, much of the Western scientific discourse would view our participants as homosexual. It is a view that, in our opinion, places a premium on biology over psychology, a premium which is inappropriate given that the central fact of these people’s lives is their identity.
Old age
This report is based on participants who were as a whole rather young, perhaps unrepresentatively so. In practice, little is known about the middle and later lives of Thai transgendered females. The final chapter of Totman’s (2003) book on kathoey focuses on their old age, and covers just two and a half pages. Our own study sheds little light on these individuals, but does say something about what our participants foresaw for their own later years. The fact that one in five anticipated they would not be living a clearly defined female role in later years, coupled with their higher level of reported depression, suggests that, even in the relatively accepting Thai environment, living a transgendered life is not easy for all. We hope soon to begin studying older transgendered females in Thailand.

Acknowledgements
For overall support in conducting this research, the Clinic of Dr Suporn Watanyusakul. For collaboration in planning and implementing the project, Fiona Kim and Pasu ‘Kie’ Lertsubin; for data collection, Nuttawut ‘Nune’ Udomsak and staff at the Suporn Clinic; for translation of participants’ open-ended responses, Nuttawut ‘Nune’ Udomsak; for data entry, Rachel Sun Chui Fun and Karen Cheung Hoi Yan.

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Table 1a: Geographic and ethnic background
Place of birth Central Region (including Bangkok) 69.5%

North-Eastern Region 16.2%

Northern Region 10.8%

Southern Region 3.6%


Location of childhood Village 20.2%

home District: 25.9%

City: 51.5%

Other: 8.8%
Ethnicity Thai 64.4%

Chinese 6.2%

Thai/Chinese 26.3%

Other: 3.1%


Note: ( a ) Except where otherwise indicated, percentage of participants endorsing different answers provided. ( b ) Totals occasionally surpass 100% as a result of some participants ticking more than one option provided.

Table 1b: Family background

Family economic status Very poor: 0.5%

Poor: 6.2%

Average: 89.6%

Rich: 3.6%

Very rich: 1.0%

Parental living Together 80.5%

arrangements Separately 19.5%

Persons responsible for rearing: Alone With one or

more others

Mother: 22.8% 51.1%

Father: 2.1% 40.9%

Older brothers 0.0% 9.2%

Older sisters 4.1% 14.0%

Others 19.7% 33.6%
Biological siblings Mean

Older brothers 0.69

Older sisters: 0.69

Younger brothers 0.46

Younger sisters: 0.39
Older transgendered brothers 0.13

Younger transgendered brothers 0.09


Stepsiblings Mean

Older brothers 0.45

Older sisters: 0.41

Younger brothers 0.42

Younger sisters: 0.40
Older transgendered brothers 0.08

Younger transgendered brothers 0.09

Note: ( a ) Except where otherwise indicated, percentage of participants endorsing different answers provided. ( b ) Totals occasionally surpass 100% as a result of some participants ticking more than one option provided.


Table 1c: Education, and employment / living conditions
Highest education Primary school 2.1%

qualifications Secondary school 46.1%

Vocational college 29.5%

University 23.3%
Current occupation: Employed: 77.5%

Student: 14.9%

Unemployed: 1.5%

No information: 8.7%


Current living arrangements: With family 44.8%

With boyfriend 21.4%

With friends 21.8%

Alone 18.2%


Note: ( a ) Except where otherwise indicated, percentage of participants endorsing different answers provided. ( b ) Totals occasionally surpass 100% as a result of some participants ticking more than one option provided.

Table 2a: Percentage of participants reporting undergoing a transition event, plus mean age and range of ages at which event occurs.
Transition event % reached Mean age S.D. reached

Feel different from other males 95.2% 8.3 years 3.6 years

Feel having a mind that is not male 99.5% 10.9 years 4.6 years

Thinking that not a male 100.0% 11.9 years 5.3 years Saying ‘kha’: 94.9% 15.1 years 4.1 years Saying ‘dichan’ etc: 92.8% 13.3 years 5.3 years

Growing my hair long: 93.3% 17.8 years 2.3 years

Living in female clothes: 90.8% 18.4 years 3.3 years

Hormones/contraceptives 93.8% 16.3 years 2.6 years

Silicone to face or body: 62.1% 22.4 years 3.8 years

Operation to forehead 14.9% 23.1 years 3.8 years

Operation to chin 18.0% 23.1 years 4.0 years Operation to nose 38.5% 22.6 years 4.3 years

Operation to adam’s apple: 7.7% 23.1 years 5.0 years

Breast enlargement 39.5% 22.9 years 3.4 years

Sex reassignment surgery 27.7% 24.1 years 3.7 years

Other surgery 22.0% 22.8 years 3.9 years


Table 2b: Attitudes towards SRS among those who have not yet undergone it
I did not do it but would like to 66.7%

I would not like to do it 17.0%

I am not sure if I would like to do it 16.3%

Table 3a: Gender identity

Note: Figures indicate percentage of participants endorsing different answers provided. Totals occasionally rise above 100% because of participants who check more than one possibility.

I feel different from other males: Yes 95.2%

No 1.1%


Not sure 3.7%
I feel I have a mind that is: Man 0.5%

Woman 70.4%



Kathoey 8.8% Phuying praphet song 15.5%

Other 5.2%


I think of myself now as a: Man 0.0% Woman 46.9%

Kathoey 12.3% Phuying praphet song 36.1%

Other 6.1%


Right now, if I could, I would prefer to be a: Man 5.1%

Woman 74.8%

Kathoey, but dressed as a man 1.5%

Phuying praphet song 15.4%

Other 4.6%


If I had a chance to start life over again, I’d like to be:Man 9.8%

Woman 71.1%

Kathoey, but dressed as a man 1.0%

Phuying praphet song 10.8%

Other 7.2%




When I am 50, I believe that I will be living as a: Man 4.6%

Woman 50.5%

Kathoey, but dressed as a man 6.2%



Phuying praphet song 27.3%

Other 12.3%



Table 3b: Sexual preference
Note: Figures indicate percentage of participants endorsing different answers provided. Totals occasionally rise above 100% because of participants who check more than one possibility.
I am attracted to:

Men 97.8%

Women 0.5%

Gay kings 4.8%



Phuying praphet song 0.5%

None 1.6%



Others 0.5%


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