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Kathoey or katoey (Thai: กะเทย; rtgs: Kathoei [kàtʰɤːj]) is a Thai term that refers to either a transgender woman or an effeminate gay male in Thailand. A significant number of Thais perceive kathoeys as belonging to a third gender, including many kathoeys themselves, while others see them as either a kind of man or a kind of woman. However, when considering transgender women (MtF) as a group in Thai society, most refer to themselves as phuying (Thai: ผู้หญิง "women"), with a minority referring to themselves as phuying praphet song (a "second kind of woman") and only very few referring to themselves as kathoey. Related phrases include phet thi sam (Thai: เพศที่สาม, "third gender"), and sao praphet song or phu ying praphet song (Thai: สาวประเภทสอง, ผู้หญิงประเภทสอง— both meaning "second-type female"). The word kathoey is of Khmer origin. It is most often rendered as ladyboy or lady boy in English conversation with Thais and this latter expression has become popular across Southeast Asia.
Although kathoey is often translated as "transgender" in the English usage, this term is not used frequently in Thailand. As well as trans individuals, the term can refer to gay men, and was originally used to refer to intersex individuals. Before the 1960s, the use of kathoey included anyone who deviated from the dominant and sexual norms. Because of this confusion in translation, the English translation of kathoey is usually "ladyboy" (or variants of the term).
Use of the term "kathoey" suggests that the person self-identifies as a type of male, in contrast to sao praphet song (which, like "trans woman", suggests a "female" (sao) gender identity), and in contrast to phet thi sam (which means "third gender"). The term phu ying praphet song, which can be translated as "second-type female", is also used to refer to kathoey. Australian scholar of sexual politics in Thailand Peter Jackson claims that the term "kathoey" was used in pre-modern times to refer to intersex people, and that the usage changed in the middle of the twentieth century to cover cross-dressing males. Kathoey became an iconic symbol of modern Thai culture. The term can refer to males who exhibit varying degrees of femininity. Many kathoeys dress as women and undergo "feminising" medical procedures such as breast implants, hormones, silicone injections, or Adam's apple reductions. Others may wear makeup and use feminine pronouns, but dress as men, and are closer to the Western category of effeminate gay man than transgender.
The term "kathoey" may be considered pejorative, especially in the form "kathoey-saloey". It has a meaning similar to the English language "fairy" or "queen". "Kathoey" can also be seen as a derogatory word for those who self-identify as gay.
Bunmi, Thai Buddhist authors, believe that the origins of homosexuality stems from "lower level spirits" (phi-sang-thewada), a factor that is influenced by one's past life. Buddhists view kathoeys as the marking of an individual who is born with a disability as a direct consequence for their past sins.
In 1965, Hopkins Hospital became the first institution to perform Sex Reassignment Surgery. Now, popular cities such as Bangkok, located in Thailand, are performing two to three gender operations per week - totaling up to more than 3,500 SRS over the past thirty years. With the massive increase in SRS, there has also been an increase in prerequisites, measures that must be taken, in order to be eligible for the operation. Patients must be at least 18 years old and permission from parents if under 20 years old. One must provide evidence of diagnosis of gender dysphoria from a psychologist/psychiatrist. Before going through gender reassignment surgery, one must be on hormones/antiandrogens for at least one year. Patients must have a note from the psychiatrist or clinical psychologist. Two months prior to the surgery, patients are required to see a Psychiatrist in Thailand to confirm eligibility for Sex Reassignment Surgery.
Many kathoey work in predominately female occupations, such as in shops, restaurants, and beauty salons, but also in factories (a reflection of Thailand's high proportion of female industrial workers). Kathoey also work in entertainment and tourist centers, in cabarets, and as sex workers. Kathoey sex workers have high rates of HIV.
Kathoeys are more visible and more accepted in Thai culture than transgender people are in other countries in the world. Several popular Thai models, singers and movie stars are kathoeys, and Thai newspapers often print photographs of the winners of female and kathoey beauty contests side by side. The phenomenon is not restricted to urban areas; there are kathoeys in most villages, and kathoey beauty contests are commonly held as part of local fairs.
Kathoeys currently face many social and legal impediments. Families (and especially fathers) are typically disappointed if a child becomes a kathoey, and kathoeys often have to face the prospect of coming out. However, kathoey generally have greater acceptance in Thailand than most other Asian countries. Legal recognition of kathoeys and transgender individuals is non-existent in Thailand: even if trans people have had genital reassignment surgery, they are not allowed to change their legal sex. Discrimination in employment also remains rampant. Problems can also arise in regards to access to amenities and gender allocation; for example, a kathoey and a transgender person who has undergone sexual reassignment surgery would still have to stay in an all-male prison.
Kathoeys began to gain prominence in the Cinema of Thailand during the late 1980s. The depiction at first was negative by showing kathoeys suffering from bad karma, suicide, and abandoned by straight lovers. Independent and experimental films contributed to defying sexual norms in queer cinema in the 1990s. In 2000, the film The Iron Ladies directed by Yongyoot Thongkongtoon depicted a positive portrayal of an almost an entirely kathoey volleyball team by displaying their confidence.  The rising middle-class in Bangkok and vernacular queer culture made the mainstream portrayal of kathoeys more popular on television and in art-house cinema.
Feminine beauty in Thailand allowed transgender individuals to have their own platform where they are able to challenge stereotypes and claim cultural recognition. Miss Tiffany's Universe is a beauty contest that is opened to all transgender women. Beginning in 1998, the pageant takes place every year in Pattaya, Thailand during May. With over 100 applicants, all across Thailand, the pageant is considered to be one of the most popular transgender pageant in the world. Through beauty pageants, Thailand has been able to promote the country's cosmetic surgery industry, which has had a massive increase in medical tourism for sex reassignment surgery. According to the Miss Tiffany's Universe website, the live broadcast attracts record of 15 million viewers. The winner of the pageant receives a tiara, sash, car, grand price of 100,000 baht (3,000 USD) - equivalent to a yearly wage for a factory worker living in Thailand.
In 1993, Thailand's teacher training colleges implemented a semi-formal ban on allowing homosexual (which included kathoey) students enrolling in courses leading to qualification for positions in kindergartens and primary schools. In January 1997, the Rajabhat Institutes (the governing body of the colleges) announced it would formalize the ban, which would extend to all campuses at the start of the 1997 academic year. The ban was quietly rescinded later in the year, following the replacement of the Minister of Education.
In 1996, a volleyball team composed mostly of gays and kathoeys, known as The Iron Ladies (Thai: สตรีเหล็ก, satree lek), later portrayed in two Thai movies, won the Thai national championship. The Thai government, concerned with the country's image, barred two of the kathoeys from joining the national team and competing internationally.
Among the most famous kathoeys in Thailand is Nong Tum, a former champion Thai boxer who emerged into the public eye in 1998. She would present in a feminine manner and had commenced hormone therapy while still a popular boxer; she would enter the ring with long hair and makeup, occasionally kissing a defeated opponent. She announced her retirement from professional boxing in 1999 – undergoing genital reassignment surgery, while continuing to work as a coach, and taking up acting and modeling. She returned to boxing in 2006.
In 2004, the Chiang Mai Technology School allocated a separate restroom for kathoeys, with an intertwined male and female symbol on the door. The 15 kathoey students are required to wear male clothing at school but are allowed to sport feminine hairdos. The restroom features four stalls, but no urinals.
Following the 2006 Thai coup d'état, kathoeys are hoping for a new third sex to be added to passports and other official documents in a proposed new constitution. In 2007, legislative efforts have begun to allow kathoeys to change their legal sex if they have undergone genital reassignment surgery; this latter restriction was controversially discussed in the community.
It is estimated that as many as six in every thousand individuals assigned as male at birth later present themselves as transwomen or phu-ying kham-phet.
Thai activists have mobilized for over two decades to secure sexual diversity rights. Beauty pageant winner Yollada Suanyot, known as Nok, found the Trans Female Association of Thailand on the basis of changing sex-designation on identification cards for post-operative transsexual women. Nok promoted the term phuying kham-phet instead of kathoey but was controversial because of its connotation with gender identity disease. The goal of the Thai Transgender Alliance aims to de-list Gender dysphoria from international psychological daignostic criteria and uses kathoey to advocate for transgender identity. A common protest sign during gender rights marches is "Kathoey mai chai rok-jit" meaning "Kathoey are not mentally ill."
Activism in Thailand is discouraged if it interferes with official policy. In January 2006, the Thai Network of People Living With HIV/AIDS had their offices raided after demonstrations against Thai-US foreign trade agreements. Under the Thai Constitution of 1997, the right to be free of discrimination based on health conditions helped to minimize the stigma against communities living with HIV/AIDS. In most cases, governments and their agencies fail to protect transpeople against these exclusions. There is a lack of HIV/AIDS services for specifically transgender people and feminizing hormones largely go without any medical monitoring.
Transprejudice has produced discriminatory behaviors that have lead to the exclusion of transpeople from economic and social activity. Worldwide, transpeople face discrimination amongst family members, religious settings, education, and the workplace. Accepted mainly in fashion-related jobs or show business, individuals who identify as transgender are discriminated in the job market and limited job oppurtonities . Kathoeys have also experienced ridicule from coworkers and having lower salaries. Long-term unemployment reduces the chances of contributing to welfare for the family and lowers self-esteem causing a higher likliehood of sex work in specialized "ladyboy" bars. "Ladyboy" bars also can provide a sense of community and reinforces a female sense of identity for kathoeys. Harrassment from the police is evident especially for kathoeys who work on the streets. Kathoeys may be rejected in official contexts being rejected entry or services.
Based on a study by AIDS Care participants that identified as a girl or kathoey at an early age were more likely to be exposed to Transphobia or violence from men in the family. Kathoeys are more subjected to sexual attack from other men than are non-effeminate homosexuals.
Anjaree is one of Thailand's feminist-lesbian organization that was established in mid 1986 by women's right activists. The organization advocated wider public understanding of same-sex sexuality based on the transnational language of human rights. The first public campaign was launched in 1996 opposing gender/sex deviance.
Identity cards are particularly important in Thailand. The vast majority of trans people in this region were unable to change their documents at all, and those who are able to were held to pretty severe standards. ID's facilitates almost every day activities such as interface with businesses, bureaucratic agencies (i.e. signing up for educational courses or even when seeking medical care), law enforcement, etc. Impeded by these identity cards on a daily basis, transgender individuals are "outed" by society.The requirement facilitated by the International Covenant on Civil and Political Rights (ICCPR) that does not offer transpeople the opportunity to change their personal documentation remains as a threat to privacy for the trans community in Thailand. There is no question that the country's rigid bureaucratic rules are still adjusting to incorporate transgender rights.
Transgender individuals were automatically exempted from compulsory military service in Thailand. Kathoeys were deemed to suffer from "mental illness" or "permanent mental disorder".  These mental disorders were required to appear on their military service documents, which are accessible to future employers. In 2006, the National Human Rights Commission (NHRC) of Thailand overturned the use of discriminatory phraseology in Thailand's military service exemption documents. With Thai law banning citizens to change their gender on their identification documents, everyone under the male category must attend a "lottery day" where they are randomly selected to enlist in the army for two years.  In March 2008, the military added a "third category" for transsexuals that dismissed them from service due to "illness that cannot be cured within 30 days".
The first all kathoey music group in Thailand was formed in 2006. It is named Venus Flytrap and was selected and promoted by Sony BMG Music Entertainment. The Lady Boys of Bangkok is a kathoey revue that has been performed in the UK since 1998 touring the country in both theatres and the famous "Sabai Pavilion" for nine months each year.
Ladyboys, also a popular term used in Thailand when referring to a transgender male, was a popular documentary filmed. The documentary was aired on Channel 4 TV in 1992 and was directed by Jeremy Marre. Marre aimed to portray the life of two teenage kathoeys, living in the rural part of Thailand, as they strived to land a job at a cabaret revue located in the popular city known as Pattaya.
Thai kathoey style and fashion has largely borrowed from Korean pop culture.
"Uncle Go Paknam" created by Pratchaya Phanthathorn is a popular gay and lesbian advice column that first appeared in 1975 in a magazine titled Pleak meaning "strange." Through letters and responses it became an outlet to express the desires and necessities of the LGBT community in Thailand. The magazine achieved national popularity because of its bizzare and often queer content. It portrayed positive accounts of kathoeys and men called "sharks" to view transgenders as legitimate or even preferred sexual partners and started queer-accepting public discourse in Thailand. Under the pen name of Phan Thathron he wrote the column "Girls to the Power of 2" that included profiles of kathoeys in a glamorous or provocative pose. "Girls to the Power of 2" were the first accounts of kathoey lives based on interviews that allowed their voices to be published in the national mainstream press of Thailand. The heterosexual public became more inclined to read about new transgender communities that were previously given negative press in Thai newspapers. Go Paknam's philosophy was "kathoeys are good (for men)."
Following Ladyboys in the vibrant social scene of Thailand, the documentary titled Thailand’s Third Gender direct insight on the lives of Ladyboys. Direct interviews with various transgender women, the film reveals the obstacles these individuals face with their family and lovers, but moreover on a larger societal aspect where they feel outcasted by the religious Thai culture. The documentary also follows contestants participating in one of the largest transgender beauty pageants known as Miss Tiffany's Universe and illustrates the process/competitiveness that takes place during the beauty pageant.