A significant number of Thais perceive kathoey as belonging to a separate sex, including some transgender women themselves. In face of the many sociopolitical obstacles that kathoeys navigate in Thailand, kathoey activism has led to legal recognition as of January The word kathoey is of Khmer origin.
Although kathoey is often translated as ' transgender woman ' in English, this term is not correct in Thailand. As well as transgender people, the term can refer to gay men , and was originally used to refer to intersex people.
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 identity , and in contrast to phet thi sam 'third sex'. The term phu ying praphet song , which can be translated as 'second-type female', is also used to refer to kathoey. Many dress as women and undergo "feminising" medical procedures such as breast implants , hormones , silicone injections, or Adam's apple reductions.
Others may wear make-up and use feminine pronouns , but dress masculinely , 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'. Bunmi, a Thai Buddhist author, believes that homosexuality stems from "lower level spirits" phi-sang-thewada , a factor that is influenced by one's past life. In , Johns Hopkins Hospital in the US became the first institution to perform sex-reassignment surgery. Patients must be at least 18 years old with permission from parents if under 20 years old.
