I'm feeling a bit bored right now and I've never seen this posted before. It may be of interest to others.

In various parts of the world we have WPATH which are a set of guidelines which doctors are free to follow or not (I'm not at all keen on WPATH myself).

Thailand however has actual laws on SRS, and here's the English translations of them. I extracted what I think are the key points for foreigners, which really have nothing to do with WPATH. It also explains why you need 1 letter from overseas and 1 letter locally.

http://www.thailawforum.com/Guidelines-sex-change-operations.html
In the event the ailing person is a foreigner and has received approval from a foreign psychiatrist already, at least one Thai psychiatrist must assess and evaluate the person prior to the operation.

http://www.thailawforum.com/sex-change-operations-law.html
Therefore, in order to ensure protection of citizens wishing to undergo a sex change operation, the Medical Council, in the role of a professional organization controlling and overseeing the standards of professional medical care, has stipulated the rules as follows:

Thanks for this AnonyMs  I am considering suing Chett now as I never had a local evaluation making my op illegal  You know I'm only joking but the thread was helpful thank you 

Hugs

Sorcha

Does anyone know how orchiectomy fits into the legals? Does it count as sex reassignment surgery?

Quote from: Richenda on August 25, 2015, 03:03:55 PM
Does anyone know how orchiectomy fits into the legals? Does it count as sex reassignment surgery?

At a guess, I'd say no, it wouldn't count but, there would still be ethical considerations on the part of the surgeon. That is to say, even though its not SRS, you're still electing to permanently amputate healthy tissue and make yourself sterile. The surgeon may want a letter from a psych to demonstrate you understand what you're doing.

In terms of going to Thailand for an orchie I am not sure there would be any value in that as most people could do it in their home country cheaper and without a long journey.

I have heard of some states in the US who have accepted a letter from a surgeon who has performed an orchie as proof enough to allow for gender change on ID if that's what you're referring to?

On a purely medical question an orchie isn't enough to say someone has changed gender but it really depends on what the patient is having the surgery to achieve

Hugs

Sorcha 

The Thai laws reflect the WPATH rulings. I will use Dr Preecha who chairs WPATH and owns the PAI clinics. The rules are as you have stated, you will need 2 letters. Usually, the Thai one, is a person you see at the last minute who just want to confirm that you know what you are getting into. I think Australia has the same rules?

Sorcha, you sounded like me in the suing, but glad its only a joke...BTW I opted for Preecha as I didnt like the idea of having surgery in a clinic. I did like Chett though.

Here's some background to the law in Thailand that helps make sense of things. One of the authors is Dr Preecha.

The Development of Sex Reassignment Surgery in Thailand: A Social Perspective
The Scientific World Journal, Volume 2014 (2014)
http://www.hindawi.com/journals/tswj/2014/182981/

Section 4.2 is interesting

4.2. Regulations for the Treatment of Gender Reassignment
Until 2009, there was no definite rule to regulate gender reassignment in Thailand; nevertheless, some plastic surgeons (as the authors of the present manuscript) were still following the SOC as suggested by the WPATH, as for the criteria to select and treat transsexual patients. However, until 2008, there were many cases of castrations to teenagers, performed by nonurologists and nonplastic surgeons, and this made the social and the mass media upset and panic.

As a consequence, pressure was put on the Thailand Medical Council to regulate the medical practice for the treatment of transsexual patients; subsequently, the Thailand Medical Council published a policy entitled "Criteria for the treatment of sex change, Census 2009", which was effective from November 25, 2009. Among the criteria, patients have to be over 20 years of age, or they can be between 18 and 20 and have consent of at least 1 guardian. Also, patients should have documents to approve their surgery from 2 different psychiatrists. For other details, the SOC of the HBIGDA/WPATH should be followed, including furthermore, the real life experience for at least 1 year.

There was some recent discussion on the forums about HRT in Thailand.

The hormonal treatment is a very weak point within the treatment, too: very few endocrinologists in Thailand have experience in this field, and patients prefer to listen to senior fellows of their society, accepting suggestions passed to each other as word of mouth, rather than giving their trust into endocrinologists. As a consequence, nearly all the transsexuals use hormones, but very few of them are under the care of endocrinologists. Hormones are usually bought directly from the pharmacy; no prescription is required.

Here's a couple of articles from 2008

Thailand Doctors Banned from Performing Castrations
April 2, 2008
http://www.medindia.net/news/thailand-doctors-banned-from-performing-castrations-34938-1.htm

Ban on Underage Castration Divides Thailand's Doctors, Activists
Aug 5, 2008
http://www.edgeboston.com/news//reviews//78460/ban_on_underage_castration_divides_thailand's_doctors,_activists

I've not tried it, but I expect its very easy to get an orchi in Thailand if you're an adult ... it's not the Western world. If it were me I'd contact some of the SRS surgeons and ask for advice.

Quote from: SorchaC on August 25, 2015, 10:40:36 PM

On a purely medical question an orchie isn't enough to say someone has changed gender but it really depends on what the patient is having the surgery to achieve

Hugs

Sorcha 

Hi Sorcha, that was a good point about maybe getting it cheaper elsewhere. Dr Sarang just quoted me $4500 for an orchie. Ouch!

Do you mean that though about on a purely medical question? Do you mean on a purely legal point? Medically I think not only is gender very fluid, and definitely not either/or but many shades of in-between, but the moment you start taking HRT you are changing your gender. Cutting off your testicles is probably the single most effective method for stopping 'male-ness' in that it cuts out the testosterone source in the body. Combined with oestrogen you're well on the way to femaleness.

I know this may be a controversial comment, but for me going to full vaginoplasty is more cosmetic than actually medically altering your gender. I guess my view on that could change as I'm taking steps, but the key thing is cutting off the testosterone driver. As I'm not interested in having a man's penis in there it would be a predominantly social step for me I 'think' e.g. being able to go into the locker room (I'm still evaluating it!).

I guess another way of putting this is that for me I don't look down at my penis and think, 'oh god I'm still a man,' I look down at my breasts and think 'yes, I'm becoming a woman.' Please just bear in mind everything I've said about feeling my way here. I'm taking steps and I definitely respect, admire and envy those who have had the courage and resources to go through with full SRS. Fantastic!

Re. the legal part I'd say it sounds very Thailand that the focus is on full SRS whilst ignoring the HRT issue. From all I've heard, there are very few endocrinologists. I'm still confused as to how kathoey become so feminine. They must self-med I guess.

xx

I mean, here's a crazy thing. You can pump your body full of drugs that could be extremely dangerous (as I found out) without any requirement for letters or anyone checking a thing. And yet, for surgeries you need loads of paperwork. I'm not saying the latter's wrong, but just it's inconsistent. HRT in high dosages can have a massive impact on the body ... without any regulation. And some of the drugs available on the internet are probably dirty as hell.

I'd quite like to see a softening on SRS requirements at the same time as better regulation of online meds so that we could find a middle ground (very Buddhist!) that enables trans people to transition without hassle. I mean, when you've lived with this all your life you really shouldn't have to start telling a doctor for a year or more that it's for real. We're adults and for the most part we know.

Quote from: Richenda on August 26, 2015, 02:48:54 AM
Re. the legal part I'd say it sounds very Thailand that the focus is on full SRS whilst ignoring the HRT issue. From all I've heard, there are very few endocrinologists. I'm still confused as to how kathoey become so feminine. They must self-med I guess.

That's in the links I posted. The 2009 law change because of 14 year old's getting orchi's (for $130) and parents getting upset about it. They do start HRT very young as its very easy.

That's really interesting. (Slightly explicit sentence follows this one.)

I know that a few TS porn videos show kathoey being able to come but is that less the norm do you think? I mean, what I'm trying to get my head around is how kathoey look incredibly feminine: the old joke that the most beautiful women in Thailand aren't isn't far from the truth. Is it that lots of them have orchies? Or do they do it by meds? I'm talking here about pre-op kathoey. I've travelled in Thailand a lot and many of the kathoey are just stunning women, but with penises. I don't entirely get it and I'm asking this in all honesty. It continues to confuse me. Is it all gradual surgery + HRT (despite non existent endos) or do many of them in fact have orchiectomies?

I saw a TV documentary about the sex industry in Thailand about 15 years ago and in that families from rural villages sold their male children about 8 or 9 years of age to people explicitly knowing they would become ladyboys. It was considered as an honour for the son to do this for his family and the parents were given an undisclosed large sum of money. Girls were bought as well but strangely the male child seemed to be given more honour than the female one. These children were educated and in the case of males given hormones so they developed as females so when they reached teen years or maybe earlier they could work. I suppose like most medications not containing illegal drugs hormones can be bought over the counter in Thailand without a prescription.

Quote from: Richenda on August 26, 2015, 02:48:54 AM

Hi Sorcha, that was a good point about maybe getting it cheaper elsewhere. Dr Sarang just quoted me $4500 for an orchie. Ouch!

Do you mean that though about on a purely medical question? Do you mean on a purely legal point? Medically I think not only is gender very fluid, and definitely not either/or but many shades of in-between, but the moment you start taking HRT you are changing your gender. Cutting off your testicles is probably the single most effective method for stopping 'male-ness' in that it cuts out the testosterone source in the body. Combined with oestrogen you're well on the way to femaleness.

I should have said surgically an orchie doesn't on it's own constitute changing gender. My reasoning being that you can have an orchie if you have testicular cancer but that doesn't mean you've changed gender. Biologically you'll still outwardly appear male. As you say gender is very fluid in many people and the physical appearance of a body isn't a good indicator of a persons gender.

Quote from: Richenda on August 26, 2015, 02:48:54 AM

I know this may be a controversial comment, but for me going to full vaginoplasty is more cosmetic than actually medically altering your gender. I guess my view on that could change as I'm taking steps, but the key thing is cutting off the testosterone driver. As I'm not interested in having a man's penis in there it would be a predominantly social step for me I 'think' e.g. being able to go into the locker room (I'm still evaluating it!).

I guess another way of putting this is that for me I don't look down at my penis and think, 'oh god I'm still a man,' I look down at my breasts and think 'yes, I'm becoming a woman.' Please just bear in mind everything I've said about feeling my way here. I'm taking steps and I definitely respect, admire and envy those who have had the courage and resources to go through with full SRS. Fantastic!

When I was pre op and suffering all the abuse people kept telling me it will all be good once I'm a postie. Of course that was wrong because nobody could tell either way. My being female had nothing to do with my body but was determined inside my head. Getting SRS was a cosmetic way of curing me of my body dysphoria. If you get as far as surgery and are saying once you have it done you'll be a female I think you are missing the point. I am definitely more confident about myself than I used to be but I have not altered how I feel about my gender. When I got my gender Recognition Certificate and my new Birth Certificate in 2009 I hadn't had my orchie then and had only been on hormones 2 years. The letter that came with it reminded me that in all legal ways I am now female and can if I choose legally marry a male. (this was before the UK had same sex marriage) for me if I hadn't been sure of my gender at that point I had already made a serious mistake

Hugs

Sorcha 

I love that Sorcha and am with you 100%, which probably also means that's how I feel about myself but just at a much earlier stage of the journey.

Congratulations, too, by the way. I'm envious, but in a good way

Hugs back x