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However, when considering transgender women (Mt F) 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.
Although kathoey is often translated as "transgender" in the English usage, this term is not used frequently in Thailand.
Using the notion of karma, some Thai believe that being a kathoey is the result of transgressions in past lives, concluding that kathoey deserve pity rather than blame.
Kathoeys currently face many social and legal impediments.
Before going through gender reassignment surgery, one must be on hormones/antiandrogens for at least one year.
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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.