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It seems everything can be bought these days with enough money and nothing sells better than sex, or a new sex that is…especially in Thailand. In Thailand’s ambitious goal to be the hub of everything, there is one field in which Bangkok undoubtedly stands out above the rest – faking it. Notwithstanding pirated CDs, DVDs and knock-off goods, the most extreme form of imitation this city is renowned for is its transexualism. Bangkok is the transgender Mecca for male-to-female sexual reassignment surgery (SRS).  While some of Thailand’s surgeons have been vilified for lacking in qualifications, there is no denying they have the most experience. Coupled with the country’ s lax laws on transgender surgery, hundreds of gender-unhappy tourists and locals flock to Bangkok’s plastic surgery clinics every month.
“Most of my clients are Thai and work in bars and other entertainment venues,” says Dr Thep, a surgeon from the the Pratunam Poly Clinic, a facility specializing in male-to-female SRS operations. The Pratunam Poly Clinic charges just $1600 USD for the procedure, compared to $25,000 in the West.
The actual operation is known as “penile inversion vaginoplasty” involving castration and inverting the skin from the penis and scrotum to create a neovagina. The depth of the new vaginal cavity depends on the size of the penis. “The most common complaint is that the cavity is not big enough,” reports Dr Thep. “In this case we can perform a colon vaginoplasty six months later using skin from the colon to extend the vagina.”
 The entire operation takes two-and-a-half to three hours. Six days after the procedure, patients can be discharged from hospital. Two months later they can engage in sexual intercourse, functioning as a woman by almost every definition of the term.
The end result will not only enable patients to walk away with a new orifice, but with techniques developed over the last five years, surgeons can now construct a clitoris and maximize vaginal sensation. Dr Thep claims most patients can even reach orgasm.
Transsexuals sporting a ‘neovagina’ are technically no longer faking it - they have become the real thing… even better than the real thing according to some.
“Everything is just like a girl, you get me? EVERYTHING!” insists Bonny, the proud boyfriend of Oy, the former Miss Tiffany’s Universe, the world’s leading ladyboy beauty pageant. Bonny is and always has been straight. “I didn’t know she was a boy when I first met her. I was really shocked when a friend told me” recalls Bonny. “Oy is just like a girl so there’s no difference for me. Some of my friends are even jealous because she’s so beautiful.”
Oy’s success in winning the 2004 Miss Tiffany’s Universe title was a teenage dream fulfilled. At the green age of 15 years, Oy traversed to Japan to undergo SRS. While Thailand is cheap, she says, the procedure in countries like Japan is better, though far more expensive.
Previously, many Thais had to travel to Japan or Singapore for their plastic fantastic fix. Today, foreign tourists are traveling to Thailand, lured by the cheap prices and a holiday in the tropics thrown in. Indeed, this is the marketing strategy employed by the Tourism Authority of Thailand to attract medical tourists to multi-billion baht institutions like Bamrungrad Hospital.
As well as cost-effectiveness and vacation options, Thai law is also one of the most lackadaisical against transgenderism.
 “Unlike China and other countries, Thailand is very liberal,” comments Dr. Thep. “The law here doesn’t interfere in the relationship between doctor and patient. A colleague from Pakistan said this kind of operation is very difficult to carry out in Islamic countries.”
Many have cited Thailand’s Buddhism as the reason why transgenderism is so visible and ostensibly tolerated in this country. But although ladyboys or katoeys are not considered sinful, they aren’t exactly regarded with equality. According to Thai Buddhist tradition, neither katoey nor women can reach enlightenment in their lifetimes. Superstition also warns that a man who commits adultery will be reincarnated as a katoey in their next life as a form of punishment.
The media are also responsible for perpetuating stereotypes of katoeys. At a recent international conference on Asian Queer Studies in Bangkok in July, the media were condemned for portraying ladyboys as hysterical, hypersexual, immodest, abnormal and unnatural characters. While representations of katoeys are prevalent on Thai television and film, they are often denigrated to humiliating roles of jokers or lower-class citizens.
The media is both a reflection of and a projection of social ideologies, but cultural prejudice against transsexuals goes much deeper. While there are no laws or regulations in Thailand against transsexual surgery or transgenderism per se, discrimination and stigma remains institutionalized against katoeys.
For example, even after SRS, transsexuals are legally forbidden to change their gender on any official documents. “After the surgery everything was perfect, I was finally who I always wanted to be. I would have really liked to change my name on official documents, but I can’t do that here,” laments Oy. But this restriction can cause more problems than confusion at immigration offices overseas. The proscription means transsexuals remain unprotected by rape laws because the official definition of rape only encompasses women and by legal definition, transsexuals are still men. Furthermore, katoeys with breasts are immediately barred from undertaking the medical examination for military conscription because of their overly feminine appearance.
 However, the dismissal carries with it an official notice stating mental illness as the reason for the discharge.
That transgendered individuals are considered mentally retarded is a common perception even among SRS surgeons. A paper by Dr Preecha Tiewtranon, considered the “godfather” of SRS in Thailand after he pioneered the surgery in the kingdom in 1975, views transexualism as a “gender identity disorder.” The paper published only last year suggests patients should first be cured of the syndrome with conventional psychiatric and endocrinologist treatment before surgery is considered.
The archaic notion of transsexuals as suffering from a psychological disease widespread among medical experts and practitioners is exacerbated by the fact that few lobby or activist groups advocate the plight of katoeys.
But the picture is not entirely grim with many families welcoming their new “daughters” with open arms. “My family accepts me for who I am without being judgmental. My mother even paid for my operation, but my father still doesn’t know,” admits Tete, this year’s Miss Tiffany’s Universe runner-up.
As our attitudes become more liberal and progressive, we can only hope changes will follow in the wider community.
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