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A significant number of Thais perceive kathoey as belonging to a third sex, including some transgender women themselves.
Most trans women in Thai society refer to themselves as phuying (Thai: ผู้หญิง 'women'), with a minority referring to themselves as phuying praphet song ('second kind of woman') and only very few referring to themselves as kathoey.
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.
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.
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 antiquity to refer to intersex people, and that the connotation changed in the mid-20th century to cover cross-dressing males.
Families (and especially fathers) are typically disappointed if a child becomes a kathoey, and kathoeys often have to face the prospect of disclosing their sexuality.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would formalize the ban, which would extend to all campuses at the start of the 1997 academic year.The ban was quietly rescinded later in the year, following the replacement of the Minister of Education., satree lek), later portrayed in two Thai movies, won the Thai national championship.Patients must be at least 18 years old with permission from parents if under 20 years old.One must provide evidence of diagnosis of gender dysphoria from a psychologist or psychiatrist.