ARTICLES ON GENDER REASSIGNMENT SURGERY

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Transsexual, Law and Medicine in Thailand
From Journal of Asian Sexology   

Transsexual, Law and Medicine in Thailand
by
Sanguan Kunaporn
Phuket Plastic Surgery ,Phuket, Thailand

okThis study is aimed at revealing the correlation between transsexual and medicine and law in Thailand. The method of study composed of documentary research, medical record analysis, personal interviews and mass media tracking.

Live openly

At present both M-F and F-M transsexuals can live openly in Thai society. They are relatively safe and are not subjected to violence. Nowadays, young people in schools and university students openly show their gender dysphoric tendencies. As their parents seem to accept it, these young people are not subjected to seek help from psychologists or psychiatrists. Moreover, transsexuals receive regular coverage from the mass media such as in television news, programs and the press. They are celebrities in various professions like entertainers, film stars, models, make-up artists and transsexual cabaret show girls. Among these are a well known singer, a boxer, Thailand's volleyball champion, and the winner of the World's Transsexual Beauty Contest. 

   Stories of two weddings involving transsexuals in 2000 received much publicity from the media. One was a wedding between a Thai F-M transsexual and a genetic woman film star. The other story was of two British M-F transsexuals who got married in Thailand a few days after their gender reassignment surgeries.

   It is common to see transsexual both in comic and more serious roles in television plays and films. A good example of this is the Thai film "The Iron Woman" about a Thai male volleyball team, made up mostly of M-F transsexuals. Despite pressure from everyone including the opponents, they were so dedicated in their training that finally they won the Thai Volleyball Championship title. This film hit the record for ticket sales in Thailand and was warmly welcomed among other Asian countries like Hong Kong and Taiwan where transsexuals are normally less tolerated. This then is a proof that the public more than well accepts the existence of transsexuals in Thailand.

   More and more transsexuals are seeking sex reassignment surgery (SRS) as the final conclusion to their transsexual situation. But before this final step, two other preparatory steps should to be taken.

Psychiatric Help

   Unlike western transsexuals, Thai transsexuals generally do not turn to psychiatrists or psychotherapists to be cured of having conflicting desires to be and live in the opposite gender nor for support in overcoming the thick wall that blocks these strong desires.

   One of the reasons for this is the fact that Thai culture and society teach one to turn to friends, siblings, parents or teachers and tutors rather than psychiatrists for emotional or psychological support. Only people with real psychotic or psychopathic disorders seek psychiatric help. Also in Thai laws there are no regulations requiring transsexuals to have a letter of approval from a psychiatrist or a therapist before obtaining SRS. So Thai transsexuals have a better chance of living in the role of their preferred gender without outside interference since their early age.

Hormone Therapy

   Thailand has a negative reputation of too easy accessibility to prescribed medicine. Unaware of possible adverse effects, transsexuals will follow their friends' examples by obtaining hormone tablets or injectibles from pharmacies without prescription.

Sex (Gender) Reassignment Surgery (SRS, GRS)

   Certain medical schools in Thailand require that SRS applicant enter the psychological and hormonal preparation program prior to being accepted for surgery, other private clinics or hospitals will perform SRS without prior psychological assessment. But up till now there has been no report of any post-op transsexuals wanting to revert to their previous gender or taking legal actions against the surgeon who performed sex reassignment surgery for them. Since SRS is recognized as a scientific way of treating a psychologically unbalanced condition, there are no valid grounds or specific law prohibiting Thai surgeons form performing SRS.

   In recent years, transsexuals from all over the world have recognized Thailand as a center of high quality SRS at reasonable cost. Thai hospitality and social acceptance are also key factors determining the increase in the annual number of overseas candidates.

   The following table shows the average age of M-F transsexuals who has SRS at Phuket Plastic Surgery Clinic during January 1997 and December 2000. These figures do not include patients from many other countries with less significant total.

   The average age of Thai transsexuals receiving SRS is 26.7 years whereas that of US is 50.5 years. Almost 100% of Thai transsexuals have never been married and have never had any children before SRS. Two of Japanese patients have been married and have had children before SRS. More than half of Western transsexuals have been married at least once, some twice and some three times and have had children.

   Thai M-F transsexuals seeking SRS are younger. They generally look and behave very natural as genetic women. Because of this, it is obvious to any non-medical person that they are qualified candidates for the surgery. On the other hand, most of the American transsexuals come out when they are much older, many do not pass so we as females. Therefore it is necessary for them to have the help of therapists or psychiatrists to help assess their condition and confirm that they are true transsexuals, eligible for SRS.

Legal aspects

   In 1990 Jackrapan Sornsuparp(1) has conducted s study in Thailand about the general opinion on transsexual and the law recognizing the post-op transsexual in the newly reassigned gender. 35.7% of the general public think that SRS is an effective form of treatment of transsexualism and that there should be a law that recognize them in their new gender after SRS.

Average age of M-F transsexual receiving SRS between 1997-2000
Phuket Plastic Surgery Clinic, Phuket, Thailand

Nationality

Average age
(Years)

Lowest age
(Years)

Highest age
(Years)

Total number

Thai  26.7 19 45 79
Japanese  39.3 19 54 8
English  39.0 26 53 5
Australia/NZ 40.8 25 50 7
USA/Canada  50.5 22 65 66
All 37.8 19 65 165

   29.5% of the population does not agree with SRS at all. The remaining 34.8% tend to agree with the surgery itself but is split in their opinion about whether there should be a law recognizing the new status concerning gender or not.

   Jackrapan Sornsuparp(1) has also conducted studies on views of pre-op, post-op and potential transsexuals. In the group of post-op transsexuals, 30% have considered but never attempted suicide. After surgery no one has any such ideas anymore. 70% of post-op transsexuals report of having no legal problems in their new role, but 30% encounter problems when dealing with government agencies or in legal matters.

   In legal aspect, all transsexuals wish to have a law that recognizes their new status after surgery. They do not think that they should need to seek approval from any government committee or officials for SRS.

Current legal situation 

   There are legal problems for post-op transsexuals because there are laws relating specifically to male or female gender, such as criminal laws pertaining to sexual offenses, rapes and sexual assaults. Thai Military Drafting Law states that all Thai males are obligated to become candidates for the drafting process for the military service. In Family Law, there are many major discrepancies such as marriage law, engagement law, divorce law, marriage dissolution law. Inheritance Law.

   In 1981 in Thailand, a post-op M-F transsexual requested a court ruling for a change of status to female and to have her personal records officially changed. The Civil Court, the Court of Appeal and finally the Supreme Court all denied her the right. Gender is another status of an individual. Like nationality, place of origin or the status of being a parent or a child to someone, it is a legal status assigned to an individual at birth. Any changes to be made have to be under the regulations set down by law. A gender change cannot be legally recognized since there is no law supporting the act. In conclusion, the rights, responsibilities and capabilities of an individual as determined by law according to the status cannot be changed because of a sex reassignment surgery (2).

   At present, Thai society is acknowledging the existence of transsexuals. If enough people join forces and demand a bill to be passed recognizing transsexuals as having the status of their new sex, then there would be a big change in Thai society.

Conclusion

   In conclusion, social flexibility has made it possible for transsexuals to live without serious harassment. Medical and health care system allows them to fulfill their physical change easily. But according to Thai law, it will be a long time yet into the future before post-operative transsexuals will obtain legal recognition in their new gender after the SRS.

References

   1) Jackrapan Sornsuparp, "Legal problems on sex transformation and the postoperative Transsexuals", A thesis submitted in Partial fulfillment of the requirements for the degree of master of Laws, Department of Law, Chulalongkorn University (1990), Page 185-212, ISBN 974-577-051-5.

   2.) Komain Pathrapirom. "Sex reassignment surgery according to the law maker's point of view", BotBandith 29 (1972), page 698-704.

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