Thailand's Teen Castration Ban Splits Doctors, Gay Campaigners

By Shanthy Nambiar and Suttinee Yuvejwattana

Aug. 5 (Bloomberg) -- Paiboon Marvin started wearing dresses and makeup before he became a teenager. Now 16, he wants to be castrated as the next step toward becoming a woman.

Until recently, that wouldn't have been a problem: Boys of any age in Thailand could have their testicles removed for as little as 5,000 Baht ($150) with no questions asked. Now Paiboon may have to wait two years because the procedure will be outlawed for those under 18, after pressure from gay rights activists who say youngsters may follow a trend and regret it later.

“I don't think I'm too young to do it,” says Paiboon, wearing a green-ribboned top, shorts, mascara and pink lipstick. “I know I won't change my mind. I've known since I was a kid that I'm not male.”

The business school student has support from doctors who perform more than 1,000 castrations and sex-change operations annually in the Buddhist kingdom, which has one of the world's largest transsexual communities. They argue many minors seeking castration have gender identity disorder and surgery is an essential treatment.

“We should respect their decisions and age shouldn't be a fixed requirement,” says Aurchat Kanjanapitak, president of the Medical Association of Thailand, which represents 4,500 doctors. “If someone happens to have a woman's heart in a man's body and doesn't want to keep his testicles, the change should be allowed.”

‘Herd Mentality’

The Ministry of Public Health in April suspended all castrations, except to treat life-threatening conditions, while the Medical Council of Thailand draws up the first regulations governing the nation's sex-change industry.

The rules, due by year-end, will forbid the castration of boys under 18, while those under 21 will need parental approval and psychoanalysis before undergoing the procedure, says the council's secretary-general, Amnaj Kussalanan.

“Sometimes kids may make decisions carelessly because it is fashionable, or because they have insufficient information or a herd mentality,” Amnaj says.

There are about 180,000 transgender people in the country of 66 million, according to Sam Winter, a psychologist at the University of Hong Kong who studies transgender issues in Asia. Castration is often a precursor to full sex-reassignment surgery.

Buddhist teachings hold that people can be reincarnated as males or females, which makes Thais tolerant of gender swapping, says Robert Thurman, a professor of Indo-Tibetan Studies at Columbia University, New York.

“The hysteria about sex is something special to the West,” he says.

Beauty Pageants

Kathoeys, a Thai term meaning “ladyboys” that applies to men who live as women, are a common sight in Thailand. Often dressed in high heels, with fake eyelashes and polished nails, they work as makeup sales staff, waitresses and hotel receptionists. Some end up in the sex trade.

Transsexual beauty pageants are popular, including the largest, “Miss Tiffany's Universe,” which is broadcast live on television. The Kampang School in northeastern Thailand built separate unisex toilets after a survey showed 200 of its 2,600 secondary-level students were transsexual.

“Sexual preferences can change as you grow older,” says Natee Teerarojjanapongs, the Bangkok-based coordinator of the Sexual Diversity Group, who led the campaign to regulate the sex- change industry after he met boys as young as 15 who wanted to go under the knife. “You can't change it back.”

Wrong Decision

Noon, a receptionist at a Bangkok hotel who asked to be identified by her nickname, became depressed after her sex change at 19.

“Right after the operation, I started feeling that maybe it was wrong,'' says Noon, 28. ``I wasn't ready for the surgery.”

Noon cut her hair short at 21 and tried dressing as a man again. ``I wasn't successful,'' she says. ``There should be some control on sex-change and castration operations.''

Thailand's regulation vacuum means some clinics fall short of international recommendations on standards of care from the Minneapolis-based World Professional Association for Transgender Health Inc., which advises against surgery on those under 18.

“It is extremely unusual for anyone aged under 18 to be offered surgery anywhere in the world,” according to guidelines published by the U.K.'s Department of Health, titled “Medical Care for Gender Variant Children and Young People.”

Even so, some doctors in Thailand are unhappy with the proposed age rule.

Boys should be allowed to “express their feeling,” says Thep Vechavisit, 55, who has castrated patients as young as 17 with parental consent and is preparing a lawsuit to challenge the new guidelines.

“They're in a very stressful situation, psychologically and socially,” says Thep, who charges 5,000 baht for a castration at his Pratunam Polyclinic in central Bangkok.

Paiboon, who first had to overcome opposition from his mother, can't wait. He's turned to the Internet to find a surgeon prepared to operate in secret.

“It's my own money, my own body,” he says. “It's nobody else's business.”

To contact the reporters on this story:

Shanthy Nambiar in Bangkok at [email protected]

Suttinee Yuvejwattana in Bangkok at [email protected].

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I think a person should be a sane adult before the medical profession proceeds with a gender change.

What would the world be like if everyone could choose their gender?

Upon being born you would be a pure eunuch with neither male or female sex organs.

Upon graduation from high school you then choose your gender.

Male, Female, or stay Eunuch.

Couples could be MM, MF, FF, ME, FE, EE and any combination would be completely acceptable by all.

Reproduction would be done by joining sperm and egg from two consenting adults in "medical wombs" (known as baby bottles) in hospitals. Babies would not be produced within a woman's body. This completely eliminates reproduction via accident or rape and makes reproduction a pre-conceived intentional act. No need to worry about the baby's gender.......all babies are born as eunuch.

What if you didn't like your choice of gender, you could request a one time change.

Eunuch's could become male or female.

Males could become female.

Females could become male.

After this one time change, if it still didn't work out you could request to go back to eunuch, but that would be permanent.

If you sexually abuse someone, you are returned to eunuch.

This might make a fascinating, but wierd, futuristic movie. If done with realism it might not qualify for an R rating though.

Made long ago a move was made called: "A Boy and his Dog". What ultimately happens to the boy was one of the most wierd things I ever saw in a movie. (but then I don't see very many movies).

I hope no one minds if I resurrect this thread, but I am curious how things have developed now that this ban has been in place for a couple of years.

Most internet searches point to the original articles about the ban, and it is hard to tell what is happening now. I suspect the doctors in Thailand are trying to keep a low profile now that they are under strict legal scrutiny.

I look toward Thailand as a place that is well ahead of the US when it comes to dealing with gender. Granted there have been some very unscrupulous doctors who took advantage of young katoey, and I understand that this is the reason for the crackdown, but I worry that the unintended consequence of all this is likely to lead to an environment where the medical profession tends to withhold treatment rather than provide it.

One thing I know is that there will always be "cutters" who will take advantage of a situation like this, and I think this ban will tilt the playing field in their favor.

I know there has been some backtracking on the ban and that adults can still get an orchiectomy, but beyond that... I can find very little.

It is forbiden to castrate under age boys but it is possible for an adult man to be castrated.

http://tribes.tribe.net/nullos/thread/d ... 8994d3ebc1

http://www.srsthailand.com/

Thank You jacques0.

http://www.doctorsaran.com/procedure.ph ... dure_id=23

It says:

Criteria

Patient must be at least age 18 years of age. Patients will require permission from parents if under 20 years old.

Patients must be diagnosed with at least one of the following disorders: gender identity disorder, gender dysphoria, or associated conditions (anxiety, depression).

Patients must have undergone at least one year of antiandrogens or/and hormones.

Patients are required to have lived full-time in the cross-gender role for at least 1 year (supported by Identification Documents).

Patients must have approval from a psychiatrist (MD), psychiatric social worker (PhD), or clinical psychologist (PhD).

----------------------------

I wonder how should one behave and what he must wear if he has eunuch gender identity

I guess that is what they request for male to female SRS but for male to eunuch it is different.

Some clinics probably have criteria that exceed requirements set by the government of Thailand. Certainly there were people willing to do orchiectomys with no letters of recommendation before the ban.

Before the ban, there were too many under age boys, who'd get castrated at low cost ($100.)at doctors offices and some time they were just cutters and they had problems. If you read carefully the letter from the clinic, the doctor made it clear that no adult man will be refused, the 2 spys will not try to dissuade any patient sent by the clinic. It is just a formality that will take just few minutes to protect the clinic. The cost is cover by the clinic and you can probably get the surgery the same day. I've never heard of any other clinic, any where, around the world that makes it so easy.

my problem is i don't want to be a chick. I am buit well and a dude and i want to keep that, i just want to have a vag instead of a cock and balls. And i don't know if i can get that done without lying. Like I am a dude and would be after, just no more nasty penis, and instead of a stub i could have something with sensation