However, at the lower end of the market, clinics have responded to demand from teenage boys to look more like girls by posting Internet advertisements offering castration for as little as 4,000 baht ($125).Demand for teenage boys to look more like girls? Is this driven by particularly harsh economic considerations, or is it an extreme manifestation of fashion?
Why are there so many kathoey/ladyboys though? Are most of them ladyboys for commercial reasons (i.e., it being a good way to make money from tourists), or does Thailand have a higher-than-average incidence of gender-dysmorphic disorder?
The price of SRS in Thailand is really expensive, and beyond the budget of most <i>kathoey</i> (what you call 'ladyboys') who aren't on high incomes. No, it's not about extreme fashion; basically, Thailand has a very high population of transpeople, and many of them are only able to access really crappy healthcare -- such as el cheapo castrations.
As you might know, cosmetic surgery is really huge in Thailand, boh for tourists and Thais. Thus far the medical tourism industry has been pretty unregulated; the Thai government is just starting to attempt to regulate it. Access to gender reassignment surgery has <i>never</i> been regulated or subject to psychiatric evaluation in Thailand. Since Western transpeople started travelling there for GRS in droves, the government has recognised that this particular market needs to be seen to be 'respectable' and compliant with international standards around who can access surgery. I doubt they will be regulating the tourist-driven market, because it's so lucrative, but o