: Gender reassignment surgery (GRS) is a specialized surgical process that transforms male genitalia into female structures.

: Unlike many Western societies where gender is binary, Thai culture historically recognizes a "third sex." Some Buddhist beliefs suggest being born as a kathoey is a result of karmic actions in a previous life.

: Some individuals use contraceptive pills, often available without a prescription in Thailand, to increase female hormones during their transition.

: Some Thai schools have officially recognized a third gender, even creating specific facilities for kathoey students to ensure a supportive environment.