Finding a Path in a Broken System

June 8, 2022 4:51 AM

Thailand is a top destination for gender affirming surgery. Low costs are only the tip of the iceberg.

"Since the first operation in 1975, Thailand has gained a reputation as the global expert in this niche field: Foreigners made up 90% of GCS patients between 2010 and 2012. But what is driving this thriving industry in the country goes well beyond the comparatively low cost of care. Over a period of six months, I spoke to a group of trans women* to better understand why many would rather fly halfway across the world than receive GCS at home. Coming from the U.S., the U.K., Norway, Bulgaria, Israel, Canada, and Australia, and facing different personal and social circumstances, they were united in their conviction that their home countries had not presented them with good options and that they had to take matters into their own hands."

This article goes into great depth regarding the gatekeeping, bureaucracy, and bigotry that many trans people who seek surgery often face, and how Thailand has long been a beacon of hope for many of these people. (CW for depression, suicide, graphic details of surgery)
posted by Aya Hirano on the Astral Plane (10 comments total)

Anecdata: I know several women who went to Thailand for their surgeries, and it went well for them.
posted by rmd1023 at 6:10 AM on June 8, 2022 [7 favorites]

I'm lucky to both have insurance that covers bottom surgery, and live in a place where there are multiple options for providers to do it. It certainly seems like this method would have had fewer hoops to jump through than I needed just to get a simple orchiectomy. To say nothing of the back and forth with my insurer and provider about whether my in-network surgeon was actually "in-network"...

Sadly, my current insurance does not cover Facial Feminization Surgery, which (aside from electrolysis for my facial and chest hair, which my insurance also doesn't cover) is the only other surgical intervention in my transition that I'm actively considering. Perhaps a trip to Thailand wouldn't be a bad idea after all..
posted by SansPoint at 7:32 AM on June 8, 2022

It seemed like everyone mentioned in the article was undergoing feminization surgery -- though maybe I glossed over some other examples. Is Thailand not the destination for men undergoing GCS? Or is that less common in general?
posted by jacquilynne at 7:47 AM on June 8, 2022 [3 favorites]

Is Thailand not the destination for men undergoing GCS?

It is. Many hospitals and clinics also offer top and bottom surgery for trans men and masc AFAB people. Generally speaking the media coverage of trans medical care tends to focus on trans women for various reasons. But if you search for FTM surgeries in Thailand there are lots of practitioners who offer all of the surgeries and advanced techniques that are often difficult to find in the West.

One complication for trans men who want phalloplasty (creating a penis) is that the procedures have to be done in a number of stages, usually 4, with 3 - 6 months passing between each stage and surgery to allow things to heal. Obviously if you're going to Thailand for these surgeries it can be much more expensive and risky in terms of travel/timelines than going out for a single surgery.
posted by fight or flight at 8:01 AM on June 8, 2022 [8 favorites]

I do not discuss bottom surgery on Metafilter on any sort of detail. Thailand is not one of the major traditional destinations for transmasculine people from North America or Europe seeking bottom surgery. (Nor is it for top surgery, but that is drastically easier to access.)
posted by hoyland at 8:57 AM on June 8, 2022 [2 favorites]

From the article: In 2020, Jezebel reported shocking surgical results at the hands of Dr. Kathy Rumer, a U.S. surgeon.
Wow, that strikes close to home. She was my surgeon, and while she did fine at that job, I saw exactly the same issue with her that the Jezebel article describes. She is recklessly insensitive in dealing with post op care.
posted by Flight Hardware, do not touch at 10:25 AM on June 8, 2022 [4 favorites]

I did this, back in 2010, going to the Suporn clinic highlighted in the article. I made the trip solo and, honestly, the after care alone really was amazing, as was the opportunity to bond with other patients during the month long stay there in Chonburi. Totally unlike any patient experience I've ever heard of in the U.S., and I never had the least regret about my choice of surgeons.
posted by Pryde at 10:57 AM on June 8, 2022 [28 favorites]

A top criteria for choosing any surgeon is pick one that has done the procedure a lot.
posted by sammyo at 3:05 PM on June 8, 2022 [1 favorite]

The article was really interesting and informative. Thanks for sharing! I especially appreciate reading about MeFites personal experiences here too.
posted by smorgasbord at 8:14 PM on June 8, 2022

A friend of mine had a second round of bottom work done in Thailand. Going back through her facebook to see how she described it, I ran into her description of the pain and problems after her first bottom surgery. I haven't found the entries from Thailand, but from what I remember, she had a much better time and felt like she was treated better.
posted by Hactar at 9:03 PM on June 8, 2022