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There are actually slight differences between ladyboys and transgender women as a whole. Ladyboy is the not so literal English translation for Kathoey. It is a Thai term that is very close to being the equivalent of a transgender woman. It can also encapsulate effeminate gay men. It is unclear what is the exact origin of the word.

A significant number of Thai people perceive kathoey as belonging to a separate sex, including some transgender women themselves. In the face of the many sociopolitical obstacles that kathoeys navigate in Thailand, kathoey activism has led to legal recognition as of January Although kathoey is often translated as ' transgender woman ' in English, this term is not correct in Thailand. As well as transgender people, the term can refer to gay men , and was originally used to refer to intersex people. Use of the term kathoey suggests that the person self-identifies as a type of male , in contrast to sao praphet song which, like "trans woman", suggests a "female" sao identity , and in contrast to phet thi sam 'third sex'. The term phu ying praphet song , which can be translated as 'second-type female', is also used to refer to kathoey. Many dress as women and undergo "feminising" medical procedures such as breast implants , hormones , silicone injections, or Adam's apple reductions.

But, of course, they are people — not a tourist attraction — leading mostly normal lives. Bangkok is home to one of the largest ladyboy communities in Thailand, and they can often be spotted at work or out walking the city streets. Thai ladyboys are an accepted part of Thai culture, and are generally widely regarded as something usual — particularly in the cities of Bangkok and Pattaya. In the west, the ladyboys of Thailand have become synonymous with sex tourism, but this is not necessarily an inevitable life path for them, with many leading their lives in normal, jobs.

A Ladyboy or Katoey in Thai is a transgender or a transsexual and most of them are based in tourist neighborhoods. People from South-East Asia have some very specific physical predispositions that allow a lot of people to easily change their gender unnoticeably. Ladyboys are perceived differently by different kinds of tourists.