Thailand has gained renown as a Mecca for all forms of cosmetic surgery. Besides being relatively inexpensive when compared to the West, the nation has many doctors with world-class credentials in the field of sex reassignment.

Dr. Preecha Tiewtranon, president of the Society of Plastic and Reconstructive Surgery of Thailand, is one of the "deans" of the Thai sex change business. He started performing the operations 25 years ago after stints at John Hopkins and Stanford in the U.S.

He has built a formidable reputation, not only medically, but aesthetically as well. The Internet abounds with web pages singing his praises and offering step-by-step advice on coming to Bangkok for the operation.

"Most Asian doctors have very small and delicate hands," Dr. Preecha comments, "and they also are very careful to consult with the patient so that results come first." Thai doctors clearly relish their reputation as being as much artisans as surgeons.

When not in the operating room, Dr. Preecha teaches his techniques to medical students at prestigious Chulalongkorn University. His workshops were conceived of as a way to bring foreign currency into the country and enhance the standing of Thai surgeons in the field. His
former students now have thriving sex reassignment practices in the regional cities of Pattaya, Phuket, and Chiang Mai.

Dr. Preecha performs the operations three times a week on foreigners while his assistant handles about the same number of Thais. It is not surprising that foreigners have flocked here for care. While Thailand is not a place where transsexuals go unnoticed or are never condemned, different lifestyles are certainly more accepted and visible than in the West.

Transsexuals are often featured in newspapers and on television. Flamboyant cabaret shows featuring female impersonators are in every large city. The Thai public has an intense interest for all news concerning transsexuals. When a suitably ironic story comes along, a media circus can result.

One such media event was the coverage of Prinya Kiatbusaba, better known by his nickname, Nong Tum.

Nong Tum, a transvestite boxer, always entered the ring in full makeup. He eventually became a staple of the "Strange News"-type columns in the Western press that report on the "wacky things" that happen in foreign countries. Once Nong Tum retired from boxing to pursue a career in singing, the irony was gone and he vanished from the international press.

Audience acceptance of a gay-themed film in 1999 also demonstrated prevailing attitudes. Satree Lex (Iron Ladies) is the true story of a volleyball team composed mainly of gay men that won the national championships in 1996. It chronicled the trials and tribulations of being gay and the roadblocks the team faced in spite of their volleyball skills.

Crowds flocked to it, making it a nationwide blockbuster.
In official circles, there is some trepidation about how Thai transsexuals are viewed by the rest of the world. Thais go to great lengths to avoid being judged, and feel quite embarrassed when they are - so gaudy female impersonators are often not the image some in Thailand want to project abroad.

Television stations have been asked to limit the number of effeminate men they show on TV so as to not unduly influence young people. And those who permanently change their sex face other burdens - changing one's sex legally (as on official documents) is still not permitted.