Thailand's Teen Castration Ban Splits Doctors, Gay Campaigners

[LaoPo]

Thailand's Teen Castration Ban Splits Doctors, Gay Campaigners

By Shanthy Nambiar and Suttinee Yuvejwattana

Paiboon Marvin, 16, sits in the food court of a shopping mall outside of Bangkok, July 26, 2008. Photographer: Adam Oswell/Bloomberg News

Aug. 5 (Bloomberg) -- Paiboon Marvin started wearing dresses and makeup before he became a teenager. Now 16, he wants to be castrated as the next step toward becoming a woman.

Until recently, that wouldn't have been a problem: Boys of any age in Thailand could have their testicles removed for as little as 5,000 Baht ($150) with no questions asked. Now Paiboon may have to wait two years because the procedure will be outlawed for those under 18, after pressure from gay rights activists who say youngsters may follow a trend and regret it later.

``I don't think I'm too young to do it,'' says Paiboon, wearing a green-ribboned top, shorts, mascara and pink lipstick. ``I know I won't change my mind. I've known since I was a kid that I'm not male.''

The business school student has support from doctors who perform more than 1,000 castrations and sex-change operations annually in the Buddhist kingdom, which has one of the world's largest transsexual communities. They argue many minors seeking castration have gender identity disorder and surgery is an essential treatment.

``We should respect their decisions and age shouldn't be a fixed requirement,'' says Aurchat Kanjanapitak, president of the Medical Association of Thailand, which represents 4,500 doctors. ``If someone happens to have a woman's heart in a man's body and doesn't want to keep his testicles, the change should be allowed.''

Paiboon Marvin, 16, looks at clothing in a shopping mall outside of Bangkok, July 26, 2008. Photographer: Adam Oswell/Bloomberg News

`Herd Mentality'

The Ministry of Public Health in April suspended all castrations, except to treat life-threatening conditions, while the Medical Council of Thailand draws up the first regulations governing the nation's sex-change industry.

The rules, due by year-end, will forbid the castration of boys under 18, while those under 21 will need parental approval and psychoanalysis before undergoing the procedure, says the council's secretary-general, Amnaj Kussalanan.

``Sometimes kids may make decisions carelessly because it is fashionable, or because they have insufficient information or a herd mentality,'' Amnaj says.

There are about 180,000 transgender people in the country of 66 million, according to Sam Winter, a psychologist at the University of Hong Kong who studies transgender issues in Asia. Castration is often a precursor to full sex-reassignment surgery.

Buddhist teachings hold that people can be reincarnated as males or females, which makes Thais tolerant of gender swapping, says Robert Thurman, a professor of Indo-Tibetan Studies at Columbia University, New York.

``The hysteria about sex is something special to the West,'' he says.

Paiboon Marvin, 16, examines beauty products at a cosmetics counter in a shopping mall outside of Bangkok, July 26, 2008. Photographer: Adam Oswell/Bloomberg News

Beauty Pageants

Kathoeys, a Thai term meaning ``ladyboys'' that applies to men who live as women, are a common sight in Thailand. Often dressed in high heels, with fake eyelashes and polished nails, they work as makeup sales staff, waitresses and hotel receptionists. Some end up in the sex trade.

Transsexual beauty pageants are popular, including the largest, ``Miss Tiffany's Universe,'' which is broadcast live on television. The Kampang School in northeastern Thailand built separate unisex toilets after a survey showed 200 of its 2,600 secondary-level students were transsexual.

``Sexual preferences can change as you grow older,'' says Natee Teerarojjanapongs, the Bangkok-based coordinator of the Sexual Diversity Group, who led the campaign to regulate the sex- change industry after he met boys as young as 15 who wanted to go under the knife. ``You can't change it back.''

A Miss Tiffany 2008 pageant contestant walks up to the stage at Miss Tiffany Theater in Pattaya, Thailand, May 25, 2008. Photographer: Adam Oswell/Bloomberg News

Miss Tiffany 2008 pageant contestants stand on stage at Miss Tiffany Theater in Pattaya, Thailand, May 25, 2008. Photographer: Adam Oswell/Bloomberg News

Wrong Decision

Noon, a receptionist at a Bangkok hotel who asked to be identified by her nickname, became depressed after her sex change at 19.

``Right after the operation, I started feeling that maybe it was wrong,'' says Noon, 28. ``I wasn't ready for the surgery.''

Noon cut her hair short at 21 and tried dressing as a man again. ``I wasn't successful,'' she says. ``There should be some control on sex-change and castration operations.''

Thailand's regulation vacuum means some clinics fall short of international recommendations on standards of care from the Minneapolis-based World Professional Association for Transgender Health Inc., which advises against surgery on those under 18.

``It is extremely unusual for anyone aged under 18 to be offered surgery anywhere in the world,'' according to guidelines published by the U.K.'s Department of Health, titled ``Medical Care for Gender Variant Children and Young People.''

Even so, some doctors in Thailand are unhappy with the proposed age rule.

Boys should be allowed to ``express their feeling,'' says Thep Vechavisit, 55, who has castrated patients as young as 17 with parental consent and is preparing a lawsuit to challenge the new guidelines.

``They're in a very stressful situation, psychologically and socially,'' says Thep, who charges 5,000 baht for a castration at his Pratunam Polyclinic in central Bangkok.

Paiboon, who first had to overcome opposition from his mother, can't wait. He's turned to the Internet to find a surgeon prepared to operate in secret.

``It's my own money, my own body,'' he says. ``It's nobody else's business.''

From Bloomberg Exclusive:

http://www.bloomberg.com/apps/news?pid=206...refer=exclusive

LaoPo

[Jingthing]

Cheeky monkeys!

This isn't exactly the same as getting a tatoo or a piercing! The fact that some Thai doctors have been willing to do this operation on children says ALOT $$$$ about their priorities. It sounds like progress that the Thai government has drawn a line on this.

[G54]

"The rules, due by year-end, will forbid the castration of boys under 18, while those under 21 will need parental approval and psychoanalysis before undergoing the procedure, says the council's secretary-general, Amnaj Kussalanan."

Under 18 is definitely too young for castration. At last the authorities are doing something about this and I agree with that.

[PeaceBlondie]

Of course, to us Western-indoctrinated farang, 15 and 16 years old sounds much too young. To Thais who have seen boys dressing up before puberty, to Thais who address some boys in boys' clothing as "she," it may not be so young. Being Western, and having been a youth worker and father in the West, I recall too many confused teenagers who changed their minds about a lot of things. Irreversible surgery is too drastic to be done that early. I say, let them wear dresses and makeup, but save the surgical knife until later.

[lomatopo]

18 seems like a reasonable age limit, I'd vote for 21. Maybe offer them subsidized hormone treatments in the meantime, which yields similar results, but is not permanent. Note that this is just about removal of the testicles, and not the penis. (meat stays, two veg go; for our more erudite members).

I'd also vote for optional therapy and support groups aimed at offering counseling and guidance, and fostering discussion among, younger transgendered boys, just so they understand their options. I wouldn't want to change their minds but sometimes when you are young you might make irreversible decisions without all the facts. Hearing from older transgendered males, both positive and negative might be a good thing, and might even be made a compulsory requirement before the removal of body parts. It seems like a lot feel forced to get breast implants before age 22 as this assures military exemption, so it'd be nice if there was some alternative to standard military conscription/service as well.

[LaoPo]

Of course, to us Western-indoctrinated farang, 15 and 16 years old sounds much too young. To Thais who have seen boys dressing up before puberty, to Thais who address some boys in boys' clothing as "she," it may not be so young. Being Western, and having been a youth worker and father in the West, I recall too many confused teenagers who changed their minds about a lot of things. Irreversible surgery is too drastic to be done that early. I say, let them wear dresses and makeup, but save the surgical knife until later.

Well said PeaceBlondie, well said !

LaoPo

[farang prince]

I think it is good that Thailand is developing rules for sex-change industry. In the United States, all candidates for sex change surgery have to undergo one year of counseling prior to the surgery. The object of the counseling is not necessarily to convince patients not to have the surgery, but rather to prepare them for the physical and psychological changes such surgery brings.

[bangkokrick]

Of course, to us Western-indoctrinated farang, 15 and 16 years old sounds much too young. To Thais who have seen boys dressing up before puberty, to Thais who address some boys in boys' clothing as "she," it may not be so young. Being Western, and having been a youth worker and father in the West, I recall too many confused teenagers who changed their minds about a lot of things. Irreversible surgery is too drastic to be done that early. I say, let them wear dresses and makeup, but save the surgical knife until later.

I totally agree PB, but do you think that if this legislation is brought in that castration industry will just go under ground. If its legal at least it can be monitored and done to an acceptable standard.

I still remember when abortion was illegal in the UK, that women who required this service were forced into back street clinics, often with horrendous results.

Cheers, Rick

[elkangorito]

Just what Thailand needs...more rules. And of course, the more rules that abound here means that the more like western countries, Thailand will become. I think a reduction of rules is the way to go.

Controlling people by age limits is like trying to control the weather...you can't tell the weather when & how to behave. It simply doesn't work! The same goes for peoples' sexuality.

And who gives a shit if someone decides to do 'whatever' with THEIR body? Who died & made us gods of their lives? Most of us couldn't care less what others did to themselves yet some people insist supporting these 'control freak' rules, which will not affect any of us who have not chosen to undergo such sexuality change.

Aren't people allowed to make mistakes anymore? Aren't people allowed to be themselves anymore...right or wrong?

[Jingthing]

I understand the objection against Thailand becoming a nanny state similar to what alot of us left, but come on, little kids wanting to remove their balls and doctors taking money for that?

Edited August 7, 2008 by Jingthing

[LaoPo]

Aren't people allowed to make mistakes anymore? Aren't people allowed to be themselves anymore...right or wrong?

'People' is not the same as children of 16....

Think of it if it would be YOUR child who wanted to make such a drastic and irreversible surgery/sex change...

....would so say OK, kiddo..go ahead ?

LaoPo

[elkangorito]

I understand the objection against Thailand becoming a nanny state similar to what alot of us left, but come on, little kids wanting to remove their balls and doctors taking money for that?

Little kids? Please!

I knew I was gay at an early age (about 7). Due to "pressure" to "fit in", I hid this fact until I was much older (23). After 3 suicide attempts (up to the age of 23), I sought help & changed my life totally.

What I'm trying to say is that most people know who they are & what they want from a much earlier age than 18. Only "open minds" can assist those who embark upon such a transitional journey. Rules will do nothing but impede this process. Nobody can have any idea what these (transgender) people think. Rules have no place in this process of "becoming you"...for better or for worse.

Aren't people allowed to make mistakes anymore? Aren't people allowed to be themselves anymore...right or wrong?

'People' is not the same as children of 16....

Think of it if it would be YOUR child who wanted to make such a drastic and irreversible surgery/sex change...

....would so say OK, kiddo..go ahead ?

LaoPo

Why wouldn't you say "go ahead"? What have you got to lose? And don't give me that rubbish about "caring". Caring people respect the wishes of others without using a law or rule to assist themselves in their belief of "right & wrong". If you really care about your potentially "transgender" child, you will listen to them & offer constructive feedback...& then allow them to make up their own mind...for better or for worse.

I know/knew many people who, from the age of 10 or 12, knew EXACTLY who they were & what they wanted to be. Strangely, the "rules" only prolonged their agony toward their freedom. Sadly, many could not endure the agony of the "rules" & thus ended their lives early. Their families had no idea what was happening to their child.

This sword has two very sharp edges & one edge is sharpened considerably by these inane & religion based rules.

Edited August 7, 2008 by elkangorito

[Jingthing]

I think in the west we put children too much on a pedestal, try to protect them too much from real life realities. I just don't see the great harm in making tranny boys wait until 18 to take such a drastic, no going back, step, that they may indeed regret.

[elkangorito]

I think in the west we put children too much on a pedestal, try to protect them too much from real life realities. I just don't see the great harm in making tranny boys wait until 18 to take such a drastic, no going back, step, that they may indeed regret.

Why do you care so much what anonymous "tranny boys" do with their lives?

[Jingthing]

I think in the west we put children too much on a pedestal, try to protect them too much from real life realities. I just don't see the great harm in making tranny boys wait until 18 to take such a drastic, no going back, step, that they may indeed regret.

Why do you care so much what anonymous "tranny boys" do with their lives?

I don't care particularly, but most reasonable people in any culture would not be very exercised about the Thai government taking this very prudent measure of concern for their young people so that at least they are more or less adult when they make such a serious adult decision. You see this as repression of trannies. I just don't. In fact, I see it as concern for their young people, tranny, or whatever.

BTW, read the article. The doctors who have a MONEY interest in this are in favor of not restricting castration. The legislation appears to be favored by tranny activists here, which doesn't surprise me. They would know best what a big decision this is and what the consequences are.

Edited August 7, 2008 by Jingthing

[elkangorito]

I think in the west we put children too much on a pedestal, try to protect them too much from real life realities. I just don't see the great harm in making tranny boys wait until 18 to take such a drastic, no going back, step, that they may indeed regret.

Why do you care so much what anonymous "tranny boys" do with their lives?

I don't care particularly, but most reasonable people in any culture would not be very exercised about the Thai government taking this very prudent measure of concern for their young people so that at least they are more or less adult when they make such a serious adult decision. You see this as repression of trannies. I just don't. In fact, I see it as concern for their young people, tranny, or whatever.

Do not be fooled. Since when does the Thai government care about its' people? (road accidents?) This is simply another chance to be "authoritarian" in a way that is congruent with their current activities. ie that wonderful thing called "morality". I can almost guarantee that the Thai government will "police" the issue of "transgender operations" moreso than than wreckless driving. You see, wreckless driving is not a "moral" issue.

Edited August 7, 2008 by elkangorito

[Jingthing]

Not every day you meet someone so passionate about the rights of underage boys to get de-balled. I think this is now tedious. Congrats to the Thai government, whatever their motivation.

Edited August 7, 2008 by Jingthing

[elkangorito]

Not every day you meet someone so passionate about the rights of underage boys to get de-balled. I think this is now tedious. Congrats to the Thai government, whatever their motivation.

Sadly, it is every day that you meet someone who wants to control the lives of others...of others they don't even know or care about.

[PeaceBlondie]

Jingthing, el kangarito does not seem to be in favor of castrating teenagers. I think he is not opposed to letting them make up their own minds at age 16 or 17. el kan is my favorite ThaiVisa anarchist.

[elkangorito]

Jingthing, el kangarito does not seem to be in favor of castrating teenagers. I think he is not opposed to letting them make up their own minds at age 16 or 17. el kan is my favorite ThaiVisa anarchist.

You mean...I am "someones" favourite? Shit! I'm shocked & delighted...all at the same time. BTW Peace, you are very correct...I am an anarchist.

[geriatrickid]

This legislation is long overdue. You can't just simply cut the testicles off and send the patient on his merry way as has been the practice with some of these chop shops. As was stated above, the proper approach is to make sure that people have been prepared for the changes that will take place. Counseling also includes preparing the patient for the physical changes and the reactions of others, including friends and families.

The mindset of an adolescent is still in development mode. A teen can shed a b/f or g/f on a whim or change hair colour on any given day. What one thinks is suitable at 15 may become unsuitable at 20. I defy anyone to say that at age 50 they still have the same positions and views about sex, love or even living preferences as they did when they were 15.

The quick chop shops do not provide either pre or post surgery upport services. There will always be sexual assignment surgeries justified at an early age. This law does not interfere with that. What the law is trying to address is the behavioural aspect, the impulse purchase decision. The "Oh look my friend got castrated, so I want to do that too" event. Yes some kids may very well be good candidates at 16 for sex reassignment. However, a delay for some of them will not be lethal and can allow for appropriate preparation. Those patients with a medical (including an identified psychological need) will still have access to the surgery.

If a subject has a life expectancy of 75 years and decides at 15 to become a woman, 3 years out of 75 is not significant. We mandate an age at which to drink, drive, vote, join the military. Surely, the procedure is just as important.

Arguing this decision from a political position is feeble. This isn't about a nanny state. Rather it is the protection of those that may be weak or uninformed from those that would seek to exploit their weakness and ignorance. The premise that a child should be allowed to choose is based upon the faulty assumption that the people running the chop shops are motivated by the patient's best interests. Unfortunately, that is not the reality. Go into any reputable sex change facility and not have a valid reason for seeking the change, and you will be turned away even if you are 35. Go into a chop shop and they will do the procedure and say next please.

As that old guy Tommy Hobbes surmised, without effective government, the life of the people becomes nasty, brutish and short. This is a case where the government is doing its job. I again stress, that no responsible physician would perform the surgery in the absence of proper counseling and a demonstrated need for the surgery by the subject.

[PeaceBlondie]

Jingthing, el kangarito does not seem to be in favor of castrating teenagers. I think he is not opposed to letting them make up their own minds at age 16 or 17. el kan is my favorite ThaiVisa anarchist.

You mean...I am "someones" favourite? Shit! I'm shocked & delighted...all at the same time. BTW Peace, you are very correct...I am an anarchist.

Yeah, sometimes you make Emma Goldman sound authoritarian. I try hard to not give you advice because you do not want to be told what to do. Me, I am a follower with a passive-aggressive streak.

If I thought Thai teens were more mature than the last four teens that I raised, they might deserve to get a driver's license by age 18. But I really doubt they are ready to have their balls chopped off some afternoon soon. Let them wear dresses. But wait for castration. Little Piboon, shown in the OP, is a real cutie. But not quite ready for prime chopping time/

[Scott]

I just left a classroom full of 16 year old kids. Honestly, I think it should be mandatory that they all get castrated!

In reality, I think someone needs to regulate this practice, and parental consent is a good place to start, for underage kids. It would probably be wisest for a branch in the medical field to come up with suggested guidelines of who and when this can be done and this presented to the gov't.

I think it takes a lot of balls to get castrated. For most men this is one of the scariest thoughts imaginable.

[kmart]

Just hope the ban doesn't lead to the poor dears trying to castrate themselves in the comfort of their own home.

I don't know about there being too many laws in Thailand. Any sort of authoritarianism / fascism usually would usually require a bit of planning; will; discipline; competence; etc.?? Hello.

[geriatrickid]

. Any sort of authoritarianism / fascism usually would usually require a bit of planning; will; discipline; competence; etc.?? Hello.

Pish posh. All you need is a uniform with some shiny ribbons and medals, and voila you have the authority.

[JimGant]

Pardon my ignorance, but are we just talking about castration -- and leaving the rest of the "package" in place?

If so, isn't the object, then, to reduce testosterone, resulting in female hormones becoming dominant, with the inherent bodily changes these folks desire?

Why, then, don't they just take hormone pills, avoiding the mutilation of castration?

Of course if this is the first step towards a sex change operation, then it makes sense (I guess). But it sounds like removing dingleberries is an end step, not an intermediary one........

What am I missing here?

[elkangorito]

Sadly, it is every day that you meet someone who wants to control the lives of others...of others they don't even know or care about.

This legislation is long overdue. You can't just simply cut the testicles off and send the patient on his merry way as has been the practice with some of these chop shops....

And why not? Why are so concerned with the "balls" of others? Particularly of others whom you will never meet nor know?

If I thought Thai teens were more mature than the last four teens that I raised, they might deserve to get a driver's license by age 18. But I really doubt they are ready to have their balls chopped off some afternoon soon. Let them wear dresses. But wait for castration. Little Piboon, shown in the OP, is a real cutie. But not quite ready for prime chopping time

I guess that as a parent, you may choose to impose restrictions upon your children, where you think necessary. This, however, is not the same as a "law", which could therefore be policed. I find it incredible that many people simply love to control the lives of others by claiming that a "rule" is required. These control freaks wish to control the lives of people who they don't know or care about.

Years ago, the "control freaks" targeted long hair. One may wish to argue that hair is not the same as testicles but on the contrary, both hair & testicles are "owned" by the individual. So if you don't like the idea of total strangers cutting off their balls or hair, I suggest that you "mind your own business".

Again, aren't people allowed to make mistakes? If mistakes are made, the "news" of such usually quickly circulates, thereby ensuring self regulation.

History has shown that "illegalising" things, makes the "illegal" activity more interesting (& attractive).

Just hope the ban doesn't lead to the poor dears trying to castrate themselves in the comfort of their own home.

Well, if it does, you & I can thank all of the control freaks who support such a stupid "rule/law".

[PeaceBlondie]

el kan, these are minors we are talking about, who are generally below the age of consent. Shall we allow them to become alcoholics (that didn't keep my son from being an alcoholic)? Let them drive fast motorbikes at age 11? Have unlimited sex with fellow juveniles? The answers might just be yes, maybe, it depends. It is silly for us farang to discuss something over which we have no control, even if it were our business. This is a traditional society with strict cultural rules that are rapidly fading. I don't know.

Oh, I have long hair, but every time I cut it, it grows back. Not so with testicles or penises.

[geriatrickid]

This legislation is long overdue. You can't just simply cut the testicles off and send the patient on his merry way as has been the practice with some of these chop shops....

And why not? Why are so concerned with the "balls" of others? Particularly of others whom you will never meet nor know?

Your line of reasoning is rooted in negativity. How about you propose an alternative solution that is workable? In respect to my point that you object to, the testicles in a normal state are a dynamic part of the body and are an integral part of hormone control and development. In the absence of an underlying condition (e.g. ambiguous physical sexuality) and a demonstrated psychological need for castration, the procedure does not pass the cost-benefit test. I put it to you that your position is the one that is unnatural as it requires interference in the natural order (in those subjects where there is no physical or psychological need).

Your logic would allow those that are mentally ill and incapable of making a rational decision to engage in self harm. (I am not saying people that want the procedure are wacko, rather pointing out that there are people out there that jump from buildings or cut themselves and we try to stop that. The logic you used would say, no problem, slash & jump.) You may not agree, but a person that has not had the benefit of counseling and support for the procedure is neither properly informed nor prepared for the consequences. The fact is that the procedure is not banned for cases where it is necessitated. It is merely delayed until the subject can withstand the procedure. Castration is a drastic intervention and the subject must be ready for that procedure.

Anarchy is b*tch as a philosophy when one is required to provide an alternative viable solution aint it? These are people's lives and they are owed a duty of care.

I have come across enough people that had elective surgery that didn't turn out to deliver what they wanted. They are still unhappy people and often had drug (and alcohol) dependencies and were unable to function effectively. Sometimes surgery isn't the solution to cure a problem that's emotional. Plenty of folks think a facelift will turn them into lookers and are disappointed to find that they still have a miserable disposition. Castration as a cosmetic procedure is not justified. As a bonafide medical procedure it is. So let the subjects work it out first before jumping to the surgery part. That is all the government is saying. Think before leaping. Hardly a curtailment of anyone's liberties, particularly since it is society that must deal with the adverse result if the procedure doesn't deliver on the subject's hopes.

Edited August 10, 2008 by geriatrickid

[Jingthing]

Don't Thais have to be 21 years old to go to a bar and buy a drink? So 18 for ball removal sounds pretty darn tolerant to me, eh?