By Pongphon Sarnsamak
Areeya Milintanapa, a 26 year old transvestite, had hoped to undergo sexual reassignment surgery at a private clinic in Bangkok next year, but her plans have hit a setback - new regulations by the Medical Council of Thailand.
The council moved recently to strictly control sex change operations and require that transgender people consult a psychiatrist, live as a woman for a year and receive hormone therapy before being such an operation is allowed.
For Areeya the new rules are an inconvenience. "I have already spent my whole life as a woman - since I was a little boy - and why (do) I have to live as a woman for another year to undergo sex change surgery?" she said.
Areeya said she had wanted to be a woman since she was a young boy. She said she had played with dolls like girls did and wore her mother's skirts.
"I know myself that I have always been woman not a man."
Areeya, who married an American man three years ago, said she started doing research and finding out information on sexchange surgery over many years, by consulting transgender people who had undergone sex reassignment operations, before making a decision to undergo the operation herself next year.
"This (operation) was going to be a special gift for me to celebrate the New Year," she said.
But her plan has been set back a year as the new regulations mean she cannot undergo a sexchange without seeing a psychiatrist first.
"The council want to make sure that they (transgender people) really want to be a woman and spend the rest of their lives as a woman, forever, not for a second," council president Dr Somsak Lohlekha said.
"Sex reassignment surgery would affect the physical body (of the person undergoing the operation), as well as people's mental health and society around them."
The council's new rules will be enforced from November - next week. They will require transgender people to consult psychiatrist to assess people's mental state before they are allowed to get hormone therapy from endocrinologists. After that they have to live as a woman for a year before they can undergo a sex change.
Somsak said at least two psychiatrists must give guarantees for transgender people who want to undergo a sexchange.
Foreigners seeking to have such operations here must get approval from a psychiatrist in their country of origin as well as a psychiatrist in Thailand before undergoing surgery.
After the operation, surgeons and physicians must follow up on their patient's condition and provide appropriate medical treatment.
The new regulations require that surgeons or physicians undertaking the sexchange be registered with the Medical Council. They must also treat any complications that occur following surgery.
Surgeons who violate the new regulations face warnings or the threat of having their medical licence revoked.
Dr Panom Ketman, of the Royal College of Psychiatrists of Thailand, said one year of living as woman should be enough to evaluate if a transgender person is ready for sexchange surgery.
"During this period, they have more time to ask themselves whether they really want to be a woman or not. If they are absolutely sure, psychiatrists will allow them to undergo such surgery," he said.
Dr Paiboon Jittrapai, of Thailand's Royal College of Surgeons, said the new rules would lift standards for sexchange operations. They would also help screen transgender people who really need sexchange surgery.
He said some patients had committed suicide after a sexchange operation as they had later rejected changing sex.
"Some transgender people underwent reassignment surgery because they wanted to do it for their job, such as performing in a cabaret show, not because they want it for their lives."
Transgender Women of Thailand chairperson Yollada Suanyot expressed satisfaction with the new regulations but said relevant agencies, such as the Interior, Foreign and Justice ministries, should revise laws to allow transgender people to change their gender title from Mr to Miss.
"Basic women's rights are also fundamental needs for transgender people," she said. "We also want the respect in human dignity, the same as anyone else."
Areeya said things would be easier if she could change from being a 'Mr' to a 'Miss', as she could then register a married certificate like other women.
"I just want my life to be complete as a woman. Why do I have to go to another country to be allowed to register a marriage certificate with a man who I love? Why can't this country where I was born give it to me?" said a business transgender woman.