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The term "kathoey" may be considered pejorative, especially in the form "kathoey-saloey".
It has a meaning similar to the English language "fairy" or "queen".
Several popular Thai models, singers and movie stars are kathoeys, and Thai newspapers often print photographs of the winners of female and kathoey beauty contests side by side.
The phenomenon is not restricted to urban areas; there are kathoeys in most villages, and kathoey beauty contests are commonly held as part of local fairs.
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) gender identity), and in contrast to phet thi sam (which means "third gender").
The term phu ying praphet song, which can be translated as "second-type female", is also used to refer to kathoey.
The winner of the pageant receives a tiara, sash, car, grand price of 100,000 baht (3,000 USD) - equivalent to a yearly wage for a factory worker living in Thailand.
In 1993, Thailand's teacher training colleges implemented a semi-formal ban on allowing homosexual (which included kathoey) students enrolling in courses leading to qualification for positions in kindergartens and primary schools.
Although kathoey is often translated as "transgender" in the English usage, this term is not used frequently in Thailand.Through beauty pageants, Thailand has been able to promote the country's cosmetic surgery industry, which has had a massive increase in medical tourism for sex reassignment surgery.According to the Miss Tiffany's Universe website, the live broadcast attracts record of 15 million viewers.One must provide evidence of diagnosis of gender dysphoria from a psychologist/psychiatrist.Before going through gender reassignment surgery, one must be on hormones/antiandrogens for at least one year.