Thailand is internationally recognized for the development of gender-affirming healthcare, including hormone therapy and gender-affirming surgery. However, access to care, medical supervision, affordability, social acceptance, legal recognition and continuity of postoperative services remain important areas for research and policy. This narrative review examines gender reassignment in Thailand using the contemporary terminology of gender-affirming care and gender-affirming surgery. It synthesizes peer-reviewed evidence on healthcare access, hormone use, surgical outcomes, quality of life, mental health, discrimination and service delivery. Studies from Thailand indicate that gender-affirming surgery can be associated with improvements in quality of life and self-esteem, while postoperative psychosocial difficulties and concerns about social acceptance can persist. Research on hormone use also demonstrates substantial use outside recommended clinical regimens, highlighting the importance of accessible, medically supervised care. A 2022 Thai real-world clinic study of 1,534 transgender women found that only 34.2% had at least one measured hormone concentration within the study's target ranges at baseline, although follow-up in a subset showed improvement with integrated care. Evidence also indicates that discrimination and limited awareness of gender-affirming services can discourage healthcare utilization. The review argues that Thailand's future policy agenda should emphasize patient-centered care, affordable and geographically accessible services, clinical safety, postoperative follow-up, mental-health and psychosocial support, professional education, data systems, and protection against discrimination. The manuscript is a secondary-source review and does not report original patient-level research.
Keywords:transgender health; gender-affirming care; gender-affirming surgery; gender reassignment; hormone therapy; healthcare access; quality of life; social inclusion; health policy