In Thailand, the term describes a broad spectrum of gender identity, typically referring to trans-feminine individuals who have existed as a "third gender" for centuries.

: Many begin identifying as female in early childhood and pursue hormones or surgeries, such as Adam's apple reduction and breast implants, to achieve their desired feminine appearance. Entertainment and Nightlife

: Unlike many other regions, Kathoey are a visible and accepted part of everyday Thai life, working in diverse fields such as beauty salons, retail, and media.