New Thai clinic provides care for transgenders
CHALIT Pongpitakwiset has always felt like a man. Now, the 25-year-old wants everyone else to see it too.
But unlike most transgender people in Asia, who are left to self-administer hormone supplements, Chalit is being helped by a pioneering clinic.
"I'm not doing it by myself so it isn't dangerous," said the software company worker who was born female but wants to be identified as a man.
Several days after receiving the first testosterone injection, Chalit returned to get a blood test at Tangerine, the new clinic inside a Red Cross centre in downtown Bangkok.
The centre is a pilot programme that organisers hope could be replicated across Asia.
Thailand has a large and visible transgender population and is one of the world's top spots for sex-reassignment surgery.
But just like elsewhere in the Asia-Pacific, home to more than nine million transgender people according United Nations estimates, long-term care for patients is patchy at best.
The clinic is a rare place providing follow-up treatment, both physical and mental, for those who have undergone sex reassignment surgery.
"Most of the centres where the surgery is performed only provide short-term post-surgical care," explained Nittaya Phanuphak, the head doctor at Tangerine.
In Thailand, hormones are commonly purchased online or at local pharmacies, and administered on advice gleaned from friends or web forums.
Benyapon Chimsud, who was born a man but identifies as female, has been taking hormones for two years.
The recent university graduate consults friends to determine the proper doses of contraceptive pills.
In addition, Benyapon gets monthly black market oestrogen injections at a rudimentary neighbourhood clinic.
That leaves Benyapon cut off from regulated healthcare, prone to receiving inaccurate medical advice and at risk of over-consuming hormones in a rush to see rapid results.
Chalit, on the other hand, met with a psychiatrist several times before receiving a first injection to prepare for changes to the body.
Now, Chalit is getting hormone injections every two weeks. "The hormones will stop my periods, change my voice, give me a beard and moustache, and develop my muscles.
"All things that will help me no longer be a woman anymore."
That should insulate Chalit from the dangers of taking the wrong doses of hormones which experts say can lead to liver and cardiovascular problems. HIV is also always a risk if needles are shared.
Rights groups like the Asia-Pacific Transgender Network (APTN) say this public health issue is largely neglected by the mainstream medical community.
"There are no official guidelines on the administration and monitoring of hormones among trans people," said Joe Wong of the APTN.
Many segments of society in Thailand remain deeply conservative. The kingdom's transgenders, often men who become women and are known colloquially as "ladyboys", are over-represented in the entertainment and sex industries.