Thailand's Cultural Diplomacy: Attracting Gender Reassignment Surgeries (GRS) Patients Through Soft Power
Abstract
People with sexual orientation deviations are certainly difficult to be accepted in the wider community, both in daily activities, in school or workplace environments, even when deciding to undergo transgender surgery. Most of them experience social discrimination that has fatal consequences, such as decreased self-confidence, depression, and even suicide. Therefore, a supportive environment will make them feel comfortable. Thailand, a country that is friendly to LGBT, provides hospitals with sex change surgery facilities. Thailand's image as the "Mecca" of transsexual body modification offers an inclusive environment that makes transgender patients feel comfortable. This study focuses on the culture that strengthens Thailand's image, so that it is able to promote sex change surgery hospitals on the international stage. Through cultural diplomacy, researchers found several cultures that are the basis for Thailand being friendly to LGBT, namely the cultural approach through Theravada Buddhism which recognizes four gender categories, the existence of art through drag and cabaret festivals and Thai music, also LGBT-friendly tourism that makes patients feel comfortable. With a strong cultural base, government, and business actors in Thailand in creating an inclusive LGBT environment, Thailand has succeeded in attracting patients for sex change surgery for both local and international communities. This is proven by the large number of foreign patients from Europe, the US and Asia who undergo surgery and medical travel in Thailand.
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Aizura, A. Z. (2010). Feminine Transformations: Gender Reassignment Surgical Tourism in Thailand. Medical Anthropology, 29(4), 424–443. https://doi.org/10.1080/01459740.2010.501314
Akhavan, A. A., Sandhu, S., Ndem, I., & Ogunleye, A. A. (2021). A review of gender affirmation surgery: What we know, and what we need to know. Surgery, 170(1), 336–340. https://doi.org/10.1016/j.surg.2021.02.013
Aksorngarn, K. (2024). Legalization of Same-Sex Marriage in Thailand: Society Steps Forward, But Policymakers Still Hesitate. Beijing Law Review, 15(01), 91–101. https://doi.org/10.4236/blr.2024.151006
Alexandre Veilleux. (2021). LGBTQ TOURISM IN THAILAND IN THE LIGHT OF GLOCALIZATION Capitalism, Local Policies, and Impacts on the Thai LGBTQ Community.
Biswas, P., Neogi, S. G., Arockiam, D., & Mitra, A. (2024). The Importance of Multi-Lingual Sentiment Analysis in Digital Marketing. 2024 11th International Conference on Reliability, Infocom Technologies and Optimization (Trends and Future Directions) (ICRITO), 1–8. https://doi.org/10.1109/ICRITO61523.2024.10522115
Bumrungrad International Hospital. (2024). Bumrungrad International Hospital. https://www.bumrungrad.com/en/
Chan, A. S. W., Choong, A., Phang, K. C., Leung, L. M., Tang, P. M. K., & Yan, E. (2024). Societal discrimination and mental health among transgender athletes: A systematic review and Meta-analysis. BMC Psychology, 12(1), 24. https://doi.org/10.1186/s40359-023-01493-9
Chaovanalikit, T., Wirairat, K., & Sriswadpong, P. (2022). Quality of Life, Self-Esteem, and Depression Among Thai Transgender Women Before and After Male-to-Female Gender Confirmation Surgery: A Prospective Cohort Observational Study. Sexual Medicine, 10(4), 100533–100533. https://doi.org/10.1016/j.esxm.2022.100533
Cogan, M. S. (2024). Thailand’s new soft power focus and the makings of a paradox. Asian Affairs: An American Review, 51(2), 90–116. https://doi.org/10.1080/00927678.2024.2333684
El Derbas, R. (2023). Cultural diplomacy: The theory and the practice of a bridging concept. In F. Gantheret, N. Guibert, & S. Stolk (Eds.), Art and Human Rights (pp. 188–207). Edward Elgar Publishing. https://doi.org/10.4337/9781802208153.00022
Farber, R. (2022). Gender, health, and labor in Thailand’s medical hub. Social Science & Medicine, 301, 114950. https://doi.org/10.1016/j.socscimed.2022.114950
Farber, R. (2024). Discrimination, Health, and Resistance for Thai Transgender Women. Journal of Racial and Ethnic Health Disparities, 11(2), 1124–1138. https://doi.org/10.1007/s40615-023-01592-8
Grincheva, N. (2024). The past and future of cultural diplomacy. International Journal of Cultural Policy, 30(2), 172–191. https://doi.org/10.1080/10286632.2023.2183949
Konishi, Y. (2024). Trans depathologisation and gender identity disorder in Japan: A critical discourse analysis of medical literature, 2010–2022. Social Science & Medicine, 353, 117039. https://doi.org/10.1016/j.socscimed.2024.117039
Laurent, E. (2005). Sexuality and Human Rights: An Asian Perspective. Journal of Homosexuality, 48(3–4), 163–225. https://doi.org/10.1300/J082v48n03_09
Li, E. P. H., Min, H. J., & Lee, S. (2020). Soft power and nation rebranding: The transformation of Korean national identity through cosmetic surgery tourism. International Marketing Review, 38(1), 141–162. https://doi.org/10.1108/IMR-01-2019-0053
Liu, X., Fu, X., Yuan, Y., Li, Z., & Suknuch, C. (2024). Understanding gay tourists’ involvement and loyalty towards Thailand: The perspective of motivation-opportunity-ability. Journal of Vacation Marketing, 30(3), 439–458. https://doi.org/10.1177/13567667221147318
Lunt, N., & Carrera, P. (2010). Medical tourism: Assessing the evidence on treatment abroad. Maturitas, 66(1), 27–32. https://doi.org/10.1016/j.maturitas.2010.01.017
Monterrubio, C., Rodríguez Madera, S. L., & Pérez, J. (2020). Trans women in tourism: Motivations, constraints and experiences. Journal of Hospitality and Tourism Management, 43, 169–178. https://doi.org/10.1016/j.jhtm.2020.04.009
Newman, P. A., Reid, L., Tepjan, S., & Akkakanjanasupar, P. (2021). LGBT+ inclusion and human rights in Thailand: A scoping review of the literature. BMC Public Health, 21(1), 1816. https://doi.org/10.1186/s12889-021-11798-2
Ocha, W. (2023). Buddhism, gender, and sexualities: Queer spiritualities in Thailand. Equality, Diversity and Inclusion: An International Journal, 42(5), 685–705. https://doi.org/10.1108/EDI-01-2020-0025
Pauli, G., Martin, S., & Greiling, D. (2023). The current state of research of word-of-mouth in the health care sector. International Review on Public and Nonprofit Marketing, 20(1), 125–148. https://doi.org/10.1007/s12208-022-00334-6
Phanat Subyubon, Dr. Pimpika Thongrom, Atchira Tiwasing, & Phumipat Chaya. (2022). Chinese LGBT Tourist Motivation Traveling to Bangkok. International Journal of Early Childhood Special Education (INT-JECSE), 14(01), 1933–19421. https://doi.org/10.9756/INT-JECSE/V14I1.225
Praditsilp, W., & Pongsakornrungsilp, S. (2024). Thai dance diplomacy: Thai government communication strategies for building soft power through staging Thai performances abroad. The Journal of International Communication, 30(1), 84–110. https://doi.org/10.1080/13216597.2023.2279311
Rijo Lopes Da Cunha, M. M. (2024). Introduction: Music and Cultural Diplomacy in the Middle East—Geopolitical Reconfigurations for the Twenty-First Century. In M. M. Rijo Lopes Da Cunha, J. Shannon, S. Møller Sørensen, & V. Danielson (Eds.), Music and Cultural Diplomacy in the Middle East (pp. 1–21). Springer International Publishing. https://doi.org/10.1007/978-3-031-36279-8_1
Rodríguez-Dorans, E., & Holmes, J. (2021). The Everyday Lives of Gay Men: Autoethnographies of the Ordinary (1st ed.). Routledge. https://doi.org/10.4324/9781003133506
Ruanglertsilp, E. (2022). Discourse of Self-Empowerment in Ariana Grande’s ‘thank u, next’ Album Lyrics: A Critical Discourse Analysis. Journal for Cultural Research, 26(2), 200–220. https://doi.org/10.1080/14797585.2022.2097882
Samitivej Hospitals. (2024). Samitivej Hospitals. https://www.samitivejhospitals.com/
Schlick, C. J. R., Ellis, R. J., Etkin, C. D., Greenberg, C. C., Greenberg, J. A., Turner, P. L., Buyske, J., Hoyt, D. B., Nasca, T. J., Bilimoria, K. Y., & Hu, Y.-Y. (2021). Experiences of Gender Discrimination and Sexual Harassment Among Residents in General Surgery Programs Across the US. JAMA Surgery, 156(10), 942. https://doi.org/10.1001/jamasurg.2021.3195
Sepulang Sekolah (Director). (2021, January 1). Membedah 18 Gender Di Thailand! Gender Berbeda Dengan Jenis Kelamin? | Learning By Googling #28 [Broadcast]. https://www.youtube.com/watch?v=OB7exMyQe58
Shuttleworth, C. (2023). Talking sex: Thai Phet and its connection to Thai drag performance as reflected by the language of kathoey performers in Chiang Mai. Humanities, Arts and Social Sciences Studies, 618632. https://doi.org/10.14456/HASSS.2023.52
Skorska, M. N., Coome, L. A., Peragine, D. E., Aitken, M., & VanderLaan, D. P. (2021). An anthropometric study of sexual orientation and gender identity in Thailand. Scientific Reports, 11(1), 18432. https://doi.org/10.1038/s41598-021-97845-9
Srikummoon, P., Thanutan, Y., Manojai, N., Prasitwattanaseree, S., Boonyapisomparn, N., Kummaraka, U., Pateekhum, C., Chiawkhun, P., Owatsakul, C., Maneeton, B., Maneeton, N., Kawilapat, S., & Traisathit, P. (2022). Discrimination against and Associated Stigma Experienced by Transgender Women with Intersectional Identities in Thailand. International Journal of Environmental Research and Public Health, 19(24), 16532. https://doi.org/10.3390/ijerph192416532
Statham, P., & Scuzzarello, S. (2023). Transgender Kathoey and gay men using tourist-zone scenes as ‘social opportunities’ for nonheteronormative living in Thailand. Gender, Place & Culture, 30(2), 183–210. https://doi.org/10.1080/0966369X.2021.1997937
Sukumar Writings (Director). (2016, Mey). Bang Bang Bangkok Official Video Song | Kumari 21F Movie | Raj Tarun, Hebah Patel | Devi Sri Prasad [Broadcast]. https://www.youtube.com/watch?v=aSPqIH7I-As
Taheri, B., Chalmers, D., Wilson, J., & Arshed, N. (2021). Would you really recommend it? Antecedents of word-of-mouth in medical tourism. Tourism Management, 83, 104209. https://doi.org/10.1016/j.tourman.2020.104209
The Suporn Clinic. (2024). Traveling to Thailand for Surgery. https://supornclinic.com/travel-to-thailand/
Wisuttipat, N. (2024). “Keeping Condition”: Gender Ambiguity and Sexual Citizenship of Queer Male Thai Classical Musicians. TRaNS: Trans -Regional and -National Studies of Southeast Asia, 12(1), 60–77. https://doi.org/10.1017/trn.2023.12
WOWPresents (Director). (2024, October 18). Drag Race Thailand Season 3, Episode 1: Thai Tea Is Back Back Back Again (Full Episode) [Broadcast]. https://www.youtube.com/watch?v=-XGJ7gBYXbs
Xiang, K., & Cheah, C. W. (2023). The embodied experience and self-identity construction of Chinese gay tourists in Thailand. Tourism Management Perspectives, 48, 101169. https://doi.org/10.1016/j.tmp.2023.101169
Zheng, D., & Liu, Y. (2024). China–Thai Cultural Diplomacy Through the Buddhist Wat: A Case Study of the Thai Wat in Chaozhou Kaiyuan si, Guangdong. Religions, 15(11), 1365. https://doi.org/10.3390/rel15111365
Aizura, A. Z. (2010). Feminine Transformations: Gender Reassignment Surgical Tourism in Thailand. Medical Anthropology, 29(4), 424–443. https://doi.org/10.1080/01459740.2010.501314
Akhavan, A. A., Sandhu, S., Ndem, I., & Ogunleye, A. A. (2021). A review of gender affirmation surgery: What we know, and what we need to know. Surgery, 170(1), 336–340. https://doi.org/10.1016/j.surg.2021.02.013
Aksorngarn, K. (2024). Legalization of Same-Sex Marriage in Thailand: Society Steps Forward, But Policymakers Still Hesitate. Beijing Law Review, 15(01), 91–101. https://doi.org/10.4236/blr.2024.151006
Alexandre Veilleux. (2021). LGBTQ TOURISM IN THAILAND IN THE LIGHT OF GLOCALIZATION Capitalism, Local Policies, and Impacts on the Thai LGBTQ Community.
Biswas, P., Neogi, S. G., Arockiam, D., & Mitra, A. (2024). The Importance of Multi-Lingual Sentiment Analysis in Digital Marketing. 2024 11th International Conference on Reliability, Infocom Technologies and Optimization (Trends and Future Directions) (ICRITO), 1–8. https://doi.org/10.1109/ICRITO61523.2024.10522115
Bumrungrad International Hospital. (2024). Bumrungrad International Hospital. https://www.bumrungrad.com/en/
Chan, A. S. W., Choong, A., Phang, K. C., Leung, L. M., Tang, P. M. K., & Yan, E. (2024). Societal discrimination and mental health among transgender athletes: A systematic review and Meta-analysis. BMC Psychology, 12(1), 24. https://doi.org/10.1186/s40359-023-01493-9
Chaovanalikit, T., Wirairat, K., & Sriswadpong, P. (2022). Quality of Life, Self-Esteem, and Depression Among Thai Transgender Women Before and After Male-to-Female Gender Confirmation Surgery: A Prospective Cohort Observational Study. Sexual Medicine, 10(4), 100533–100533. https://doi.org/10.1016/j.esxm.2022.100533
Cogan, M. S. (2024). Thailand’s new soft power focus and the makings of a paradox. Asian Affairs: An American Review, 51(2), 90–116. https://doi.org/10.1080/00927678.2024.2333684
El Derbas, R. (2023). Cultural diplomacy: The theory and the practice of a bridging concept. In F. Gantheret, N. Guibert, & S. Stolk (Eds.), Art and Human Rights (pp. 188–207). Edward Elgar Publishing. https://doi.org/10.4337/9781802208153.00022
Farber, R. (2022). Gender, health, and labor in Thailand’s medical hub. Social Science & Medicine, 301, 114950. https://doi.org/10.1016/j.socscimed.2022.114950
Farber, R. (2024). Discrimination, Health, and Resistance for Thai Transgender Women. Journal of Racial and Ethnic Health Disparities, 11(2), 1124–1138. https://doi.org/10.1007/s40615-023-01592-8
Grincheva, N. (2024). The past and future of cultural diplomacy. International Journal of Cultural Policy, 30(2), 172–191. https://doi.org/10.1080/10286632.2023.2183949
Konishi, Y. (2024). Trans depathologisation and gender identity disorder in Japan: A critical discourse analysis of medical literature, 2010–2022. Social Science & Medicine, 353, 117039. https://doi.org/10.1016/j.socscimed.2024.117039
Laurent, E. (2005). Sexuality and Human Rights: An Asian Perspective. Journal of Homosexuality, 48(3–4), 163–225. https://doi.org/10.1300/J082v48n03_09
Li, E. P. H., Min, H. J., & Lee, S. (2020). Soft power and nation rebranding: The transformation of Korean national identity through cosmetic surgery tourism. International Marketing Review, 38(1), 141–162. https://doi.org/10.1108/IMR-01-2019-0053
Liu, X., Fu, X., Yuan, Y., Li, Z., & Suknuch, C. (2024). Understanding gay tourists’ involvement and loyalty towards Thailand: The perspective of motivation-opportunity-ability. Journal of Vacation Marketing, 30(3), 439–458. https://doi.org/10.1177/13567667221147318
Lunt, N., & Carrera, P. (2010). Medical tourism: Assessing the evidence on treatment abroad. Maturitas, 66(1), 27–32. https://doi.org/10.1016/j.maturitas.2010.01.017
Monterrubio, C., Rodríguez Madera, S. L., & Pérez, J. (2020). Trans women in tourism: Motivations, constraints and experiences. Journal of Hospitality and Tourism Management, 43, 169–178. https://doi.org/10.1016/j.jhtm.2020.04.009
Newman, P. A., Reid, L., Tepjan, S., & Akkakanjanasupar, P. (2021). LGBT+ inclusion and human rights in Thailand: A scoping review of the literature. BMC Public Health, 21(1), 1816. https://doi.org/10.1186/s12889-021-11798-2
Ocha, W. (2023). Buddhism, gender, and sexualities: Queer spiritualities in Thailand. Equality, Diversity and Inclusion: An International Journal, 42(5), 685–705. https://doi.org/10.1108/EDI-01-2020-0025
Pauli, G., Martin, S., & Greiling, D. (2023). The current state of research of word-of-mouth in the health care sector. International Review on Public and Nonprofit Marketing, 20(1), 125–148. https://doi.org/10.1007/s12208-022-00334-6
Phanat Subyubon, Dr. Pimpika Thongrom, Atchira Tiwasing, & Phumipat Chaya. (2022). Chinese LGBT Tourist Motivation Traveling to Bangkok. International Journal of Early Childhood Special Education (INT-JECSE), 14(01), 1933–19421. https://doi.org/10.9756/INT-JECSE/V14I1.225
Praditsilp, W., & Pongsakornrungsilp, S. (2024). Thai dance diplomacy: Thai government communication strategies for building soft power through staging Thai performances abroad. The Journal of International Communication, 30(1), 84–110. https://doi.org/10.1080/13216597.2023.2279311
Rijo Lopes Da Cunha, M. M. (2024). Introduction: Music and Cultural Diplomacy in the Middle East—Geopolitical Reconfigurations for the Twenty-First Century. In M. M. Rijo Lopes Da Cunha, J. Shannon, S. Møller Sørensen, & V. Danielson (Eds.), Music and Cultural Diplomacy in the Middle East (pp. 1–21). Springer International Publishing. https://doi.org/10.1007/978-3-031-36279-8_1
Rodríguez-Dorans, E., & Holmes, J. (2021). The Everyday Lives of Gay Men: Autoethnographies of the Ordinary (1st ed.). Routledge. https://doi.org/10.4324/9781003133506
Ruanglertsilp, E. (2022). Discourse of Self-Empowerment in Ariana Grande’s ‘thank u, next’ Album Lyrics: A Critical Discourse Analysis. Journal for Cultural Research, 26(2), 200–220. https://doi.org/10.1080/14797585.2022.2097882
Samitivej Hospitals. (2024). Samitivej Hospitals. https://www.samitivejhospitals.com/
Schlick, C. J. R., Ellis, R. J., Etkin, C. D., Greenberg, C. C., Greenberg, J. A., Turner, P. L., Buyske, J., Hoyt, D. B., Nasca, T. J., Bilimoria, K. Y., & Hu, Y.-Y. (2021). Experiences of Gender Discrimination and Sexual Harassment Among Residents in General Surgery Programs Across the US. JAMA Surgery, 156(10), 942. https://doi.org/10.1001/jamasurg.2021.3195
Sepulang Sekolah (Director). (2021, January 1). Membedah 18 Gender Di Thailand! Gender Berbeda Dengan Jenis Kelamin? | Learning By Googling #28 [Broadcast]. https://www.youtube.com/watch?v=OB7exMyQe58
Shuttleworth, C. (2023). Talking sex: Thai Phet and its connection to Thai drag performance as reflected by the language of kathoey performers in Chiang Mai. Humanities, Arts and Social Sciences Studies, 618632. https://doi.org/10.14456/HASSS.2023.52
Skorska, M. N., Coome, L. A., Peragine, D. E., Aitken, M., & VanderLaan, D. P. (2021). An anthropometric study of sexual orientation and gender identity in Thailand. Scientific Reports, 11(1), 18432. https://doi.org/10.1038/s41598-021-97845-9
Srikummoon, P., Thanutan, Y., Manojai, N., Prasitwattanaseree, S., Boonyapisomparn, N., Kummaraka, U., Pateekhum, C., Chiawkhun, P., Owatsakul, C., Maneeton, B., Maneeton, N., Kawilapat, S., & Traisathit, P. (2022). Discrimination against and Associated Stigma Experienced by Transgender Women with Intersectional Identities in Thailand. International Journal of Environmental Research and Public Health, 19(24), 16532. https://doi.org/10.3390/ijerph192416532
Statham, P., & Scuzzarello, S. (2023). Transgender Kathoey and gay men using tourist-zone scenes as ‘social opportunities’ for nonheteronormative living in Thailand. Gender, Place & Culture, 30(2), 183–210. https://doi.org/10.1080/0966369X.2021.1997937
Sukumar Writings (Director). (2016, Mey). Bang Bang Bangkok Official Video Song | Kumari 21F Movie | Raj Tarun, Hebah Patel | Devi Sri Prasad [Broadcast]. https://www.youtube.com/watch?v=aSPqIH7I-As
Taheri, B., Chalmers, D., Wilson, J., & Arshed, N. (2021). Would you really recommend it? Antecedents of word-of-mouth in medical tourism. Tourism Management, 83, 104209. https://doi.org/10.1016/j.tourman.2020.104209
The Suporn Clinic. (2024). Traveling to Thailand for Surgery. https://supornclinic.com/travel-to-thailand/
Wisuttipat, N. (2024). “Keeping Condition”: Gender Ambiguity and Sexual Citizenship of Queer Male Thai Classical Musicians. TRaNS: Trans -Regional and -National Studies of Southeast Asia, 12(1), 60–77. https://doi.org/10.1017/trn.2023.12
WOWPresents (Director). (2024, October 18). Drag Race Thailand Season 3, Episode 1: Thai Tea Is Back Back Back Again (Full Episode) [Broadcast]. https://www.youtube.com/watch?v=-XGJ7gBYXbs
Xiang, K., & Cheah, C. W. (2023). The embodied experience and self-identity construction of Chinese gay tourists in Thailand. Tourism Management Perspectives, 48, 101169. https://doi.org/10.1016/j.tmp.2023.101169
Zheng, D., & Liu, Y. (2024). China–Thai Cultural Diplomacy Through the Buddhist Wat: A Case Study of the Thai Wat in Chaozhou Kaiyuan si, Guangdong. Religions, 15(11), 1365. https://doi.org/10.3390/rel15111365
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