Many in Thailand believe that being a kathoey is a result of Karma from past lives, viewing them with acceptance or pity rather than moral condemnation.

Some Thai residents emphasize that kathoey are distinct from transgender women in the strict Western binary sense, though many kathoey also identify as trans. Ladyboys in Tourism and Media

They are widely visible in Thai society, working in varied fields such as hospitality, entertainment, retail, and education, rather than just nightlife. Identity and Terminology