Sustainability Expo

Oct 22, 2024

Healthy Pride: Unlocking Dimensions of Sustainable Health through Inclusive and Joyful Dialogue

As part of the SUSTAINABILITY EXPO 2024 (SX 2024)—now in its fifth year under the theme “Sufficiency for Sustainability”—the event continues its mission to explore balanced paths to survival in today’s era of Global Boiling. This year’s expo has expanded its network of over 270 partners from public, private, diplomatic, and civil sectors both locally and internationally, driving deeper conversations around sustainability across all dimensions.

One of the standout moments at the SX Talk Stage was the forum titled: “Gender Diversity and Wellbeing”—a panel discussion that dove into the intersections of gender identity, healthcare access, and sustainable wellbeing.

Featured speakers included:

Assoc. Prof. Dr. Kasean Panyakhamlerd, Head of the Division of Sexual Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University
Dr. Nittaya Phanuphak, Executive Director, Institute of HIV Research and Innovation (IHRI)
Asst. Prof. Dr. Poonpitsamai Suwajo, Gender Health Expert, Faculty of Medicine, Chulalongkorn University
Prof. Dr. Thaninee Sahakitrungruang, Medical Genetics Specialist, Faculty of Medicine, Chulalongkorn University
Asst. Prof. Dr. Amarin Suwan, Sexual Medicine Specialist, Faculty of Medicine, Chulalongkorn University
Along with community and sector representatives

A Holistic, Inclusive, and Compassionate Approach to Gender and Health

Opening the session, Assoc. Prof. Dr. Kasean Panyakhamlerd cited the World Health Organization's (WHO) global objective to achieve sustainable health equity for all—regardless of gender identity—by the year 2030. This principle laid the groundwork for Thailand’s pioneering Gender Health Clinic at King Chulalongkorn Memorial Hospital, launched in 2018. The clinic provides equitable, holistic care for sexual and gender health based on global WPATH (World Professional Association for Transgender Health) standards.

Today, similar clinics are emerging across medical faculties in Thailand—at institutions such as Ramathibodi, Siriraj, Thammasat, Khon Kaen, Chiang Mai, and Prince of Songkla Universities. Thailand has also become a regional leader in gender-affirming surgeries and transgender health services.

Empowering Communities to Lead Health Equity

Dr. Nittaya Phanuphak emphasized the persistent stigma transgender individuals face in Thai healthcare settings. Her work focuses on empowering communities as the "capillaries of society" to participate in designing health services that reflect their needs.

This approach inspired the Tangerine Community Health Center, established in 2015. Known as Tangerine Clinic, it became Thailand’s first transgender-specific health facility offering hormone therapy, sexual health services, mental health care, and wellness support—staffed by trans professionals who understand the unique concerns of the community.

“While nearly all of us use hormones to affirm our gender, nearly half have never received comprehensive care. Many face inappropriate or invasive questions from providers—such as ‘Have you had the surgery yet?’—which are irrelevant to receiving quality healthcare. These microaggressions are barriers to access.”

Hormonal and Surgical Considerations in Gender-Affirming Care

Asst. Prof. Dr. Amarin Suwan elaborated on the types of hormonal treatments available in Thailand:

For trans women: oral, topical, and injectable estrogen. However, injectable options are often unavailable in hospitals and carry risks if dosed improperly.
For trans men: oral, topical, and injectable testosterone, though oral options are less effective and may impact liver function or mood stability.

He strongly warned against the use of over-the-counter contraceptive pills for transitioning, citing a 20-fold increased risk of blood clots compared to natural hormone options.

“Do not use birth control pills for transitioning. They drastically increase the risk of thrombosis and have a mortality rate three times higher than natural hormone therapies. Always consult with a physician. There's no one-size-fits-all solution. Personalized care is key.”

Before starting hormones, individuals are also advised to preserve reproductive cells, as long-term hormone use can compromise fertility.

Gender-Affirming Surgery: Preparedness and Lifelong Impact

Asst. Prof. Dr. Poonpitsamai Suwajo shared that Thailand’s first gender-affirming surgery took place in 1975. Surgical eligibility today requires at least six months of hormone therapy and 12 months of living full-time in the desired gender identity. Hormones must be discontinued prior to surgery to reduce clotting risks, and patients must stop smoking to avoid complications.

“Gender-affirming surgery is irreversible. Proper understanding of the procedures, risks, and personal readiness are vital. But when done well, it significantly improves quality of life.”

From Insight to Inspiration: The Next Generation Leads the Way

Closing the forum, the stage welcomed student ambassadors from Chulalongkorn University who serve as youth advocates and representatives of the Gender Health Clinic. They shared personal journeys, tackling real issues such as: