As well as trans individuals, the term can refer to gay men, and was originally used to refer to intersex individuals.
Because of this confusion in translation, the English translation of kathoey is usually "ladyboy" (or variants of the term).
However, when considering transgender women (Mt F) as a group in Thai society, most refer to themselves as phuying (Thai: ผู้หญิง "women"), with a minority referring to themselves as phuying praphet song (a "second kind of woman") and only very few referring to themselves as kathoey.
Two months prior to the surgery, patients are required to see a psychiatrist in Thailand to confirm eligibility for sex reassignment surgery.
One must provide evidence of diagnosis of gender dysphoria from a psychologist/psychiatrist.
Before going through gender reassignment surgery, one must be on hormones/antiandrogens for at least one year.
Beginning in 1998, the pageant takes place every year in Pattaya, Thailand during May.
With over 100 applicants, all across Thailand, the pageant is considered to be one of the most popular transgender pageant in the world.
In January 1997, the Rajabhat Institutes (the governing body of the colleges) announced it would formalize the ban, which would extend to all campuses at the start of the 1997 academic year.