In a commentary published in the Lancet, the authors Suchanan Chieowisamana and Krit Pongpirula highlight important challenges and opportunities related to the ageing of transgender people in Thailand. Although the country is internationally recognised for its visible transgender community and long-standing knowledge in gender affirming care, many transgender adults continue to face significant barriers that affect their health, wellbeing and ability to age with dignity.
Despite Thailand’s reputation for openness, transgender people, particularly transgender women frequently experience stigma, discrimination and limited economic opportunities. These long term inequalities can accumulate over the life course, making older age especially vulnerable. The article underlines that healthy ageing is not solely about living longer but ensuring that everyone, regardless of gender identity, has access to appropriate care, social protection and recognition.
In July 2025, a policy milestone came in when hormone therapy was included in Thailand’s Universal Health Coverage scheme, known as the Gold Card. This marked an important step forward by acknowledging that gender affirming treatment forms an essential component of healthcare. The introduction of subsidised hormone medication and specialised clinics was widely welcomed by advocates and represents meaningful progress for transgender people across the country.
Significant gaps remain and many transgender adults continue to lack legal recognition, face persistent social stigma and struggle to secure stable income or age appropriate healthcare. These barriers limit their opportunities to fully participate in society and to access the support needed to maintain autonomy and wellbeing in later life.
Overall, it is emphasised that healthy longevity must be inclusive. Ensuring that transgender people can age with dignity requires sustained attention to their rights, lived experiences and specific health and social needs.
The full article: https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(25)00132-1/fulltext
