Eligibility for Gender-Affirming Surgery (Based on WPATH SOC-8)

At WIH Hospital, eligibility for gender-affirming surgery follows the internationally recognized WPATH Standards of Care, Version 8 (SOC-8), which emphasize ethical, inclusive, and patient-centered treatment. To qualify, patients must experience persistent gender dysphoria, have the capacity to make informed decisions, and be of legal adult age. Any coexisting mental health conditions must be reasonably well-managed prior to surgery.

Gender dysphoria refers to the emotional distress that arises when a person’s gender identity (their inner sense of self) does not align with their sex assigned at birth. In earlier medical terminology, this was called “Gender Identity Disorder (GID)”, but modern standards such as DSM-5 and ICD-11 now use the term gender dysphoria to emphasize the person’s experience, rather than pathologizing their identity. This diagnostic term remains essential for fulfilling psychiatric letter requirements under Thai regulations, as it validates the medical necessity of surgical intervention.

Unlike older models, WPATH SOC-8 no longer mandates hormone therapy or social transition as prerequisites for surgery. While these steps—such as living in one’s affirmed gender role or undergoing hormone therapy—may be meaningful and beneficial for many, they are not universally required. The modern approach recognizes that every individual’s transition journey is unique.

Patients who wish to learn more about transition processes, including social transition and the concept of a real-life test, can visit our detailed guide on Transition and Real-Life Experience
for further information.

At WIH Hospital, Dr. Chettasak Tulayaphanich and his multidisciplinary team understand that for many, gender-affirming surgery represents the final step in aligning body and identity. By adhering to WPATH SOC-8 and international diagnostic standards, our hospital ensures each patient receives compassionate, evidence-based, and individualized care grounded in the latest medical and ethical practices.

Surgery Is a One-Time Life Decision

Gender-affirming surgery is not cosmetic; it is a medically necessary, life-changing procedure for many transgender individuals. When performed correctly, it not only aligns the body with one’s true identity but also restores confidence, emotional well-being, and quality of life. Revision surgeries can never fully replicate the functional and aesthetic outcomes of a well-executed primary surgery. That’s why patients around the world dedicate time and research to making the right choice from the beginning.

At WIH Hospital, Dr. Chettasak Tulayaphanich brings nearly 30 years of expertise in gender-affirming procedures. As the pioneer of the advanced NPI vaginoplasty technique, he is trusted globally for producing natural-looking results, preserving sexual sensation, and maintaining surgical safety. Choosing the right surgeon the first time is the most important decision you can make — and it’s the key to achieving lasting satisfaction and surgical success.

A: Before travelling

1. Booking Your Surgery Date

Once the surgery date is mutually agreed upon, a 20% deposit is required to secure your booking. Surgery must be performed within one year from the booking date. After confirmation, the WIH team will assist in coordinating all necessary pre-surgery arrangements, including your psychiatric consultation.

2. Psychiatric Evaluation by a Thai psychiatrist

This session is typically conducted online before your travel to Thailand, ensuring all documents are in place prior to your arrival.

3. Medical Lab Test Submission

All patients must complete their medical lab tests 4–6 weeks before surgery. Test reports older than 6 weeks will not be accepted. Please submit your results in JPEG or PDF format at least 3 weeks before your travel date to allow time for review by the surgical and anesthesia teams.

Required Lab Tests by Age Group:

If you have any medical conditions or a history of surgery, please also include referral letters or clearance from your treating doctor.

4. Travel Planning

Once your surgery date has been confirmed, it is important to book your flight to Bangkok based on the total duration of your required stay. For example, if you are undergoing gender-affirming surgery with vaginoplasty, WIH Hospital recommends staying in Thailand for at least 30 days, and you should plan to arrive in Bangkok 4 days before your surgery date.
Once your round-trip flight has been booked, please send your full itinerary to the WIH Hospital team. We will assist you in booking your stay in the Recovery Ward based on your travel schedule and ensure that complimentary airport pick-up is reserved for you.

5. Finalize the Remaining Fee

To ensure a smooth arrival and pre-surgery process, we kindly recommend completing all remaining payments—including the surgical fee and Post surgery accommodation—at least 2 weeks before your travel date.

→ Payment Options:

• International Wire Transfer – Recommended for security and ease. This method allows sufficient time for processing and confirmation before your arrival.

• Online Payment Link (2C2P) – A secure and convenient online payment gateway. If you prefer this method, please inform our team, and we will issue a personalized payment link for you.

Plan for Perineal Hair Removal Before Vaginoplasty

If you are preparing for gender-affirming surgery (GAS), particularly vaginoplasty, it’s important to start perineal hair removal at least 6 months in advance. The perineum is the area of skin between the base of the scrotum and the anus. While not every patient requires hair removal in this area, it is highly recommended for those with dense or thick hair growth.

Why is this important? If hair remains in the perineum, it will still be present after surgery and may grow inside the newly constructed vaginal opening. This is not typical of cisgender female anatomy and can affect both aesthetics and hygiene.

Two Common Hair Removal Methods

1. Laser Hair Removal
   Laser is effective only for dark-colored hair (black or dark brown). It reduces hair growth but does not permanently destroy hair roots. The diode laser, used at WIH Hospital, is suitable for all skin tones and less painful than other types.
2. Electrolysis
   Electrolysis destroys the hair root permanently and is effective for all hair colors and thicknesses. However, it is time-consuming and typically requires many sessions to complete.

Hair removal is not recommended for the penile or scrotal skin, as electrolysis or laser treatment on these areas may negatively affect the quality and elasticity of the skin used for genital reconstruction. These tissues are essential for creating the outer labia and other structures, where maintaining natural skin characteristics is important.

In cases where scrotal skin is used as a graft to create the vaginal lining, Dr. Chettasak will completely remove all hair follicles during surgery using his specialized skin graft preparation technique. This method ensures a hair-free result without compromising skin quality.
→ For more details, please visit the Skin Graft Vaginoplasty page.

How Ontario Residents Can Use OHIP for Gender-Affirming Surgery

For patients living in Ontario, Canada, the Ontario Health Insurance Plan (OHIP) is an excellent resource for accessing insurance benefits related to primary gender-affirming surgery, covering many types of vaginoplasty except peritoneal pull-through (PPV).

In addition, OHIP may also cover secondary or revision surgeries—such as corrections to the external genitalia or procedures addressing concerns within the vaginal canal—when these are considered medically necessary.

Ontario’s Gender-Affirming Surgery Coverage — An Excellent Resource for Patients

1. Mission of OHIP

The Ontario Health Insurance Plan (OHIP) is Ontario’s publicly funded health insurance program. Its mission is to provide residents with free medically necessary healthcare services funded through provincial taxes, ensuring equal access to essential medical treatments and surgeries.

2. Who Is Eligible 

To qualify for OHIP coverage, you must meet all of the following requirements:

• Be a Canadian citizen, permanent resident, or have an eligible immigration status (e.g., a valid work permit).
• Live in Ontario as your primary residence.
• Be physically present in Ontario for at least 153 days per year.

Your Seamless Journey with OHIP and WIH

We make the process of accessing care as straightforward as possible. Here’s a step-by-step guide to how it works for our Canadian patients:

1.Initial Contact & Assessment:

Reach out to us and complete our confidential health information form. We will review your details to assess your eligibility for the procedure.

2.Procedure Confirmation:

Once your eligibility is confirmed, we will help you determine the surgical procedure that best aligns with your needs.

3.OHIP Funding Request:

WIH International Hospital prepares and submits a detailed funding request directly to OHIP on your behalf. Please allow at least one week for OHIP’s approval.

4.Approval & Scheduling:

Once OHIP approves the funding and confirms the covered services and amount, we will notify you to proceed. You will be scheduled for surgery within the typical 6-month to 1-year timeline from the date of OHIP approval.

5.Pre-operative Planning:

We will guide you through all pre-operative consultations and preparations to ensure you are ready for your surgery.

6.Arrival & Care:

Arrive in Thailand and check in at WIH International Hospital. Our expert team will provide exceptional surgical care and comprehensive post-operative support.

7.Direct Billing:

We handle all the paperwork. WIH submits the bill directly to OHIP, and they process the payment, ensuring a direct and hassle-free settlement.

By choosing WIH International Hospital, you can focus on your health and well-being while we manage the logistics of your OHIP-approved out-of-country care.

Learn more about OHIP funding, eligibility, and step-by-step application instructions in our full guide.