Research highlighted by Academia.edu notes that stigma from family, community, and authority figures is common.

Qualitative Analysis of Thai Ladyboys' Occupational Wellbeing

In media and online spaces, certain physical features like hands or Adam's apples are frequently highlighted, sometimes in ways that reinforce stereotypes or contribute to "gender surveillance". Vulnerabilities and Rights Many in the community experience marginalization:

The Thai word kathoey is the more accurate and respectful term for individuals who identify as a feminine gender despite being assigned male at birth.

The phrase "hard thumbs" often refers to physical markers that are sometimes used to identify transgender individuals.

Transgender women may have physical characteristics from their male birth assignment, such as larger hands or distinct bone structures.

Scientific studies, like those from ResearchGate , have explored the ratio between the index (2D) and ring (4D) fingers as a biological marker, though results regarding gender identity are often mixed and not definitive for identifying individuals.