On September 7, 2025, Thailand marked another major milestone in its Universal Health Coverage (UHC), widely known as the “Gold Card,” when the National Health Security Office (NHSO) officially announced the inclusion of gender-affirming hormone therapy as a new benefit. This long-awaited policy represents a crucial step toward Equal Health Access directly addressing the urgent health needs and rights of transgender people.
Dr. Nithiwat Sangrueang, Assistant Secretary-General of NHSO, explained that “This benefit originated from the demands of transgender communities who had previously raised the issue with the former Prime Minister. It was later carried forward as a key policy of the current government. The process involved collaboration among multiple stakeholders—including civil society, LGBTQ+ groups, academics, and the medical profession—culminating in the formal integration of gender-affirming hormone therapy into the Gold Card system.”
Equal Health Access – Why Gender-Affirming Hormone Therapy Matters
Gender-affirming hormone therapy refers to the medical use of hormones to help align an individual’s body with their gender identity when it does not match their sex assigned at birth. Access to appropriate hormone treatment improves the quality of life for transgender people, reduces psychological distress, and enhances confidence in daily living.
- Transgender Women (Male-to-Female): Hormones are used to block testosterone and enhance estrogen, leading to softer voices, wider hips, reduced body hair, and less facial hair.
- Transgender Men (Female-to-Male): Most use injectable testosterone, which deepens the voice, promotes muscle growth, and stimulates facial hair.
This is not a matter of “cosmetic enhancement” or “fashion.” Rather, it is a necessary medical intervention directly tied to fundamental human rights and the right to live with dignity.
Budget and NHSO Support
To make gender-affirming hormone therapy accessible, the NHSO has allocated an initial budget of 140 million THB (approximately USD 3.8 million). The budget covers the costs of medication, health check-ups, and professional consultations. If demand exceeds projections, NHSO will allocate additional funding in subsequent years.
Currently, NHSO is in the process of procuring medications for distribution to regional service units. Hospitals and clinics in Bangkok and other areas that already provide these services will continue operations until NHSO supplies are delivered.
Equal Health Access – Gold Card Hormone Benefit
Under the Gold Card scheme, transgender people may access both oral and injectable hormone therapies, prescribed according to individual health conditions, age, and medical assessments. Importantly, this benefit extends beyond simply providing medication. It encompasses holistic care, including:
Comprehensive Consultation
Every patient must first undergo counseling by a multidisciplinary team—doctors, nurses, social workers, and psychologists—to assess readiness, explain potential benefits and side effects, and provide clear understanding of expected bodily changes.
Physical and Blood Examinations
Regular health screenings are included, as long-term hormone therapy may affect bodily systems. Coverage includes cholesterol checks, blood pressure monitoring, and assessments of liver, kidney, and heart function to ensure safety and prevent complications.
Ongoing Health Monitoring
After beginning treatment, patients must return for follow-ups at intervals of three months, six months, one year, or two years, depending on risk levels and medical evaluations. These follow-ups allow physicians to adjust dosages or treatment plans as necessary.
Telemedicine Services
To expand access and convenience, telemedicine is now integrated into the benefit package. Transgender patients, particularly those in rural areas, can consult doctors and receive follow-up care online, reducing travel burdens and costs.
It can be said that the “gender-affirming hormone therapy” benefit under the Gold Card is not merely an additional treatment option, but is designed to establish a comprehensive healthcare system that addresses both physical and mental dimensions. Its goal is to enable transgender people in Thailand to live with confidence, safety, and a truly improved quality of life.
Equal Health Access – Steps to Gender-Affirming Hormone Therapy
Those who wish to access gender-affirming hormone therapy under the Gold Card scheme must go through the following process::
| Step | Details |
|---|---|
| 1. Initial Consultation | Multidisciplinary assessment with doctors, nurses, social workers and psychologists to evaluate gender identity and readiness. |
| 2. Health and Mental Screening | Screening for contraindications such as heart disease, hypertension, or depression. |
| 3. Risk Information | Explanation of benefits and risks, including possible side effects such as allergies, stroke risk, breast cancer, and irreversible physical changes. |
| 4. Begin Treatment | Start hormone therapy in oral or injectable form under medical supervision. |
| 5. Continuous Monitoring | Regular blood tests and consultations to ensure safe and effective treatment. |
Telemedicine: A New Path for Transgender Healthcare
Telemedicine is one of the highlights of this new policy. It allows transgender individuals to consult doctors and track hormone levels remotely—particularly useful for those already on stable regimens. This reduces travel costs and improves continuity of care.
Service Availability and Expansion
Initially, NHSO will roll out services through hospitals and medical schools in major provinces, along with existing clinics already providing gender-affirming hormone care. The Ministry of Public Health is developing models to expand coverage nationwide.
Additionally, NHSO will publish a list of participating hospitals and clinics on its website to help the public easily find service locations. For those seeking consultations, appointments can also be booked online at https://love2test.org
Voices from the Transgender Community
The inclusion of gender-affirming hormone therapy has been warmly welcomed by the transgender community. Many describe it as a “historic step” that moves Thailand closer to true equality.
Previously, transgender individuals often had to bear the costs themselves, purchase unsafe hormones online, or access unregulated treatments—leading to serious health complications. Coverage under the Gold Card helps reduce inequality and ensures safety under proper medical supervision.
Social and Human Rights Dimensions
Access to gender-affirming hormone therapy is not just about physical and mental health—it is also about human dignity and human rights. Integrating this benefit into Thailand’s national health system reflects governmental recognition of gender diversity at the policy level.
This initiative also aligns with the United Nations Sustainable Development Goals (SDGs), which emphasize reducing inequality and ensuring universal access to healthcare.
Ongoing Challenges
While this policy is a breakthrough, challenges remain, including:
- Expanding services nationwide to ensure equal access.
- Building understanding among healthcare providers who may still hold biases.
- Ensuring sustainable, sufficient long-term funding.
- Educating the public to reduce stigma and discrimination against transgender people.
Related Articles
- Want to take hormones? Read this first: A guide to taking hormones safely and without danger.
- Hormone Therapy Access Expanded for Transgender in Thailand
Conclusion: A New Era of Equal Health Access
The inclusion of gender-affirming hormone therapy in Thailand’s Gold Card system represents a major advancement—not only in transgender health but also in the nation’s journey toward equality.
It affirms that healthcare is a right for everyone, leaving no one behind. NHSO and the Ministry of Public Health continue to strengthen services—ranging from counseling and medical check-ups to telemedicine—to ensure quality, safe, and inclusive care for all transgender individuals.
This is not only a victory for transgender people but also a milestone for Thai society as a whole, reinforcing respect for diversity and the dignity of every human being.
Reference:
สปสช. เปิดสิทธิฮอร์โมนยืนยันเพศสภาพในบัตรทอง ดูแลครบวงจรกลุ่มคนข้ามเพศ
- https://www.hfocus.org/content/2025/09/35203
สปสช.แจงรายละเอียดสิทธิประโยชน์ บริการฮอร์โมนสำหรับคนข้ามเพศ
- https://prachatai.com/journal/2025/09/114541
สปสช.แจงรายละเอียด สิทธิประโยชน์ ‘บริการฮอร์โมน’ สำหรับคนข้ามเพศ
- https://www.thecoverage.info/news/content/9584