Thailand Adds Gender-Affirming Hormone Care to the Gold Card Benefit Package

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) was reported to have 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.”

List of Contents

1. Why Gender-Affirming Hormone Therapy Matters
2. Budget and NHSO Support
3. Gold Card Hormone Benefit
4. Steps to Gender-Affirming Hormone Therapy
5. A New Path for Transgender Healthcare
6. Voices from the Transgender Community
7. Ongoing Challenges

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 was reported to have 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 is expected to 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.

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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. Not all transgender people want or need hormone therapy, and eligibility depends on clinical need and the terms of coverage. Importantly, this benefit extends beyond simply providing medication. It encompasses holistic care, including: Comprehensive Consultation The exact steps vary by service. In many programs, patients begin with counseling from a care team—which may include doctors, nurses, social workers, and psychologists—to discuss readiness, explain potential benefits and side effects, and clarify expected bodily changes. Care should follow the clinic's own protocol and shared decision-making between the person and their providers. Being transgender is not a psychiatric diagnosis, and this counseling is meant to support informed choices rather than to act as a gatekeeping requirement. 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 planned as part of the benefit package. The aim is for transgender patients, particularly those in rural areas, to 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. The plan is for it to let transgender people consult doctors and track hormone levels remotely—particularly useful for those already on stable regimens. This is intended to reduce travel costs and improve 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

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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 people 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 people.

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: NHSO adds gender-affirming hormone benefits to the Gold Card, providing comprehensive care for transgender people

• https://www.hfocus.org/content/2025/09/35203

NHSO explains the details of hormone service benefits for transgender people

• https://prachatai.com/journal/2025/09/114541

NHSO explains the details of the 'hormone service' benefit for transgender people

• https://www.thecoverage.info/news/content/9584

Verified references

Links and relevance to the article’s main topic were reviewed on 13 August 2026. Each source supports only the scope stated in the original document and does not replace personalised medical, legal, or service advice.

1. สปสช.: รายงานประจำปี 2567 Accessed 13 August 2026
2. สปสช.: บริการสุขภาพสำหรับชุมชน LGBTQ+ Accessed 13 August 2026
3. WHO: Guideline development for trans and gender-diverse health Accessed 13 August 2026