Originally Posted by The Woodpecker

Good question. It's part nature, and part training, and part surgery.

A lot of Thai men are born with very feminine characteristics. If the psychology is overtly feminine as well, the men are identified by others or define themselves as women. Often those men with softer features, smoother skin, or excessive lack of hair are thought to be potential ladyboy candidates. Buddhist Thai's believe in karmic reincarnation, so if one is to be a ladyboy, they are usually BORN a ladyboy.

If a boy decides he is a kathoey, or his mother (rarely his father) identifies him as a ladyboy, he begins living like a girl very early. He will probably not engage in sports, and will not participate in other activities that will develop his body in a "manly" way. By the time he is a teen, his body will be slender and toned, not muscular and large.

Those who can afford it and who make the life choice to look as much like a woman as possible will undergo various cosmetic surgeries. Surgery in Thailand is very cheap (a nose job runs about $150), so some kathoeys will get nose jobs, chin jobs, cheek implants, breast augmentations, silicone injections, GRS, and various other modifications that they feel make them more feminine.

Getting the honest truth from many kathoeys is a difficult and very trust-oriented process. And a very personal subject as well. I can't tell you who had what done on this site, because I don't know. But they are beautiful, aren't they?