National Health Security Office (NHSO) is set to begin providing gender-affirming hormone therapy under the country’s Universal Coverage Scheme (UCS), marking a significant step toward improving access to transgender healthcare and advancing health equity.
The new benefit package, approved by the NHSO executive board and published in the Royal Gazette recently, includes hormone medications, laboratory monitoring, mental health counseling, and ongoing clinical follow-up for transgender people seeking gender-affirming care.
Distribution of hormone medications to participating healthcare facilities began on June 10.
The policy is among the first efforts in the region to integrate gender-affirming healthcare into a publicly financed universal health coverage system. It aims to reduce financial barriers to care while encouraging transgender individuals to access broader preventive and primary healthcare services.
“Once transgender healthcare becomes a health benefit, it encourages people to seek services. This helps bring them into the healthcare system,” said Dr. Jakkrapat Boonruang, physician-researcher at the Institute of HIV Research and Innovation (IHRI) and clinician at Tangerine Clinic, a specialized transgender health service in Bangkok.
“We can then encourage HIV testing and the use of HIV pre-exposure prophylaxis (PrEP), ensuring their overall wellbeing. Beyond gender transition, it also improves their quality of life through mental health support, proper medication use, and inclusion in health databases.”
Until now, many transgender people in Thailand have paid out of pocket for hormone therapy.
While some community-based clinics have received external support for laboratory services, medication costs have often remained the responsibility of service users, creating a substantial financial burden. For some individuals, monthly expenses for hormone treatment can reach several thousand baht.
Under the new benefit package, healthcare providers will be reimbursed for essential laboratory tests, including hormone level monitoring, liver and kidney function assessments, and other blood tests required for the safe administration of hormone therapy.
The package also covers a range of gender-affirming medications, including feminizing hormones, masculinizing hormones, anti-androgen medications, and injectable hormone-suppressing treatments.
According to Dr. Nitiwat Saengruang, Deputy Secretary-General of the NHSO, the agency has coordinated with Rajavithi Hospital to procure eight hormone products for nationwide distribution. These medications are divided into four categories: oral and topical estrogen products, injectable testosterone, oral anti-androgen medications, and injectable agents that suppress hormone production.
The NHSO expects approximately 50 healthcare facilities to participate in the initial phase of implementation. Participating providers include selected government hospitals, Bangkok Metropolitan Administration health centers, and civil society-led clinics with experience in transgender healthcare.
Healthcare facilities must complete specialized training before providing services to ensure that hormone therapy is delivered safely and according to clinical guidelines.
“Hormone therapy can have side effects affecting both physical and mental health, potentially leading to future health problems,” said Dr. Nitiwat.
“Therefore, individuals must receive comprehensive counseling before starting hormone treatment and should continue to be monitored by qualified specialists. Currently, several healthcare facilities are already prepared to provide these services.”
In parallel, the NHSO and the Ministry of Public Health are working with the Department of Corrections and the Prime Minister’s Office to develop service models that will enable transgender inmates to continue receiving hormone therapy while in custody, ensuring continuity of care for a population that has historically faced significant barriers to treatment.
The NHSO is currently finalizing the list of participating healthcare providers and will announce service locations in the coming weeks.
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