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In Thailand, the term (often translated as "ladyboy" for tourists) is a deeply rooted part of the social fabric. Unlike in many Western cultures, where gender is often seen as a binary, Thai culture has long recognized a spectrum. Some see being a kathoey through the lens of karma—a unique path to be met with pity or acceptance rather than judgment.

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However, language is evolving. While some creators use the term "ladyboy" affectionately or for searchability, others find it reductive or offensive, preferring to be called . The Rise of "Tube" Storytelling In Thailand, the term (often translated as "ladyboy"