NHSO Details New "Gender-Affirming Hormone Therapy" Benefit Under Gold Card, Expanding Healthcare Access for Transgender Individuals

The National Health Security Office (NHSO) has announced the details of its new "Gender-Affirming Hormone Therapy" benefit for members of Thailand's Universal Health Coverage (UHC) scheme. The coverage, which includes services for both transgender women and men, marks a significant step towards equitable healthcare. Recipients will be required to undergo a comprehensive counseling and evaluation process with a multidisciplinary team to ensure patient safety and understanding.

On September 8, 2025, Dr. Nithiwat Saengruang, Assistant Secretary-General of the NHSO, elaborated on the details of the "Gender-Affirming Hormone Therapy" benefit package, which was officially approved by the NHSO board in July 2025. This move is seen as a major advancement for Thailand's universal healthcare system.

Dr. Nithiwat stated that the initiative was born from the advocacy efforts of the transgender community, which brought the issue to the attention of the previous government and has been carried forward as a key policy by the current administration. The benefit was developed through a collaborative effort involving transgender community representatives, medical professionals, and the NHSO, incorporating extensive research and public hearings to make the policy a reality.

Benefit Details and Types of Hormones Covered

The benefit package developed by the NHSO will cover hormone treatments in both pill and injectable forms, with the specific regimen tailored to the individual's needs:

• For Transgender Women (Male-to-Female): Treatment plans may vary based on age and prior hormone use. For example, younger individuals might only require male hormone blockers, while others may use estrogen pills. These treatments will induce physical changes such as hip development, reduced facial hair, and a softer voice.
• For Transgender Men (Female-to-Male): The most common treatment involves testosterone injections, which lead to physical changes such as a deeper voice, facial hair growth, and increased muscle mass.

Process and Conditions for Receiving Services

To ensure patient safety and informed consent, anyone wishing to access these services must undergo a rigorous evaluation process managed by a multidisciplinary team. This team will include specialized physicians, nurses, social workers, and psychologists at designated healthcare facilities. The goals of this process are to:

• Assess and confirm that the individual has Gender Incongruence.
• Provide comprehensive counseling on the benefits, side effects, and potential risks of hormone therapy, such as allergic reactions, cardiovascular disease, stroke, and an increased risk of breast cancer, as well as the reversibility of the changes.
• Conduct a thorough physical and mental health screening to identify any other health issues that may need to be addressed before beginning treatment.

Budget and Implementation Plan

The NHSO has allocated an initial budget of 140 million baht to support the benefit. This budget covers the cost of hormone medication as well as necessary services like blood tests, cholesterol screenings, and other regular check-ups (at 3, 6, 12, or 24-month intervals). The budget will be re-evaluated and potentially increased in the following year if patient demand exceeds projections.

The program is currently in the drug procurement phase, with a rollout plan as follows:

• Bangkok Metropolitan Area: Clinics that are already providing these services can continue to do so. The NHSO will later provide the medication to replenish their stock.
• Other Provinces: The Ministry of Public Health is currently developing service models, with an initial launch planned at well-equipped facilities, such as university hospitals in major provinces.
• Use of Telemedicine: A telemedicine system will be used for consultations and follow-up appointments, especially for patients who are on a stable and continuous hormone regimen.

"The introduction of this benefit package is good news and a source of hope for all transgender people in Thailand," Dr. Nithiwat concluded. He added that the NHSO will soon publish a list of participating hospitals and clinics on its official website to make it easy for the public to find and access these vital services.