T*********rism is not an American thing regardless of how you view it.

It is a COURAGEOUS Decision to seek inner peace with one’s body.


Mindanao, Philippines and Bangkok, Thailand —


By 8:30am on April 27, 2023, the Pratunam Polyclinic in Bangkok was already full. Women sitting in rows of plastic chairs occupied most of the already cramped reception area. An empty fish tank with dirty water stood in one corner of the room and a receptionist snapped instructions in broken English in the other.

It is here, according to the owner of the clinic, that hundreds of t*********r women, from across Asia and further afield, come every year, hoping to get an anatomy that better reflects their g****r identity – at a fraction of what it costs elsewhere.

On that Thursday, 29-year-old Bianca Balala from the Philippines was one of them. After years of “being trapped in a wrong body,” and working to save up the money for a g****r affirming vaginoplasty, Balala finally took what she called the “longest journey of my life.”

The 12-hour trip started when she took a bus from her rural hometown in southern Philippines to Pagadian City, where she caught a flight to Manila. The next day, she boarded another plane to Bangkok. Balala checked into a hostel once she arrived, and four days later, she walked a short distance to the Pratunam Polyclinic, feeling nervous but determined.

A staff member handed her a dressing gown and gestured for her to get changed in an adjacent room with yellowed newspaper clippings of women in lingerie and before-and-after breast surgery pictures were taped to the walls. Then she was led up three flights of narrow stairs to a windowless operating room. After she lay down on an old operating table, her arms were strapped by the wrists to a narrow wooden plank placed horizontally under her upper back.



Listen to this woman who says she risked it all for g****r affirming surgery
The small operating room was stuffed with random items, including a VCR, and empty boxes of breast implants were stacked up to the ceiling, Balala told CNN. The sight “shocked” her because it didn’t look like anything like an operating room.

Despite being told to leave all her belongings at the reception desk, she said she snuck in a pink rosary in her dressing gown pocket. Her mother had pressed it into her hands as they waited for the bus that would take her on a trip that would mark the end of one chapter of her life and the beginning of another.

“My heartbeat was so fast,” Balala told CNN. “I was just thinking, what if bad things happen to me?” Balala began to pray.


The reception area of Pratunam Polyclinic, Bangkok, in July 2023. Watsamon Tri-yasakda for CNN

Pratunam Polyclinic, opened in 1988 by Dr. Thep Vechavisit, has built a reputation, according to media reports, as a low-cost destination for g****r affirming and cosmetic procedures including breast augmentation, nose jobs, and vaginoplasty, which involves rearranging g*****l tissue to create a vagina and vulva.

Balala told CNN that she was quoted $7,300 for a vaginoplasty by a clinic in the Philippines. In Thailand, few clinics publicly disclose their pricing. But one plastic surgeon in Bangkok charges between $6,500 and $12,000, depending on the surgical technique, according to his website. Another clinic in the Thai capital says the cost can vary from $10,000 to $17,000. But Pratunam Polyclinic offers vaginoplasty using the penile inversion technique for just $2,065.

Dr. Thep, as everyone calls him, said he performs roughly 350 vaginoplasties every year. Most of his patients are from Thailand but about 20% travel to the clinic from other Asian countries, including: India, China, Indonesia, Malaysia and the Philippines. They come despite the discrimination they face and the lack of healthcare support for t*********r people in their home countries.


“People come to see me for my sk**ls, not because of what my clinic looks like,” said Dr. Thep Vechavisit, 71, who founded and runs Pratunam Polyclinic. Watsamon Tri-yasakda for CNN

In the case of the Philippines, the national health insurance program, PhilHealth, does not currently cover g****r affirmation surgeries for t*********r people, said Dr. Albert Domingo, deputy spokesperson for the Philippine Department of Health.

Balala had known about the Pratunam Polyclinic’s low-cost surgeries for some time but said she had initially been reluctant to go to Dr. Thep. She told CNN that she’d heard mixed reviews. Some of his patients had been happy with their operations, but others said they’d experienced medical complications or been unhappy with the results of their surgeries, because they weren’t aesthetically pleasing. There were also complaints about the rudeness of the clinic’s staff.

But Balala would soon change her mind.

“I risked everything to go”
Balala was assigned male at birth. When she was around five years old, she remembers wrapping a handkerchief around her head to mimic long hair and telling her grandmother, “This is my hair. I am a woman.”

Her mother, Juhanna Balala, told CNN that she let Balala be. “She has always been my daughter.” Despite their strong Catholic faith, family members helped Balala accept her g****r identity as she grew up.


Having heard mixed reviews about Dr.Thep, Balala held on to her faith as she underwent surgery at his clinic in Bangkok. Mailee Osten-Tan for CNN

As a teenager, she started to participate in local t***s beauty pageants. Exposure to older t***s beauty queens, who had undergone surgical t***sitions, made Balala think about getting g****r affirming surgeries herself. “I wanted to have the surgery to become more confident in my body. It was really hard for me to have the male part.”

Not all people who identify as t***s or non-binary feel they need surgery, but for some, the g****r dysphoria or discomfort caused by the incongruence between their physical bodies and g****r identity, can take a heavy mental and emotional toll. Globally, according to a 2023 review and meta-analysis of 65 selected studies, the prevalence of suicidal thoughts and attempted suicide among t*********r people over their lifetime was 50%, and 29% respectively, and nearly half of the t*********r people who had suicidal thoughts did end up taking their own lives.

Despite the distress Balala’s body caused her, the cost of a vaginoplasty was much more than she could afford. She said a clinic in Manila had quoted her $7,300 for the procedure.

But Balala lives hundreds of miles away in the southern Philippines, where the incidence of poverty among families in the province was estimated at around 44% in the first part of 2023, according to official government statistics. Most people in her rural hometown support themselves through farming or run small businesses. Balala sold husky puppies and, occasionally, sex online. “I h**e to say it but it’s part of survival,” she told CNN.

Yep...so important that all you put in your posts is mumbo jumbo that still identified absolutely zero marriage.... everything you wrote in your post is nothing but beat around the bush and a bunch of spin that still for all your efforts....NO MARRIAGE....why?.... because marriage is man made and because it's man made then let whoever wants to marry then let them marry....I notice you didn't spend any efforts defending the times that men could have multiple wives.....but the t***h is marriage is man made...as i said earlier if it's so important then it would be in Genius and a ceremony would have been articulated...not in a way you put the spin on ....my whole point is that why dont you trumpers just let others be and worry about yourselves instead of a few q***rs that dont call you names or make degrading comments about you...when you people bring in the Bible to support what you claim dont forget that there is some stories in the Bible that are not so wholesome...this world will be better place to live when everyone respects everyone and handles their own business and not others

I am heterosexual and always have been ...its you trumpers that think you're on a mission from God to make the world a better place...but better according to your standards..I read posts that say Biden didn't send out Happy Easter greetings to all Christians...that's false because he most certainly did...No outrage last year when on March 31 Fox News sent out t*********r greetings...The point is that people that believe in freedom also believe to stop worrying about everyone else and quit putting false information out...like saying there are Dr.s performing reassignment surgery on kids because it's not happening in this country.i don't know about other countries but not in America...these young people have to go to counseling for 2 years before they can even get hormones prescribed....so stop making things more then what they are...you can always find someone to back up a narrative no matter what it is from or the subject being presented.i remember when the traditional marriage people where so outraged when it became legal for gays to get married....saying it diminished their marriage....the only thing that seems to diminish any marriage is not realize that it takes work and sacrifice to have a lifelong lasting partnership that both sides should do...I think the number today is over 80 percent of marriages end in divorce....that's really sad if we think about it

T*********r is a made up name for something that people are doing. There is no such thing. Males use that in sports because they are not good enough to compete with other males but can win if they compete with females. Some males use that to get into girls toilets and dressing rooms. They are sick and need help from a mental institution and thrown out of the dressing rooms and toilets. Females should not be subjected to that kind of treatment. It is my opinion that anyone who condones what is happening is just as sick also.

T*********rism is not an American thing regardless of how you view it.

It is a COURAGEOUS Decision to seek inner peace with one’s body.


Mindanao, Philippines and Bangkok, Thailand —


By 8:30am on April 27, 2023, the Pratunam Polyclinic in Bangkok was already full. Women sitting in rows of plastic chairs occupied most of the already cramped reception area. An empty fish tank with dirty water stood in one corner of the room and a receptionist snapped instructions in broken English in the other.

It is here, according to the owner of the clinic, that hundreds of t*********r women, from across Asia and further afield, come every year, hoping to get an anatomy that better reflects their g****r identity – at a fraction of what it costs elsewhere.

On that Thursday, 29-year-old Bianca Balala from the Philippines was one of them. After years of “being trapped in a wrong body,” and working to save up the money for a g****r affirming vaginoplasty, Balala finally took what she called the “longest journey of my life.”

The 12-hour trip started when she took a bus from her rural hometown in southern Philippines to Pagadian City, where she caught a flight to Manila. The next day, she boarded another plane to Bangkok. Balala checked into a hostel once she arrived, and four days later, she walked a short distance to the Pratunam Polyclinic, feeling nervous but determined.

A staff member handed her a dressing gown and gestured for her to get changed in an adjacent room with yellowed newspaper clippings of women in lingerie and before-and-after breast surgery pictures were taped to the walls. Then she was led up three flights of narrow stairs to a windowless operating room. After she lay down on an old operating table, her arms were strapped by the wrists to a narrow wooden plank placed horizontally under her upper back.



Listen to this woman who says she risked it all for g****r affirming surgery
The small operating room was stuffed with random items, including a VCR, and empty boxes of breast implants were stacked up to the ceiling, Balala told CNN. The sight “shocked” her because it didn’t look like anything like an operating room.

Despite being told to leave all her belongings at the reception desk, she said she snuck in a pink rosary in her dressing gown pocket. Her mother had pressed it into her hands as they waited for the bus that would take her on a trip that would mark the end of one chapter of her life and the beginning of another.

“My heartbeat was so fast,” Balala told CNN. “I was just thinking, what if bad things happen to me?” Balala began to pray.


The reception area of Pratunam Polyclinic, Bangkok, in July 2023. Watsamon Tri-yasakda for CNN

Pratunam Polyclinic, opened in 1988 by Dr. Thep Vechavisit, has built a reputation, according to media reports, as a low-cost destination for g****r affirming and cosmetic procedures including breast augmentation, nose jobs, and vaginoplasty, which involves rearranging g*****l tissue to create a vagina and vulva.

Balala told CNN that she was quoted $7,300 for a vaginoplasty by a clinic in the Philippines. In Thailand, few clinics publicly disclose their pricing. But one plastic surgeon in Bangkok charges between $6,500 and $12,000, depending on the surgical technique, according to his website. Another clinic in the Thai capital says the cost can vary from $10,000 to $17,000. But Pratunam Polyclinic offers vaginoplasty using the penile inversion technique for just $2,065.

Dr. Thep, as everyone calls him, said he performs roughly 350 vaginoplasties every year. Most of his patients are from Thailand but about 20% travel to the clinic from other Asian countries, including: India, China, Indonesia, Malaysia and the Philippines. They come despite the discrimination they face and the lack of healthcare support for t*********r people in their home countries.


“People come to see me for my sk**ls, not because of what my clinic looks like,” said Dr. Thep Vechavisit, 71, who founded and runs Pratunam Polyclinic. Watsamon Tri-yasakda for CNN

In the case of the Philippines, the national health insurance program, PhilHealth, does not currently cover g****r affirmation surgeries for t*********r people, said Dr. Albert Domingo, deputy spokesperson for the Philippine Department of Health.

Balala had known about the Pratunam Polyclinic’s low-cost surgeries for some time but said she had initially been reluctant to go to Dr. Thep. She told CNN that she’d heard mixed reviews. Some of his patients had been happy with their operations, but others said they’d experienced medical complications or been unhappy with the results of their surgeries, because they weren’t aesthetically pleasing. There were also complaints about the rudeness of the clinic’s staff.

But Balala would soon change her mind.

“I risked everything to go”
Balala was assigned male at birth. When she was around five years old, she remembers wrapping a handkerchief around her head to mimic long hair and telling her grandmother, “This is my hair. I am a woman.”

Her mother, Juhanna Balala, told CNN that she let Balala be. “She has always been my daughter.” Despite their strong Catholic faith, family members helped Balala accept her g****r identity as she grew up.


Having heard mixed reviews about Dr.Thep, Balala held on to her faith as she underwent surgery at his clinic in Bangkok. Mailee Osten-Tan for CNN

As a teenager, she started to participate in local t***s beauty pageants. Exposure to older t***s beauty queens, who had undergone surgical t***sitions, made Balala think about getting g****r affirming surgeries herself. “I wanted to have the surgery to become more confident in my body. It was really hard for me to have the male part.”

Not all people who identify as t***s or non-binary feel they need surgery, but for some, the g****r dysphoria or discomfort caused by the incongruence between their physical bodies and g****r identity, can take a heavy mental and emotional toll. Globally, according to a 2023 review and meta-analysis of 65 selected studies, the prevalence of suicidal thoughts and attempted suicide among t*********r people over their lifetime was 50%, and 29% respectively, and nearly half of the t*********r people who had suicidal thoughts did end up taking their own lives.

Despite the distress Balala’s body caused her, the cost of a vaginoplasty was much more than she could afford. She said a clinic in Manila had quoted her $7,300 for the procedure.

But Balala lives hundreds of miles away in the southern Philippines, where the incidence of poverty among families in the province was estimated at around 44% in the first part of 2023, according to official government statistics. Most people in her rural hometown support themselves through farming or run small businesses. Balala sold husky puppies and, occasionally, sex online. “I h**e to say it but it’s part of survival,” she told CNN.