Many kathoey use Theravada Buddhism to frame their identity, sometimes viewing their gender status as a result of "bad karma" while simultaneously performing acts of merit to improve their future rebirths. Vulnerabilities in the Sex Industry

Beyond the vulnerabilities, many individuals find empowerment through transition and community:

Research shows that kathoey sex workers who have experienced family abuse are less likely to use protection, increasing the risk of HIV and other STDs. Specialized "ladyboy bars" can also put workers at risk when customers refuse to use condoms. Identity and Personal Agency

Discrimination in mainstream employment often funnels these individuals into specific sectors, most notably the entertainment and sex industries.

The intersection of gender identity and sex work creates heightened risks, often described in narratives of "extreme" or coercive experiences: