Thailand’s government has passed stricter rules for patients seeking gender reassignment surgery.
Patients will now be required to live and dress as the opposite gender for a year before surgery and must be over 18. Men aged between 18 and 20 must also gain parental consent.
They must also undergo a mental evaluation before the procedure and attend appointments with a psychiatrist afterwards.
The law change was prompted after doctors reported seeing a rise in the number of young trans women seeking genital surgery.
Dr Sampandh Komrit of the Medical Council of Thailand told Associated Press that the regulations gave patients more time to consider the surgery.
He said: “This is a very important decision in their life. After the operation, there is no way to fix it.”
Gender reassignment surgery in Thailand can cost as little as $2,000 (£1,218), making it a popular surgery destination for western trans people.
It is one of the more tolerant countries towards trans men and women.
They have regular presence on TV, in movies and the entertainment business, but many still face family pressure, social prejudice and domestic violence.