Symptoms of Untreated Hupogonaudism After SRS
These symptoms begin within weeks of surgery if HRT is not started. The longer HRT is delayed, the greater the impact on health and quality of life. APS’s programme ensures you leave Bangkok with your first prescription already in hand — so there is no gap in your hormonal care.
Interested in all MTF gender affirming surgeries offered at APS? Browse APS’s home page here.
Pre-Consultation Blood Work
What APS Tests and Why
Before your initial HRT consultation in Bangkok, a comprehensive blood panel is taken to establish your hormonal baseline and screen for any health factors that could affect your prescription. These tests are included in the initial consultation fee and taken at APS during your recovery stay.
| TEST | WHAT IT MEASURES & WHY |
|---|---|
| Estradiol (E2) | Measures circulating oestrogen levels. The primary target hormone for MTF HRT — used to calibrate the correct starting dose of oestrogen therapy. |
| Total Testosterone & Estrogen | Confirms suppression of testosterone or estrogen. Essential for establishing a hormonal baseline and adjusting anti-androgen needs if applicable. |
| Lipid Profile | Screens for cholesterol and triglyceride levels. HRT can affect cardiovascular health — this baseline helps Dr. Thanaphop choose the safest form of oestrogen delivery for your individual profile. |
| AST & ALT (Liver Enzymes) | Checks liver function. Some forms of oral HRT are processed by the liver — abnormal levels may indicate preference for transdermal (patch or gel) delivery instead. |
| CBC (Complete Blood Count) | Full blood count including red and white blood cells, haemoglobin, and platelets. Screens for anaemia and other conditions relevant to HRT safety. |
| Creatinine (Cr) | Kidney function marker. Ensures your kidneys are processing medications effectively before prescription. |
| FBS (Fasting Blood Sugar) | Screens for diabetes or pre-diabetes. Relevant because HRT can affect insulin sensitivity in some patients. |
Interested in all MTF gender affirming surgeries offered at APS? Browse APS’s home page here.
Total estimated annual cost after the first year: approximately ฿3,600–฿7,200 for two follow-up consultations (฿1,800 × 2) + ฿6,000–฿12,000 in medication (฿500–฿1,000/month × 12) = ฿9,600–฿19,200 per year (~$265–$530 USD / ~$415–$830 AUD). Significantly more affordable than equivalent private HRT programmes in Western countries.
Frequently Asked Questions About the APS HRT Program
No. The APS HRT Program is open to any patient who has undergone sex reassignment surgery or hysterectomy — whether at APS or at another clinic anywhere in the world. If you are seeking a reliable, professionally managed HRT provider after surgery elsewhere, you are welcome to join the program. Contact APS to discuss your situation and we will confirm the onboarding process for patients who did not have surgery at APS.
The APS HRT Program is primarily designed for post-surgical hormonal management — specifically for patients who have undergone procedures that remove their primary hormone-producing organs (orchiectomy, oophorectomy). Pre-surgical HRT for patients who still have their gonads intact is a different clinical situation. Contact APS to discuss your specific circumstances and Dr. Thanaphop will advise on whether the programme is appropriate for you at this stage.
Medication delivery from Thailand is subject to the import and customs regulations of your home country. APS will confirm whether delivery to your country is feasible before you enrol in the program — we will not take payment for medication delivery to countries where we cannot reliably ship. Most countries with significant APS patient populations (Australia, USA, UK, EU countries) can receive medical shipments from Thailand, but restrictions vary. Contact APS to confirm your country’s status before enrolling.
Yes — Thai law and international WPATH guidelines require two independent psychiatric evaluations by certified Thai psychiatrists confirming gender dysphoria before HRT can be prescribed for gender-affirming purposes. APS arranges these evaluations fully online through certified psychiatrists at major Bangkok hospitals — you do not need to travel to Thailand for them. If you have already completed psychiatric evaluations through another provider, contact APS to discuss whether your existing documentation can be accepted.
Follow-up consultations with Dr. Thanaphop are scheduled every 3–6 months, depending on how stable your hormone levels are and how you are responding to your current prescription. Each follow-up requires a blood test from a local laboratory in your home country — at minimum, an Estradiol (E2) test, though Dr. Thanaphop may request additional tests based on your individual health profile. The blood test is arranged and paid for locally by you — the ฿1,800 consultation fee covers the online consultation and prescription renewal only.
The initial HRT consultation at APS takes place during your surgery recovery stay in Bangkok — typically a few days after your procedure, once you are stable and comfortable. It includes a pre-consultation blood panel covering 7 tests (Estradiol, Total Testosterone, Lipid Profile, AST, ALT, CBC, Creatinine, and FBS), an in-person consultation with Dr. Thanaphop to review your results and assess your hormonal needs, and your initial HRT prescription. You leave Bangkok with 3–6 months of medication — ensuring continuity of care from day one and no gap in your hormonal management between leaving Thailand and your first follow-up at home.