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The winner of the pageant receives a tiara, sash, car, grand price of 100,000 baht (3,000 USD) - equivalent to a yearly wage for a factory worker living in Thailand.In 1993, Thailand's teacher training colleges implemented a semi-formal ban on allowing homosexual (which included kathoey) students enrolling in courses leading to qualification for positions in kindergartens and primary schools.As well as trans individuals, the term can refer to gay men, and was originally used to refer to intersex individuals.Because of this confusion in translation, the English translation of kathoey is usually "ladyboy" (or variants of the term).Families (and especially fathers) are typically disappointed if a child becomes a kathoey, and kathoeys often have to face the prospect of coming out.However, kathoey generally have greater acceptance in Thailand than most other Asian countries.

It has a meaning similar to the English language "fairy" or "queen".Using the notion of karma, some Thai believe that being a kathoey is the result of transgressions in past lives, concluding that kathoey deserve pity rather than blame.Kathoeys currently face many social and legal impediments.One must provide evidence of diagnosis of gender dysphoria from a psychologist/psychiatrist.Before going through gender reassignment surgery, one must be on hormones/antiandrogens for at least one year.

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However, when considering transgender women (Mt F) as a group in Thai society, most refer to themselves as phuying (Thai: ผู้หญิง "women"), with a minority referring to themselves as phuying praphet song (a "second kind of woman") and only very few referring to themselves as kathoey.