“When we were young”: A qualitative study on early life experiences of medical students with sexual and gender diversity assigned male at birth in Thailand

This study explored the childhood experiences of young adults with sexual and gender diversity (SGD) assigned male at birth in Thailand, using semi-structured interviews with 18 medical students recruited from four universities and thematic analysis. Understanding early life experiences of individuals with SGD is important, as these formative years shape identity development, mental health, and patterns of self-disclosure, yet remain underexplored in non-Western contexts. Three main themes were developed: Distant paternal existence and closer connections to mother or female family members; Self-discovery through romantic relationships leading to identity confusion; and Perceived fears of parental disapproval not supporting self-disclosure. The findings highlight the central role of family dynamics, particularly the influence of female figures and extended family structures. They identify distinct milestones in the SGD journey, including romantic relationships preceding sexual activity and the impact of anticipated non-acceptance on disclosure. These findings emphasize the need for culturally informed research beyond Western frameworks. They also have implications for public health, underscoring the necessity of developing mental health services, sexual health education, and support systems that are sensitive to cultural contexts and family dynamics.