In the past decade, the websites of Thai tourist agencies have expanded their offerings to include medical tourism, and medical tourism online has experienced dramatic changes in packaging and marketing. These shifts suggest a move from Thai-style surgical offerings that were defined as primarily cosmetic to tourist-package style sex/gender-related surgeries under the category of sexual reassignment surgery (SRS). The existence of these websites and the changes in the promotion of sex/gender-related medical tourism over time reveal nuanced interplay of discontinuous sex/gender regimes. By examining the changes on a single website during an eighteen-month period, I indicate larger trends in the Thai medical tourism industry online that I have collected in a three-year period. "Trans" theory-translation, transnational, transsexual, transactional, and transitive-is the framework from which I describe these dynamic, discontinuous, dialogic transitions.