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Despite a public perception of tolerance, many face exclusion from family, community, and official policies.

The intersection of gender identity and sex work creates heightened risks, often described in narratives of "extreme" or coercive experiences: ladyboys in extreme sex

There is often ambiguity regarding consent in these environments. Individuals may agree to sexual advances due to financial desperation or the promise of payment, even when the situations are coercive. Despite a public perception of tolerance, many face

Studies indicate a high vulnerability to abuse. This includes being forced into sexual acts through physical struggle or threats with weapons. Despite a public perception of tolerance