There are clear linkages between discrimination and health for people across intersections of race, ethnicity, socioeconomic status, citizenship, sexual orientation, gender identity and expression, and other social identities. Yet, less research has examined discrimination and health for transgender people outside of the USA, who can face different cultural ideals, access to resources, and social structures. How might research on discrimination and health account for the interplay of diverse social identities, micro-level experiences, meso-level settings, and macro-level structural/cultural contexts? Based on 14months of fieldwork in Thailand and interviews with 62 participants, this article bridges the minority stress model with an ecosocial framework to analyze how Thai transgender women navigate and resist structural and everyday discrimination across a variety of settings and encounters. Incorporating minority stress theory's attention to discrimination, stigma, and stereotypes, the article demonstrates how Thai transgender women face indignity, disrespect, and dehumanization based on gender. Incorporating the ecosocial framework, the article analyzes how discriminatory structural laws, policies, and rules-as well cultural hierarchies of femininity, interpersonal relations, internalized beliefs, and commodified health/medical technologies-are pathways to Thai transgender women's health and health decision-making. By merging these theoretical frameworks, the article goes beyond an "event-focused" approach to minority stress and discriminatory encounters, instead illuminating the interconnected micro, meso, and macro levels impacting Thai transgender women's health outcomes, decision-making, and everyday life.