Elephant tourism in Thailand, Cambodia, and elsewhere includes a wide range of welfare outcomes from severely harmful to genuinely ethical.
Elephants trained for riding undergo cruel conditioning involving restraint and pain to suppress natural defensive behaviors. Riding causes spinal damage from the weight of carrying chairs and passengers. Performing elephants show chronic stress indicators including stereotypies and aggression toward handlers. By contrast, sanctuary elephants that are observed foraging and socializing naturally show dramatically better welfare indicators.