Sex Change Operations In Thailand
by Richard S. Ehrlich
BANGKOK, Thailand -- After a former U.S.
Army corporal became a grandfather, he
stopped secretly wearing women's clothes,
flew to Bangkok for a sex change operation
and emerged as a lesbian.
 "The price was reasonable. And what I liked about Bangkok is there was only a one-month waiting list, whereas in the U.S. there is at least eight months to wait to have the change." Thai doctors are experts at chopping off a male's sex organ and fashioning a vagina. "It's not until they remove the bandages that you realize it's gone," Ms. Higgins said, laughing in her modern hospital room. Five-feet seven-inches (170 centimeters) tall, 152 pounds (68.4 kilograms) and blonde, Ms. Higgins said the operation was not painful and, after a prescription of hormones, she did not need silicone to create breasts. Her story -- from birth as Robert James Higgins, a troubled Catholic childhood, marriage and parenting a daughter and becoming a grandfather -- illustrates the plight of thousands of people worldwide who feel they were born in the body of the opposite gender. Successfully concealing the confusion, Higgins was drafted and served in the U.S. Army from June 1968 to June 1970, including as a corporal and chief engineer in Okinawa. "Some people think it is strange that I was in the service and I'm [now] transgendered." Unlike some men who lived as gays before becoming women, Ms. Higgins said she has always been aroused only by women. "I still love my ex-wife." Despite divorcing in June over the sex change issue, the couple currently live together in Murrysville, Pennsylvania, 20 miles east of Pittsburgh where Ms. Higgins was born, she said. "The relationship is still the same. I still change oil in the cars, and cut the grass and do the household chores. I always did. In fact, I even do the cooking now, because she works 12 hours sometimes and when she comes home, she's hungry, so I have a meal for her," Ms. Higgins said. "I'm more attracted to women," she added. "I'm sort of classified as a lesbian." With "sex reassignment" operations now common in many countries, Thailand is trying to position itself as the best place for patients to go for medical facilities equal to the West, and delicate surgeons who can make the cut at cut-rate prices. Genital surgery in Bangkok cost Ms. Higgins 6,500 U.S. dollars, plus about 1,000 U.S. dollars for hospital care, and an additional 1,050 U.S. dollars for round-trip airfare between America and Thailand, she said. "You're going to spend about 25,000 dollars total, maybe a little more," including about 14,000 U.S. dollars for electrolysis. If she underwent transgender surgery in America, the bill would have been several thousand dollars higher, she said. People throughout the world are flocking to Bangkok for the operation, delighting Dr. Preecha Tiewtranon, who operated on Ms. Higgins. "Mainly men become women," Dr. Preecha said in an interview at his Preecha Aesthetic Institute where he is head of plastic and reconstructive surgery. "We do less [cases of] the woman becoming a man, because a woman to become a man is more complicated and needs many operations." He claimed to have performed "almost 3,000 cases in 25 years" changing males to females, plus "about 44 cases of a woman to become a man." Most patients are concerned about their ability to orgasm after changing sex. "They ask about the orgasm, they ask about the erogenous sensation," the plastic surgeon said. "Orgasm is complex. With our patients, about 60 to 80 percent have the orgasm" among men who become women. "The difficulty is because they need the hormones, and the hormone suppression suppresses part of the orgasm. For the woman who becomes a man...they have the orgasm because we keep their clitoris." American, European, Australian and other foreign males have a tougher time becoming attractive females, compared with Southeast Asian, Chinese, Japanese and other men from this region, he said. "The Westerner, you can see, is very big, very huge, overweight. If the patient is overweight and the pelvis bone is very narrow, surgery becomes more difficult and the appearance of the genital organ is not as good as the patient who has the normal weight, or the Oriental," Dr. Preecha said. "The reason the Oriental is better is because the Oriental takes the hormone and prepares themselves since they were young. "But the Westerner, they were treated when they become an older age. The result of the manipulation of the hormone is not as good as when you take it younger," he said. "And most of the Westerners who come in, they are already married, they already have children. Not like the Oriental." In Thailand, a youngster who feels like a girl trapped in a boy's body will often start taking hormones as a teenager. "For example, for the Thai [male] when they are young, if they thought they are going to be a woman, they associate among a group who are going through the same thing. They take the hormones since they were young, and they become already like a female, they dress, they behave, everything like a female," Dr. Preecha said. By the time they qualify for surgery, hormones have molded them similar to a female's body, while a foreigner may have only started taking hormones after developing muscle mass and other masculine attributes, he said. Thai transsexuals and transvestites are popular in Thailand and appear virtually every week on TV as guest speakers, comedians and in soap operas, and are accepted in a variety of professions and vocations. A large number work illegally as prostitutes but some have a reputation as violent consorts. Dr. Preecha drew attention to his skills at a "workshop" in the Thai capital on Dec. 9 and 10 when his institute hosted "The World's First Live Sex Reassignment Surgery", and invited international doctors and media to watch on a big monitor screen while Thai doctors turned a Thai man into a woman. "The reason we have this workshop is we want to show to Thai society, and we want to show to the world, that the standard of care, the standard of surgery in Thailand is now up to [international] standard," Dr. Preecha said. "No matter if the patient goes to have the operation anywhere in the world, it is going to be the same like in Thailand," he said. The two-day workshop coincided with Ms. Higgins' recovery from her sex change operation on Nov. 30, so she met the media at Dr. Preecha's institute before flying home. The workshop also emphasized the need for governments to allow transgendered people to have their passport and other identification cards reflect their new sex. In Thailand, transgendered people "do not have the I.D., they are still not complete," Dr. Preecha said. "So we want to show to society, show the government, show the people in Thailand, this is the existing entity. When they are travelling overseas, it is still 'mister' inside the passport." The U.S. State Department and Pennsylvania officials easily agreed to update Ms. Higgins' passport and other identification, she said. "I went to the courts and had my name legally changed to female," Ms. Higgins said. "My drivers license, and voting card and social security, they are all female now." Her American passport, issued just before she flew to Bangkok, also identified Ms. Higgins as female. 
All text and photos © copyright by Richard S. Ehrlich
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