In the Rockies, a Gender Crossroads
Elderly Surgeon Makes a Tiny Hospital Mecca for Sex
Change
By Sue Anne Pressley
Washington Post Staff Writer
TRINIDAD, Colo.—It was early morning, before surgery,
and Stanley
Biber was reading the sports pages, as calm as if he
were about to tackle a
routine hip replacement. His patient waited drowsily
on a stretcher,
wondering one final time if he had made the right
decision. For him, the
next few hours would be profoundly life-altering. He
was about to become
the woman of his dreams, a legal "F."
In the transgender lexicon, he had taken "the road to
Trinidad" -- and to
Biber.
Biber, 75, is one of the world's leading
gender-reassignment surgeons, and
his renown over the past 30 years has given this
former mining town of
8,500 the unlikeliest of nicknames. Much to the quiet
dismay of its
residents, it is known across the country as the
"sex-change capital of the
world."
This is where men -- and increasingly women -- who
feel they were
trapped in the wrong anatomy come, as they see it, to
correct their bodies.
For $10,000 and up, they give up their pasts and their
secrets to Biber's
matter-of-fact manner and surgical skills. He says he
can do in 2 1/2 hours
what it takes the handful of other surgeons in this
specialty 7 or 8 hours to
accomplish. And his work is so realistic, he boasts,
that it has fooled at
least one gynecologist, husband of a former patient.
Biber's select group of out-of-towners -- he also is
general surgeon to the
town -- contributes to the local economy and helps
keep the private,
82-bed Mt. San Rafael Hospital afloat. Before surgery,
patients stroll
down the Old West-style streets of Trinidad, 200 miles
south of Denver,
and climb the steep hill behind the hospital to pray
at the blue-and-white
shrine to the Virgin Mary. In the hospital, they
occupy rooms at the far end
of the hall, where the staff treats them
sympathetically. After 3,500 of these
operations by Biber in the last three decades, no one
bats an eye.
"To me, it's just plastic surgery. It's something they
want done," said Tina
Lankford, an operating room nurse. "These people have
put a lot of
thought into this. Insurance doesn't cover it; they
had to work two or three
jobs to afford it. It is not something that is a
whim."
A visit to Trinidad, to Biber's office and to his
operating room provides a
look at a subject that many people probably will never
understand. It
raises questions about what constitutes a man, when a
woman is a woman,
whether it is possible to be something in-between or
encompassing both.
In a society that has already weathered a sexual
revolution or two, this
remains a taboo.
It is not, of course, as if anyone planned it to work
out this way. Trinidad
would prefer someday to be known as a tourist town. If
Biber's parents
years ago back in Iowa had had their choice, he would
have become a
rabbi.
Instead, a series of circumstances led to the present
development. Biber,
an Army surgeon in the Korean War, was later assigned
to nearby Fort
Carson, and decided he wanted to be a rancher as well
as a doctor. His
entry into transgender surgery came about in 1969 when
a friend confided
a secret.
"She was sitting right there at the desk, a female
social worker. She
brought all her kids in to me. In those days, I was
doing all the harelips for
Social Services. She said, 'Can you do my surgery?' In
those days, I had
no humility. You know how young surgeons are. 'I can
do anything.' "
Biber consulted with a doctor at Johns Hopkins Medical
Center in
Baltimore, who had done the procedure, and proceeded
for the first time
to transform a man into a woman. The result, he said,
was
"horrible-looking but functional, it's just that the
cosmetic technique was so
bad."
Refinements quickly followed. "Once I got started, the
grapevine was so
great. There was nobody else to send them to."
At first, Biber was cautious, scheduling the unusual
surgeries for after
hours, with set crews. While not denying what he was
doing, he did not
advertise it either. Soon, he met with area ministers
and other residents and
explained his new specialty. After that, the
questions, if not the raised
eyebrows, ceased.
Now so many patients have journeyed to Trinidad that
they have formed a
loose information network, calling themselves,
"Biber's girls."
"Originally, I probably accepted it as a surgical
challenge," he said. "But
after being exposed to these people for a considerable
period of time, you
develop a lot of empathy for them because they have a
horrible life they
have to lead.
"And once you begin to understand what they go
through, and how they're
hiding all the time, how they can't find a good job,
how they can't pass a
physical examination, how they're not accepted
anywhere if they come out,
you start thinking, 'I could offer them a service,'
and it was a satisfactory
service, and it seemed to me I was turning out good
products and making
good citizens out of them."
The first gender-reassignment patient to gain infamy
was Christine
Jorgensen in 1952. "Ex-GI Becomes Blonde Bombshell!"
screamed the
headlines after her surgery in Denmark. But attempts
at the procedure had
been made as early as the 1800s. The International
Foundation for Gender
Education estimates that one in 100,000 people
experience some feelings
of gender confusion and cite evidence throughout
history, including Joan of
Arc.
There is no medical explanation for this condition.
But Biber believes
research will prove the size of the hypothalamus, the
part of the brain that
regulates many body functions, is involved.
Although more surgeons are doing gender-reassignment,
the core group
for Americans remains a handful of doctors in Oregon, Canada,
New Zealand and
Britain. The patriarch is Biber, who still performs
one or two procedures a
week.
That is why a 44-year-old Baltimore man recently came
to Trinidad,
seeking to solve a lifelong problem "that was not
going to go away."
"I've been racking my brains, why did I have to do
this. I didn't have to do
this, but I had to," said the man, who refused to be
identified. "It was just
that point in my life where I had to find out. There
are choices, I guess.
You can either keep this all pent up inside and go
crazy, or do this and go
into bankruptcy."
In the transgender world, Trinidad has come to
represent a mecca. In sight
of an impressive series of snow-capped mountains, the
town also has its
own Fisher's Peak and Simpson's Rest; at night, a
white Hollywood-esque
"Trinidad" sign illuminates the settlement below.
Downtown, a collection of
old-fashioned buildings is preserved, including a
movie theater and small
bars wreathed in neon.
Residents regard strangers politely, asking at most
veiled questions such
as, "Are you tourists in town?" Trinidad's medical
claim to fame, however,
is pointedly not advertised by officials or merchants,
neither on T-shirts or
trinkets.
The Baltimore man had researched the issue for years,
deciding finally on
Biber. A self-described "mighty big woman," nearly 6
feet tall, he defied
any stereotype, coming across more as an earth mother
in denim overalls
and work boots than a glamorous type.
But he also fit Biber's criteria for acceptance as a
patient: He had always
felt himself a misplaced female; his favorite secret
childhood game was
dressing up in his grandmother's clothes. He had
sought therapy for his
problems, and about 10 years ago, had begun the first
steps in becoming a
woman -- hormone treatments, electrolysis. Since 1993,
he had been living
as a female.
Like many transgender people, he did not consider
himself gay, although
he had had gay experiences in which he pretended to
himself that he was a
woman. He was even married for five years to a
heterosexual woman, to
whom he confided his deepest fears on the third date.
She said she thought
she understood, but the marriage broke up, in part
over the gender issue.
The man's friends and co-workers were shocked at first
to encounter him
in what he felt was his true identity.
"I was a believable male," he said, "and when I first
went out in drag, it
would be around my straight friends who never failed
to make a comment,
'You look like a linebacker in a dress.' "
On his last morning as a male, the man woke up early,
very calm, and
wrote in his journal that he had "had a good life. I
was a pretty good
boy/man . . . "
Biber's operating room was relaxed but efficient later
on that morning.
Viewing the procedure was not for the faint-hearted,
however.
As Biber sewed, the Baltimore man slept on, snoring
slightly, as his body
and life were changing forever. In a world where
pronouns often are
unreliable, "he" was quickly becoming a "she."
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