Doctor Performed Two-Thirds of Operations : Transsexuals Trek to Remote Town to Get ‘Best’ Sex-Change Surgeon

Dr. Stanley Biber sent away for another surgeon’s drawings the first time he changed a man into a woman.

That was a quarter of a century and more than 1,000 transsexuals ago, long before Biber could boast of performing two-thirds of all the sex-change operations in the world.

He does them here in a remote southern Colorado town of 9,660 people, notably distant from big cities and any major medical research institute.

“It’s not a peculiar place to do it,” Biber says. “This just happens to be where I live and work.”

The straight-lined red brick homes and buildings of Trinidad sit on hillsides above the Purgatoire River, below a sentinel butte called Fletcher’s Peak, 100 miles south of Pueblo, the nearest Colorado city.

Once a stop on the Santa Fe Trail, Trinidad later served as a hub for the area’s coal mines. Most of the mines sit idle today. From any direction Trinidad is an isolated place.

The distances don’t faze the 100 or so transsexuals a year who come here from all over the world to start new lives.

“Dr. Biber has a very good record,” a gravelly voiced blonde from Connecticut said the day before undergoing surgery to make her body match the female clothes she had worn for eight years. “If I’m going to take the step, I want the best.”

The best is good enough to fool a gynecologist, Biber says. The best is also quick; someone who goes in male at 9 a.m. can be female by noon.

“We know there have been some who have been married and not told their husbands,” Biber said late one recent morning after the third of that week’s four sex changes. “We warn them not to do it, but we know it happens.”

In part, he adds, the successes can be measured by the number who are never heard from once they leave town, despite Biber’s plea for participation in a six-month follow-up survey.

“Thirty percent we lose to follow-up,” Biber says. “These are the patients who are slipping into new areas of society and being completely female.”

It has been six years since Anna Louise Jenkins talked face to face with her mother, the night she disclosed that she was going to Colorado for a sex-change operation. She still calls occasionally, but her mother hangs up.

Six years ago, Anna was George, a married man who worked as a supermarket produce manager by day, then hurried home at night to don a dress.

“What I went through is something I would never wish on my worst enemy,” Jenkins says of her former life, which included 14 years in the Army.

She moved here from Kentucky in 1978, after reading about Biber in a magazine.

Anna Louise Jenkins--her mother’s first name, her former wife’s middle name and her maternal grandmother’s last name--remained in Trinidad “because I was born here.” She calls Sept. 2, 1979--the date of her surgery--her birthday.

The only one of Biber’s patients who elected to stay here after surgery, Jenkins thinks it is a good idea to talk about her experiences as much as she can. She sometimes talks to psychology students at the local junior college.

“I kept it to myself for 31 years,” she says one day during a break from her job as chief baker and cookie specialist at a local bakery. “If I reach one person and give a little more understanding, then I feel I’ve done some good.”

At her home later, Jenkins beams as she displays her doll collection, curtains and bedspreads she sewed herself, a slew of dogs and cats and kittens.

She brings out photos of a first birthday party for “Little One”--the first doll in her collection, the one she was forbidden as a child--and of a dark-haired man from San Francisco who read her story in a paper and began courting her by phone.

In November, she married her long-distance suitor in a ceremony at her house. She baked her own wedding cake.

“The only wish I have is, I’d love to have a little girl. My friends say I’d spoil her terribly. I suppose I would.”

Nearly a quarter of those who come to him for surgery end up as parents, Biber says.

Area residents don’t welcome the label “Sex Change Capital of the World,” but there is little of the furor that first accompanied the rumors of what Biber was doing at Mount San Rafael Hospital.

It was 1959, and Biber’s first sex-change patient was a social worker who had accompanied various children to the doctor’s office over a period of years.

“One day, she came to me and asked me if I’d do her operation; she said she was a transsexual,” Biber remembers. “I didn’t even know what a transsexual was. She looked completely female to me.”

Biber talked with the doctors who had studied the social worker’s psyche and who had prescribed female hormones to get her started toward womanhood. Biber had a Johns Hopkins University surgeon send him how-to drawings and he used them to finish the social worker’s transformation.

More than 1,000 transsexual changes later, fewer than a dozen have been female-to-male operations. There are relatively few such cases among the 5,000-plus files in Biber’s office from transsexuals still in the lengthy pre-operative screening process he requires.

Most transsexuals come to Trinidad as women born into male bodies. The female-to-male procedure is more difficult and is still considered experimental.

Biber talks plainly about his experiences with what is formally known as “reassignment sex-organ surgery.” Transsexualism remains largely a mystery to the scientific community.

Some believe the condition is genetically determined. Others say gender identities are skewed by early childhood experiences. Biber believes that children are born with their gender “imprinted,” and that, sometimes, the imprints don’t match the bodies.

Frequently, transsexuals say their earliest memory is of the moment when they realized--sometimes at 3 or 4--that they were inside the wrong body.

Later memories, sometimes decades full of memories, often paint a sad, tortured picture of people trying hard to be what they do not believe they are.

Why not just wear a dress, if that is what makes a person feel best? Wouldn’t that suffice for some?

“Transsexuals get this tremendous urge that they are a girl--or boy,” Biber explains. It is a driving force, he says, and primarily a psychological, not a physical, problem.

Before Trinidad, Biber, a native of Iowa, was a MASH surgeon in Korea. He now lives on a ranch outside the town with his wife and those of his seven children still at home.

He came here in the mid-1950s because another doctor stationed with him at Ft. Carson, Colo., said the town needed a surgeon. Trinidad still needs doctors, Biber says, but its remoteness, the economic downturn since the mines closed and the hard work required of a small-town physician make it difficult to attract more.

More than anything, Biber is a small-town physician. Sex-change surgery makes up only 20% of his work, he says. It seems an important 20%, and not only because it subsidizes some of the other medical work he does for free.

“You have to see these people and know these people to have empathy with them,” he says of transsexuals. “You feel so sorry for them.”

When Biber started this, “the moral code was a lot different,” he says. “Transsexuals were not recognized by the medical community. Now there is a name for what we see--the ‘transsexual syndrome.’ ”

Biber doesn’t like to talk about the local reactions in the first few years. Pressed to remember it, he shrugs.

“You work under adverse conditions if you believe in it,” he says at last. “I’m not a religious man but morally, I think we’ve done these people a tremendous service.”

Today, with up to four patients undergoing the surgery weekly, Biber’s biggest problem is sorting out who should have it and who should not.

“We have to be very careful to avoid schizophrenics,” says Biber. “We have to be very careful of the extremely feminine homosexual. There’s an occasional transvestite who falls into a gray area.

“I’ve seen so many that I can almost count on my gut feeling when they walk through the door.”

There is a minimum requirement of psychological gender-identity testing, a year of cross-dressing and at least that much hormonal treatment. Even after that, Biber goes by his gut feeling and some get turned away.

“But not abruptly,” he adds. “I might suggest more counseling, or I might suggest trying something reversible--like breast implants--and seeing how it works for a few months.”

The surgery is inexpensive by some standards--$3,225 for Biber and his team, another $3,000 for the hospital.