Sex-Change Webcast Stirs E-thics Debate
A Southern California online company is planning what it says will be the first sex-change operation cybercast over the Internet on Friday, a venture that several ethicists and doctors say is unsavory but inevitable.
Headed by a plastic surgeon out of his Costa Mesa office, a group of five surgeons organized as https://www.amazingsurgeries.com say they are unafraid of taboos, that their World Wide Web site simply seeks to teach people about the inner workings of medicine--at $9.95 a glimpse.
The patient, a Southern California man whose identity is being withheld, will be operated on in Florida at no charge in exchange for his permission to show the procedure on the Web and later on videotape.
“Ever since I was on ‘Extra’ [a television newsmagazine], I have been swamped with calls from transsexuals who want to get this surgery,” Dr. Fred Sahafi said. “This will do some good.”
But others say the company is exploiting patients and question whether its cybercasts of surgeries such as penile enlargements and breast augmentations offer people anything beyond a voyeuristic thrill. (The company sells videos of 11 different surgeries on its site.)
“This invades the personal-ness of real medicine, and it moves it from the mainstream to the midway . . . at the carnival,” said Arthur Caplan, a professor of bioethics at the University of Pennsylvania. “We live in a talk-show culture where nothing is private. But do we really want to [turn] everything into the bizarre?”
From open-heart surgery to online childbirth, many people are using the Internet to make very public what once was private.
According to Sahafi, the patient is a 46-year-old man who since childhood has felt like a female. A biography posted on the company’s site describes “Richard” as the only boy among seven children and as an Army veteran of the Vietnam War. The company says he was married twice but in recent years has come to feel he is a woman in a man’s body.
Operating at an unnamed hospital in Tampa Bay, one of the company’s surgeons will remove the man’s penis and fashion a vagina, Sahafi said. The procedure--which normally would cost $25,000 to $50,000--is a key part of a series of operations and other procedures necessary to complete a sex change.
The operation is scheduled to be cybercast on Friday, with the site also offering a chat room and a place for visitors to suggest surgical procedures they would like to view in the future.
Sahafi said he and four other plastic surgeons--whom he described only as “silent partners” based around the country--created the site in November because prospective patients often ask to watch operations “to see what they were getting into.”
The surgeons wanted to demystify sex changes and other operations on sexual organs, Sahafi said, adding that too many people are afraid to face their true sexuality and that a Webcast of a “sexual reassignment” would help eliminate the stigma.
“This will be totally raw. This will not be edited at all,” he said.
Sahafi said the site is no different from prime-time TV shows that rely on advertising revenues, entertainment series such as “ER” or documentaries about brain surgery on the Discovery channel.
“I don’t think we are doing anything unethical ,” Sahafi said.
And he acknowledged the doctors hope to make a profit.
“Any doctor who says they don’t care about money is a liar. Sure, you do medicine because you love it, but you also want to make money.”
Sahafi acknowledges that most who view the cybercast will do so out of curiosity. Others will be medical professionals, and at least some will be prospective patients, he said. Experts say the site’s very name implies less than pure medical motives.
“The whole thing and the way it sounds . . . undermines the healing purposes of medicine,” said Lawrence Gostin, a professor of law and public health at the Georgetown University Law Center in Washington, D.C.
Other doctors are disturbed by the site but say they knew it only was a matter of time before doctors ventured onto the Internet in ways that would be viewed as unhealthy for the profession.
Devinder S. Mangat, president of the American Academy of Facial, Plastic and Reconstructive Surgery, called the site “a disgrace that looks like nothing better than pornography.
“I think it really cheapens medicine, but unfortunately in this age of commercialization, medicine has also fallen victim to the bottom line: Money,” Mangat said, pointing out that the surgeons could show videos to prospective patients in their offices at no charge if they simply wanted to educate. Like other experts, Mangat said the difference between the site and a television show such as “ER” is that the top-rated network drama clearly is fiction. And “there is no mistaking a documentary on the Discovery channel as something other than educational and scientific. It’s a very professional delivery,” Mangat said. But Howard Rheingold, a professional Web watcher in the San Francisco Bay area who has written several books on the ethos of the Internet, said the critics are simply blaming the messenger. Nobody will be forced to watch the surgery, he said.
