As a physician and general surgeon in the remote southern Colorado town of Trinidad, Dr. Stanley Biber treated the usual sore throats and broken arms and did his share of delivering babies, removing appendixes and replacing hips and knees.
But that's not what made Biber the most famous resident of Trinidad and put the former coal-mining town in the eastern foothills of the Rocky Mountains on the map.
Biber, who died of complications of pneumonia in a Pueblo hospital Monday at age 82, was known for turning tiny Trinidad into the "Sex-Change Capital of the World."
By Biber's count, he performed sex changes on 5,000 men and 800 women over the last three decades. At one point, he could boast of doing 60% of the world's sex-change operations.
"He did it for 35 years, so it's pretty hard to imagine eclipsing" his record, Dr. Marci Bowers, who took over Biber's sex-reassignment surgery practice in 2003, told The Times this week.
"He was a very huge presence for the local community here," Bowers said, "but he was an even larger presence for the transgender community."
Biber had said his sex-change patients included politicians, actors, models, police officers, judges, clergymen, teachers, a 245-pound linebacker, three Georgia brothers and an 84-year-old man "who wanted to die as a female."
Biber referred to them all as "my transsexuals."
A short, balding man given to wearing a Stetson hat, blue jeans and cowboy boots, Biber was proud of his reputation as "America's dean of sex-change surgeons."
But as he told the weekly newspaper Denver Westword in 1998, "I didn't just decide to do this. They came to me."
An Iowa native who moved to Trinidad in 1954 after serving as chief surgeon of a mobile army surgical hospital unit in Korea, Biber ran a general medical practice while serving as the town's only surgeon.
But Biber's professional life took a new direction in 1969 after a social-worker acquaintance dropped by his office. She had referred young clients with cleft palates to Biber and was impressed with his skill as a surgeon. The conversation, as Biber recounted in numerous interviews, went like this:
"Can you do my surgery?" the social worker asked.
"What kind of surgery?" Biber said.
"I'm a transsexual."
"What's that?" Biber said.
It turned out that the social worker was really a man who had been undergoing hormone treatments that soften skin, redistribute fat and cause breasts to develop in preparation for a sex-change operation.
"I wasn't very humble in those days," Biber told the Rocky Mountain News in 2004. "I was young. I told this girl, 'You know, I haven't done any, but there's no reason why I can't do this.' "
After seeking advice from Dr. Harry Benjamin, a pioneer in transsexual research, and examining hand-drawn diagrams sent to him from Johns Hopkins Hospital in Baltimore that detailed the procedure for transforming a man's genitals into a woman's, Biber performed his first sex-change operation.
Although he later described the results as aesthetically unsatisfactory, he said his patient was pleased.
Over the years he refined the procedure and boasted in a 1995 Times interview that his work was so good that one former patient was married to a gynecologist who didn't suspect a thing.
Biber performed his sex-change operations at Trinidad's only hospital, Mount San Rafael, which was initially run by Catholic nuns.
"I hid the files from the first two or three cases in the administrator's office in the safe so nobody would know about it," he said in his Rocky Mountain News interview.
Aware that word would eventually get out, Biber gave the local Ministerial Alliance a series of three lectures about sex-change surgery and the psychological needs of the patients.
"That was the smartest thing I've ever done," he told Denver Westword. "Much to my amazement, there was no opposition. They were very understanding and accepting. All of a sudden, townspeople became very sophisticated and knew everything about transsexuals."
Not that everyone was supportive.
Biber said in the interview with The Times that he initially was ostracized by some doctors, who believed transsexuals were suffering from psychiatric problems best treated nonsurgically. It is now believed that gender dysphoria -- discomfort with one's natal gender -- has a biological basis, Bowers said.
Soon, patients from around the world were showing up at Biber's office in an old stone bank building in downtown Trinidad, a onetime stop on the old Santa Fe Trail with a population that's now about 9,000.
"He was pretty much the only place to go for quite some time," Bowers said. "In the early '70s, what happened is that while university gender dysphoria treatment programs were restricting access or getting out of the business altogether, Dr. Biber welcomed these patients.
"Dr. Biber looked at patients without judgment. He performed a safe and reliable surgery and, moreover, he believed in them. He understood what they were all about. He made it OK."
Over the years, Biber's reputation as a leading sex-change surgeon led to appearances on the Oprah Winfrey, Sally Jessy Raphael and Geraldo Rivera shows, as well as the Learning, Discovery and Playboy channels.
The prolific sex-change surgeon also was featured on the "Guinness World Records: Primetime" TV show.
Biber performed his last sex-change surgery in 2003, giving up his sex-change practice after his insurance carrier left the state and other prospective insurers placed him in a high-risk category that carried premiums of up to $300,000 a year, which he could not afford.
He figured the high premiums were because of his age.
"It's a shame," he told the Rocky Mountain News. "Intellectually, I'm sound. My hand is steady. This has been my life."
"It is indeed the end of an era with Dr. Biber retiring," Angela Gardner, executive director of the Pennsylvania-based Renaissance Transgender Assn., told Denver Westword at the time.
Trinidad officials marked the occasion by declaring Oct. 10 Stanley Biber Day.
Born in Des Moines, Biber attended a rabbinical seminary in Chicago after graduating from high school and worked as a civilian in Alaska for the Office of Strategic Services, the forerunner of the CIA, during World War II.
During the war, he decided to become a doctor instead of a rabbi and earned his medical degree from the University of Iowa in 1948. He ended his military service after the Korean War as head of the orthopedics department in what is now Ft. Carson in Colorado Springs. When he moved to Trinidad in 1954, he thought he'd work as a surgeon there for a year or so and move on. He never left.
Biber, who owned a large cattle ranch in the area, served as a Las Animas County commissioner from 1990 to 1996.
After finding an insurance company that would insure him as a general practitioner, he resumed practicing medicine in early 2004.
"He couldn't stay away," Bowers said.
Biber is survived by his wife, Mary Lee; seven children; seven stepchildren; and 22 grandchildren.