Feature | Gloves Come Off: Round One begins at the Legislature to end prejudice against the transgendered | Cover Story | Salt Lake City | Salt Lake City Weekly
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January 23, 2008 News » Cover Story

Feature | Gloves Come Off: Round One begins at the Legislature to end prejudice against the transgendered 

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Dr. Gender Bender: An interview with pioneering sex-change surgeon Marci Bowers To understand the convictions of some transgendered individuals it’s helpful to know what sex reassignment surgery actually involves. Dr. Marci Bowers, a gynecologist and leading reassignment surgeon in Trinidad, Colo., understands the operation well. Bowers performs up to 150 sex-change surgeries a year. She is renowned as one of the most prolific sex change surgeons, a pioneer in the field not only for her expertise but because she is also a transgendered woman herself. She was born Mark Bowers, in 1961. She is the first transgendered surgeon to perform the procedure. Bowers’ focus is on male-to-female surgery, and notes that the price tag for the operation depends on where it’s done. “It can vary,” Bowers says. “In the U.S. there are standards of care that have to be followed—not like in Thailand.” Her jab is aimed at the cheaper procedures available in Asia—inviting to often-desperate shoppers of sex reassignment surgery. Bowers estimates a potentially risky operation in Thailand could run as cheaply as $6,000 while a high-end U.S. clinic might charge around $39,000. Bowers’ Colorado clinic splits the difference at about $18,500. Bowers explains the basics of her male-to-female surgery, or, vaginoplasty is about working with what you’ve got. “You need to create homologous female sex organs from male ones. The penis becomes the clitoris, the penile lining becomes the vagina,” she says. This means an actual inversion of the penis must take place to create a vagina, labia, and a new uteral opening. The female to male procedure, or phalloplasty, is more of a challenge. The urethra must be extended. The labia are united to form an empty scrotum, which can be filled with prosthetic testicles. A prosthetic penis can be constructed or one can be created from the tissue of the clitoris. Bowers considers the procedure less successful as vaginoplasty. “They still really haven’t found a good way to make a phallus, they tend to be micropenises, kind of hung like a Chihuahua,” jokes Bowers, adding “but you know the heart comes first in love. Tools and hardware are very secondary.” Many other secondary procedures are involved with both types of sex reassignment. Most male- to- female patients get breast implants, just as female- to- male patients often get mastectomy breast reductions. Bowers herself often performs a number of cosmetic operations such as tracheal shavings, which make Adam’s apples less pronounced. Bowers’ position from both ends of the scalpel has given her a unique perspective, and while not politically active on transgendered issues, she hopes her experience can help her patients. “I empathize with them [my patients], knowing what they’re going through. I really take it personally if they don’t do well.”
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