(Mr. Ghosh has graciously allowed the limited internet publication of almost the entire text of his article. He wishes it to be noted that “it has not been published anywhere, and only an edited version was published. If any commercial journal later would appear and want to publish, they can also do so but only after receiving permission.”)
Bangkok - Dr. Preecha Tiewtranon, 60, is Thailand’s grand old man of cosmetic surgery and a pioneer of sex reassignment surgery (SRS).
His brand new Preecha Aesthetic Institute on the seventh floor of Bangkok Nursing Home is one of the capital’s top hospitals. It looks more like an art gallery than a cosmetic surgery centre. There is uniform bright white light and white upholstered soft furniture, with recesses in the walls decorated with elegant artwork. Dr. Preecha himself, in a white suit, is a lively, debonair man with an upbeat bedside manner that endears him to his patients.
He chuckles as he says “All of them are my students” when referring to some of Thailand’s top SRS surgeons, like Chonburi’s Dr. Suporn Watanyusakul.
Dr. Preecha does an average of three SRS cases a week, and has by now performed over 2,600.
The claim in his clinic’s brochure that he has “earned the admiration of transsexuals all over the world” is no exaggeration.
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The two recovering patients were cheerful and upbeat and had nothing but praise for the entire experience of coming all the way to Thailand for their surgery.
Indeed as Dr. Preecha once remarked, while general surgery patients often complained, his SRS patient are always happy. Price is not the sole determining factor in the decision to come to Bangkok. Although the average cost of a normal SRS procedure is around US$ 6,000, much lower than in the USA or indeed in Singapore.
Most patients flying all the way from the USA end up saving perhaps around US$ 1000 for their troubles. But they get the attention of some of the best SRS surgeons in the world, in some of the most comfortable and friendly facilities and they can cut through the Harry Benjamin red tape that often frustrates transsexuals in North America.
German-born Harry Benjamin (1885-1986) moved to New York and pioneered research into gender dysphoria, starting the International Gender Dysphoria Association.
The Harry Benjamin standard adopted by the Association stipulates that before having a sex change operation, a series of psychiatric evaluations are required, with transsexuals’ lives being put under the microscope in order to ascertain whether they are genuine, committed cases.
The standard also regulates the consumption of hormones crucial to fundamental changes in the body. In Thailand, these hormones are available over the counter, without a prescription.
Thailand’s kathoeis (transsexuals) have long been legendary as being indistinguishable from genetic females, because in most cases they have been taking hormones from an early age unlike in the west.
Feminization cosmetic surgery completes body jobs that erase all traces of maleness. Many kathoeis are stunningly beautiful; many marry and live normal lives as women.
Canadian Lesley Carter, who retired in 2001 after teaching computer networking and hardware at several post-secondary training institutes in the Oshawa and Toronto areas, had her operation at the age of 63 at Dr Suporn’s clinic in Chonburi, late last year.
Over the email she told The Straits Times “Price is always a consideration, but it was not the biggest issue. I could have had my surgery in Montreal, just a few hours drive away for just slightly more than the total cost of going to Dr. Suporn. I was and remain convinced that Dr. Suporn’s technique is superior.”
”The biggest concern was to find a surgeon who would provide this service to me without having to fulfill the usual interpretation of the Harry Benjamin International Gender Dysphoria Association’s Standards of care. I am not a “disordered” person. I found an excellent private psychiatrist; he saw me for 5 months, declared me a “classical transsexual” and was more than happy to write a recommendation letter to Dr. Suporn. Gender Dysphoria is ultimately self diagnosed. There is no test for it. I believe public acceptance of those with Gender Dysphoria will only come when there is fuller understanding and we are simply accepted as women. We are just people, and most of us live very quiet lives with no-one ever suspecting we have had the surgery. My goal, which has been accomplished, is simply to live in the community as a woman and be ignored!”
Ms. Carter’s SRS cost her around S$ 11,700. The entire trip and procedure came to around S$ 15,000. She ended up saving around 1,000 Canadian Dollars (a little less than S$ 1000) but, as she explained, price was not the biggest issue.
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Dr. Preecha recently performed SRS on a 75 year old Caucasian, and on a 55 year old who he said had “tried very hard to be a man by marrying and raising a family.” “Nowadays, we believe these people must be treated early. Transsexuality has been traced to a difference in the Y chromosome, not just psychology.”
The number of cases of SRS has been growing briskly, with Thailand now the world center for this surgery.
In one SRS clinic in Bangkok which declined to be identified, the doctor (an eminent surgeon) told The Straits Times he performed SRS on about 7 Singaporeans on average, every month and found Singaporeans easier to deal with because there was less language barrier.
Though he maintained translators for Japanese and Korean patients, communication gaps had in the past led to hysterics in some patients. ”Proper communication and understanding is critical in SRS” he said.
Countries around the world are beginning to legislate to recognize sex changes and name changes. Thailand has always led the way, says Dr Preecha, because “Thais accept anything” But in other societies the response of society is often marred by prejudice. In Iran, interestingly, transsexuality is recognized and sex change is legal, while homosexuality is not. ”In ten years or so, because the rising number of cases will propel more research, it may be possible to install a reproductive system in a transsexual” Dr. Preecha predicted.
Lesley Carter, Interviewee and Dr Suporn graduate
Asians, Caucasians flock to
Thailand for sex changes
by Nirmal Ghosh, Thailand Correspondent
