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January 2023

Bangkok Has Become Inexpensive Mecca for Sex Change Surgeries for People from Around the World

Dr. Preecha Tiewtranon, a plastic surgeon at Preecha Aesthetic Institute, talks to a reporter on Tuesday, Aug. 22, 2006, about his specialty, sex-change operations. Bangkok has a worldwide reputation for performing sex-change operations cheaply and American John Mark Karr, the suspected killer of child beauty queen JonBenet Ramsey, was reportedly preparing to undergo

such an operation before he was arrested and deported to the United States. (AP Photo/Sakchai


By MARGIE MASON AP Medical Writer BANGKOK, That and Aug 23, 2006 (AP)

For people who believe they were born the wrong gender, the sex change they’re yearning for can easily be found in this crowded capital. The surgery is so common that it’s advertised in bold print in newspaper classifieds.

Kate Monroe-Gillibrand, 50, was married for 20 years. She was Andrew then, and fathered two children. Now in her hospital bed, days after surgery, she opens her pink satin nightgown and displays a flat bandage with a catheter. Her 73-year-old mother and her partner stand proudly at her side.

“This is a completion. This is where life begins,” she says. “I’m going to stop being in a lie now.”

Perhaps the least strange twist in the lurid tale of JonBenet Ramsey murder suspect John Mark Karr, who was detained in Thailand last week, is that he reportedly was preparing to seek what is formally called gender reassignment surgery in Bangkok. Dr. Preecha Tiewtranon has performed more than 3,000 male-to-female reassignment surgeries over nearly three decades. Most patients have travelled around the world for the treatment, having decided years ago, like Monroe-Gillibrand, that they just couldn’t live with the sex organs they were born with.

Preecha said Karr would have been turned away from his Aesthetic Institute, inside Bangkok’s prestigious BNH Hospital. To qualify, applicants must already have been living and dressing as a woman full time and must provide at least one recommendation letter from a psychiatrist.

Patients typically book appointments in advance from their home countries and are already women in every sense, except anatomically, Preecha said. The majority of foreign patients come from the United States, followed by Europe and Australia. For many, it’s their first trip abroad and most travel alone. Preecha performs up to 200 surgeries a year himself and estimates roughly 1,500 procedures occur annually in Thailand at his clinic and elsewhere with his students.

“The patients are so desperate to have this kind of operation,” Preecha said. “The reason they come, No. 1 is because they can get good results, and No. 2 the price is low and they can afford it.”

The most expensive genital reconstruction at Preecha’s clinic costs $9,500, a fraction of what doctors charge in the U.S. Sex- change surgery can be risky. The procedure for men becoming women takes about three hours. Doctors shorten the urethra and use skin from the penis and scrotum to create a vagina, clitoris and labia. Possible complications include blood clots and leakage from the rectum or bladder through the new cavity created for the vagina.

Cecilia Chung, deputy director of San Francisco’s Transgender Law Center, flew to Bangkok eight years ago to see Preecha. She said she paid about $8,000 for the surgery and returned home with complications that later required corrective surgery in the U.S.

“I think Asia is still one of the popular places for transgender people to seek surgery,” she said by telephone. “Thailand’s surgeons are readily available and they have less red tape. It’s cheaper, even including air fare and hotel stay.” She said another draw is Thailand’s large, open transgender community.

A few other places, including Belgium and Montreal are popular for reassignment surgery. But Thai clinics including in Bangkok and the resort island of Phuket actively market such services on the Internet, said Jamison Green, a transsexual man on the board of the Harry Benjamin International Gender Dysphoria Association.

The association sets guidelines for doctors with patients who want to pursue hormone therapy or surgery to change their sex. However, no doctor is required to subscribe to the standards, which generally require two letters from mental health professionals and proof that the patient has been living as the desired gender for a significant period before surgery.

“If people want to go outside the system to get whatever they want, they can do it,” Green said in a telephone Interview from San Mateo, Calif.

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