Dr. Marci Bowers is not a hero in her small-town Colorado.

At first glance, the small Colorado town of Trinidad seems an unlikely travel destination, yet over the last four decades, thousands of trans women have flocked to the quiet burg. Their pilgrimage continues today despite the resistance of local religious leaders.

Behind its quaint architecture and coal mining history, Trinidad conceals its reputation as “sex-change capital of the world.”  The town first became a trans destination in the late 1960s when Dr. Stanley Biber began performing vaginoplasty for male to female transsexuals.  When Biber retired in 2003 after 5,800 surgeries, his protĂ©gĂ© Dr. Marci Bowers took over the practice.  

A trans woman and former Biber patient who lives in Trinidad with her female partner, Bowers brings a rare insider perspective to her practice, but it’s not appreciated by some of the town’s 9,000 mostly conservative residents.   For the past year, Trinidad Ministerial Association has circulated petitions and pressured Mount San Rafael Hospital to prohibit Bowers from operating at their facility.  

In their campaign to oust Bowers, the Ministerial Association frequently cites a Johns Hopkins University study they claim proves surgery isn’t successful in treating gender identity issues.  Bowers (marcibowers.com) calls the 1972 John Hopkins study “a sham,” that misinterpreted its own data and has never been replicated.  Originally pioneers in sex reassignment surgery, Johns Hopkins abandoned the practice decades ago, partly based on the study’s findings.

“If you look at the actual study itself, the satisfaction rates and happiness rates after [surgeries] were overwhelmingly positive,” Bowers insists.  “Their interpretation of the study was that the respondents—the patients themselves—couldn’t possibly be accurate about what they were feeling, because they were crazy in the first place.”

The 40-something Bowers, who practiced as an OB/GYN for nearly two decades says that today’s vaginoplasties bear little resemblance to those 30 years ago, and she boasts, “Sixty percent of what I do no one else does anywhere else in the world.”  

One revolutionary modification says Bowers, is the clitoris is now made of material that preserves nerves and arteries, and mimics a natal clitoris’ sensory effects.  The new clitoris, Dr. Bowers says, “correlates much more with women’s place in the world—they’re not just sexual objects and somewhere for a man to deposit his seed but actual living sexual beings.  And the need for a functional clitoris is really important.”  
Dr. Bowers says her innovations have been primarily based on trial and error.  Without the protective environment of a university setting, the transwoman says it’s very difficult to be truly innovative, and many possibilities simply can’t be pursued.

“It’s very stifling in American medicine because innovators are punished in terms of getting malpractice coverage.  It’s been horrible, basically, for me getting coverage.  If I was on a university faculty somewhere, oh my god, it would be such an advantage.”

Bowers has repeatedly approached the University of Colorado about supporting gender reassignment research but says their response has been less than positive.  In the meantime, Bowers continues to do what she can to improve her techniques without putting her patients at risk.  She’s also learned how to adapt her skills to offer surgeries for FTM patients.  One of the innovations she’d like to try is utilizing vaginal materials in the construction of a phallus, but she says that kind of experimentation may have to wait for a university setting.  

She hopes that as more and more family doctors and internists treat transgender people, the more they will realize how much they don’t know—but should—and that might spark a change in university interest.    

“I think primary caregivers are beginning to look back at their institutions and say ‘You know what?  You failed us here. How could you not teach us about this?’ I think if they’re honest about it that’s a big missing piece in medicine these days.”

Trans writer Jacob Anderson-Minshall can be reached at jake@trans-nation.org.  He co-authors the Blind Eye mystery series which premiers March 2007 with Blind Curves.