Birthday Suits Altered While You Wait
"Do you dress right or left, Madam?"
First appeared in Salon
Magazine as Bangkok's got a brand new bag.
Bangkok’s old-timers recall that in the 1970s — before
someone clued the owners on the proper spelling — many tailoring
establishments were emblazoned with signs reading "Man Chop".
In retrospect, the signs seem far ahead of their time. Visitors
still shop Bangkok for inexpensive, well-tailored suits but the
city is rapidly gaining renown for a new type of alteration. In
gay and lesbian circles, the city is known as a "gender reassignment
center." Translated into plain English, it means "sex
change operations." On returning home from this vacation,
your friends will exclaim "My, your holiday did wonders for
you; you look completely different" and mean it.
This is not a shady back-alley business. The operations are
performed by some of the city's best plastic surgeons, and in
aseptic private clinics, hospitals, or university medical centers.
Little wonder that Bangkok has become a magnet for transsexuals
from Europe, Asia, and the U.S. who, in a somewhat perverted Buddhist
sense, undergo reincarnation beneath the knives of eminent surgeons.
It seems highly fitting that Bangkok should enjoy its present
fame. It is a town where nothing is ever quite as it seems, and
one can assume a new persona by sheer will. In this City of Angels,
one can rent a gorgeous woman for the night and discover too late
that the "lady" has handles and faucets. For a little
cash, the gender challenged can match a psychic disguise with
a physical transformation.
Transsexuals flock to Bangkok for gender reassignment because
it is regarded as safe and inexpensive. "In Bangkok, you
can change sex from male to female for only $7,000; it would cost
at least $15,000 at home," says Dr. Preecha Tiewtranon, one
of the art's foremost practitioners. He performs two male-to-female
operations each week at Bangkok's prestigious Chulalongkorn University
Hospital, "for demonstration purposes to medical students."
In addition, he performs 20 operations per month at his Chollada
Clinic in the city's heart. The clinic sits down Soi 1 off busy
Sukhumvit Road in a modest townhouse that gives little hint of
the activities taking place within. Even Dr. Preecha’s mien
is deceptive. A 60-year-old avuncular man in horn-rimmed glasses,
he looks less like a medical doctor and more like a bureaucrat.
His waiting room is filled primarily with Thais who seem quite
happy with their gender assignment but who want to enhance what
nature gave them. Facial alterations. Breast augmentation. Among
them, however, are several "lady boys", transvestites
employed in gay bars who have decided to move beyond the mere
illusion of femininity. Increasingly, they are joined by foreigners
of both sexes, drawn by the doctor’s fame; to date Dr. Preecha
has transformed more than 600 Asian, Americans, and Europeans.
"Foreigners come here because the laws in their countries
are very strict and the waiting period for governmental approval
for the operations can often be three years,” claims Dr
Preecha. “Here in Thailand, doctor are supposed to wait
two years to see if the patient is mentally prepared for the life
that comes after the operation." What he doesn't say but
everyone knows is that laws are lax and if the doctor and patient
feel the time is right, then the operation is performed.
The relaxed attitude stems in part from Thailand’s social
acceptance of gays of any persuasion, local or foreign. Gays play
a major role in Thai social life. At one major hotel, the British
General Manager takes off his suit each day at 5 p.m. and dons
a wig and a gown for an evening on the town.
In the past 25 years, the nation has had two reputedly gay prime
ministers. At the moment, a "katoey" (transvestite)
professional "muay Thai" (Thai kick-boxing) boxer enters
the ring wearing make-up. It is not a gimmick but a statement;
once the fists and feet begin pummeling you know he is in deadly
earnest…and deadly effective. Nor is his ferocity a reaction
to ill-treatment; the idea of "gay-bashing" prevalent
in temperate climates, is an alien concept in the Land of Smiles.
Gender orientation or re-orientation is even recognized in the
nation's bill of rights. The newly-promulgated Constitution allows
those who have undergone sex alterations to change their gender
on certain legal documents.
Although Thai laws are applied liberally, Dr. Preecha lays down
strict guidelines for those seeking to change their gender.
"My advice is that if a male wants to be a female, he should
(a) dress like one for a year, (b) take hormones for six months
to reduce the male features and hair, and (c) undergo an assessment
by a urologist/gynecologist to see if it will be safe to operate.
The doctor must explain to the patient everything that is involved.
Unfortunately, most patients don't want to wait, they want it
Using the latest techniques, Thai surgeons normally complete
the operation in 90 minutes. In the past, the skin used to create
the new vagina was taken from the inner thigh. The technique was
abandoned because the grafts left unsightly scars and the resultant
organ was not supple. "Penal skin is very elastic so we use
that skin to line the inner walls of the vagina," said Dr.
Preecha. The resultant vagina is remarkably realistic and the
penis head is shaped into a small clitoris that is sensitive to
Foreign patients also note the superior hospital care as a key
reason for undergoing male-to-female operations in Bangkok. Clinics
are hygienic, employ advanced equipment, and enjoy a high caregiver-to-patient
ratio. A typical operating team includes the doctor, an anesthetist,
and five nurses. In the university demonstrations (which cost
less because the subject — called a "service patient"
— serves as a teaching tool) the doctor may be assisted
by several interns.
Complications are low, a good thing, because malpractice suits
are rare in Thailand. One reason is that patients are required
to sign consent waviers absolving the surgeon of all responsibility
While he is adept at male-to-female operations, Dr. Preecha
balks at female-to-male transformations. "It is a very difficult
operation and foreign patient expectations are generally too high.
They want everything to come out as it is in Nature but this just
Foreigners, he says, arrive thinking they can simply walk into
the clinic a woman and come out a man. "It takes at least
four operations to re-shape the female genitalia and create a
penis from the skin covering the abdomen. You can't do them a
week apart; sometimes you have to wait six months for the previous
operation to heal."
"And they are expensive, nearly $100,000. Most foreigners
don't have the money or the time to live here for the two years
it usually takes. And very few have the money to fly here time
and again for the next procedure," he claims. "For these
reasons, I don't do these types of operations any more."
Many female-to-male operations fail because they involve use
of a small, $3,000 pump that allows the patient to erect his new
penis. The pumps are notoriously unreliable, with a high failure
rate. Even if it does work, the patient can satisfy his partner
but not himself.
Yet, foreigners continue to flood into Thailand, seeking both
types of operations. In "Amazing Thailand", as the tourism
authorities are billing the country this year, they can purchase
new genders as easily as they once bought suits. Except that with
this alteration, the customer supplies the fabric.