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TG History:The Cowboy Way, Dr. Stanley Biber — Part 2

| Mar 22, 2010
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TG in History by Michelle Lynn
Michelle Moore brings you TG History(Part 1)

Where is my honorable man? Where is my prairie son? Where is my happy ending? Where have all the Cowboys gone? — Paula Cole

Ol’ Doc Biber’s greatest adventure began with a special visitor in 1969. Her name was Ann. Social worker by trade. Reddish hair. Medium build. Not bad-looking, either. She was a good friend of Biber’s and brought him all her welfare cases, poor folks from all around Las Animas County needing corrective surgery for harelips and cleft palates. But this time Ann was approaching Dr. Biber for herself:

“Can you do my surgery?” she asked.

By now Doc Biber’s 46 years old and has already fought two wars. He’s confident, cocky, and riding high

“Sure,” Biber says. “There’s not a surgery I can’t do.”

Then he asks: “What kind of surgery is it?”

“I’m a transsexual,” Ann says.

“A transsexual? What in hell’s name is that?”

biber1Now this is 1969 and most people, Dr. Biber included, never heard tell of transsexuals. Heck, up until thirty seconds ago Biber never thought of Ann as anything other’n a woman. Turns out, Ann is one of the first patients to receive hormone therapy from the famous Dr. Harry Benjamin. So that afternoon Biber calls up New York and asks Dr. Benjamin for his advice. Finds out that Ann’s lived as a woman for a year, met all of Dr. Benjamin’s evaluations, and is ready for the final step. Satisfied, Dr. Biber then contacted the surgeons at Johns Hopkins Hospital in Baltimore, who’d just two years earlier announced they were performing reassignment surgery (what the doctors call ‘vaginoplasty’). Except for a few other universities, nobody else really knows anything about it. So Dr. Biber arranged with a Johns Hopkins doctor to send him some hand-drawn diagrams detailing their surgical procedure. Hopkins’ technique’ back then was pretty basic, crude even. But it was also similar to a procedure for dealing with prostate cancer that Dr. Biber knew well.

Now before physicians stopped making house calls and became replaceable parts in today’s impersonal healthcare system, there was a time in American medical history when a different breed existed: the “cowboy doctor.” Independent, supremely confident in their own abilities and not afraid to take chances, “cowboy doctors” mostly hailed from small towns where the welfare of the patient was all that mattered. That was the medical tradition Biber grew up with. Combine that tradition with Biber’s own experience in a wartime MASH unit with its unofficial “patient first/screw the regulations” credo and in hindsight Dr. Biber’s final decision isn’t all that surprising.

“Okay,” he decided. “We can do it.”

“It looked like hell, but it worked,” he says of that first operation. Nevertheless, Ann herself was mighty pleased with the results.

“She was very happy,” he recalled. “And then it started spreading all over.” As the word got out to other transsexuals, Dr. Biber decided to take on a few more cases. Just to see how things went…


By 1972 Dr. Biber was one of a handful of reputable surgeons recommended by the Erickson Educational Foundation for performing gender reassignment surgery. At first Dr. Biber only meant for vaginoplasty surgery to be a sometime thing. Now mind you, the town’s only hospital, Mt. San Rafael, was run by Catholic nuns and naturally Dr. Biber’s unsure of their reaction. At first he hid the charts of his transsexual patients in the hospital administrator’s safe. But as more patients arrived, Dr. Biber knew he’d eventually need the approval of the hospital board and even the town itself.

So Dr. Biber explained his work to the Sisters of Charity and the hospital staff. “I went through the psychology of it all. They decided as long as we were doing a service, and it was a good service, that there was no reason we couldn’t continue doing them,” Biber recalled, adding that while some were opposed, others began counseling his patients.

Dr. Biber then rounded up Trinidad’s religious leaders and townsfolk for a series of lectures and meetings. “That was one of the smartest things I’ve ever done,” he recalled. “Much to my amazement, there was no opposition. They were very understanding and accepting. All of a sudden, townspeople became very sophisticated and knew everything about transsexuals.”

By 1976 Dr. Biber had refined Hopkins’ crude technique and already performed around 100 vaginoplasty operations. “Just like that, word was out on the grapevine that this was the place to do it. The whole goddamn world came here. All races, all colors, all classes. Movie stars, judges, mayors “” everything. Even people from Poland. I don’t know how they afforded it, but they came.”

Dr. Biber soon became America’s most visible reassignment surgeon and its foremost advocate. “No amount of psychological help can change a true transsexual,” Biber said. “The longer you work with these people, the more you develop empathy. You realize how hard it really is for them. We definitely think it’s a physiological or anatomical change that makes these people different. Papers are written every year. It’s now well-accepted.”

biber2Yet Dr. Biber wasn’t without critics. First, a few local religious fundamentalists came out of the woodwork. Then Johns Hopkins, the most visible name in reassignment surgery, pulled out in 1979 and “sex change surgery” itself came under increasing assault. That included its most visible practitioner. A turf war soon erupted between some psychologists and vaginoplasty surgeons. Some of those shrinks took aim at Dr. Biber, slammed him in a national news magazine. Claimed he was “committing mayhem” on his transsexual patients. (Note: For more details see Creating Mayhem, TG in History, Dec 02-Apr 03)

“They tore me to pieces,” Biber remembered. “They said what I was doing was outrageous, cutting off normal organs and disfiguring people. And the worst part about it was that I wasn’t the only one doing it.”

Maybe, but through the Eighties he was one of the few doing it well. Weren’t that many places a body could go for surgery back then. Some universities would do it but just try getting through their waiting lists and crazy evaluation criteria. Quality of surgery wasn’t always worth jumping up and down about, neither. Some private doctors did operations too, but many none too good. Truth was, Dr. Biber thrived because he was one of the few getting it right.

Ought to say something here about Mt. San Rafael Hospital. Aftercare’s always been a mighty big issue for transgendered patients. The 70 bed Mt. San Rafael Hospital boasted a knowledgeable, courteous, well-trained staff and it was the first medical facility to offer decent care for recovering vaginoplasty patients. In return their business helped keep this small town hospital afloat and stay proficient as Trinidad continued losing people.

But while other surgeons disappeared and university programs closed, Dr. Biber and San Rafael Hospital kept working. And working. And working. Four sex-change operations a week. Two hundred operations a year, every year. Dr. Biber continued operating through the Seventies, then through the Eighties, then on through the Nineties. His patients reported orgasms at a 90% frequency, too, a rate even better’n natal women claim. Didn’t just do vaginoplasty surgeries, though. Biber did it all ““ breast augmentations, tracheal shaves, you name it. Did a lot of procedures for transmen, too, one of the few doctors that would.

Wasn’t long before reporters got wind of it all and began snooping around town, asking folks all sorts of fool questions. Geraldo Rivera himself even popped in for a visit. But Biber had done a good job of preparing everyone for this. If most reporters expected a bunch of ignorant rubes they got a shock from the townsfolk’s live-and-let-live attitude. But then small towns can be funny that way ““ everybody there may know your business but you’re still expected to mind your own. “My people are so sophisticated,” Biber said of his town. “They’re all experts on transsexualism. They understand better than anybody in the world because they live with these people. The understanding came from exposure.” Plus the vast majority of Biber’s practice still was serving the people of Trinidad. He gave his small rural community a first-rate doctor and they all knew it. It’s pretty hard to criticize a man for performing a sex-change operation when he just reattached your son’s leg the week before.

All of Biber’s transsexual patients required prior evaluation approvals before he’d operate. Despite performing thousands of operations though, Dr. Biber was never successfully sued by a transsexual patient and he performed only three reversals on unstable patients. The first was a patient whose original operation was inappropriately done by another surgeon and later had psychological problems. The second was a well-known mathematician who eventually gave in to intense peer pressure. The third patient used the operation as a way to appear on talk shows “” then switched back. “Those patients are harder to spot, because they come to us with good evaluations,” he says. “Sometimes they slip through.” But there’s no counting the thousands of good people Dr. Biber helped over the decades, people often without hope and nowhere else to go, people who he gave the chance for a decent, normal life. Sad to say, Dr. Biber also saw way too much business trying to help patients who’d been mutilated by other doctors. Gradually, Dr. Biber’ reputation helped put a lot of those “chops shops” out of business. It’s estimated at one time Dr. Biber was doing two out of every three reassignment surgeries in the world.


But as time went on, rumors circulated that ol’ Doc Biber was maybe getting a mite too old. And by the Nineties he had rivals ““ good ones now. Several new doctors showed up with fine reputations and fancy new techniques. Dr. Biber himself trained two of the best. Drs. Toby Meltzer and Eugene Schrang both studied in Trinidad. So patients finally had themselves some other options. Yet every year, hundreds and hundreds more still continued finding their way to Trinidad…

The final numbers are staggering. Over 6,000 cases in his career (including over 350 FtM procedures). Now that’s a lot of surgery. Those Guinness World Records people thought so, too. Put him in their record books, they did. Most sex change operations ever. And like it or not, Trinidad got itself a new unofficial moniker, too: “The Sex Change Capital of the World.”

Dr. Biber remained pretty much unaffected by all this hullabaloo. Real down-to-earth kind of guy; most people thought. One reporter described him as: “A man who curses like a sailor and writes like a poet.” This was a man who performed reassignment surgery in the morning and then drove his cattle to market in the afternoon. Also into local politics: elected to city council in 1990, a real mover and shaker. Gregarious man, loves talking to people. An old school type around the ladies. Family man, too ““ has a wife and nine kids he’s real devoted to. One neighbor remembered: “He used to come up to my children, tweak their noses, give them a hug and joke around. It was the love he gave. You don’t see that anymore, and that’s too bad.”

And today? Now boasting about 9,000 hardy townsfolk, Trinidad has itself a new physician, Dr. Marci Bowers, whom Dr. Biber helped train.

Doc Biber rode off into the sunset on January 16, 2006. There’s no way to speak for the thousands that Dr. Biber helped over the decades. But here’s a start. Remember Ann, the one who started it all? Well sometime back, Biber got a Christmas card from her. Ann had moved to Washington, D.C. and been hired by the Federal Government. She passed the interviews, the background checks, and the physical. She was doing just fine, thank you, and her life was going well. She just wanted him to know that.


Sex Machine. Dr. Stanley Biber has made 3,500 women””and 300 men, Harrison Fletcher, Aug 27, 1998 ©2003 New Times, Inc.

Former Cattle Town Becomes Sex-Change Capital. Trinidad, Colorado, Owes It All To Pioneering Surgeon, James Brooke, New York Times

Old Mining Town Now ‘Sex-Change’ Capital, Pauline Arrilaga, The Sun Chain, May 24, 2000

Dr. Compassion, One surgeon’s work has made residents of a small Colorado town experts on transsexualism, Lisa Neff, The Advocate, May 25, 1999

How Sex Changed: A History of Transsexuality in the United States, Professor Joanne Meyerowitz

Aging Sex-Change Doctor Seeking Insurer, Associated Press, 22 Sep 03

Marci Bowers Interview, Transgender Community News, April 2003

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