TG History — JOHN RONALD BROWN

“I swear this oath by Apollo Physician, by Asclepius, by Health and by all the gods and goddesses: In whatsoever place that I enter I will enter to help the sick and heal the injured – and I will do no harm.” — The Hippocratic Oath

In 1973 Paul Ciotti was a junior reporter working for Time Magazine when he first encountered Dr. John Ronald Brown. Brown and his business partner, James Spence, held an unusual formal dinner at Spence’s home where Ciotti and several other guests were served by a dozen attentive transsexuals. Spence and Brown hoped to convince a group of urologists, proctologists, and internists to join them in setting up “the finest sex-change facility anywhere.” Spence maintained that Brown had developed a revolutionary procedure for giving transsexuals fully orgasmic clitorises and realistic looking vaginas. To make his point Dr. Brown showed his guests several gristly photos of his surgical technique.

At first, the other doctors seemed interested in Spence’s proposal for a full-service sex change clinic. Ciotti watched Spence cut up a pear with a pocketknife while one doctor asked how they would select candidates for surgery. “It takes one to know one,” Spence told his stunned guests. “We let other transsexuals make the decision. They can tell best when someone is a true transsexual — a woman trapped in a man’s body.” Yet a month later Brown called Ciotti in near panic, begging him not to publish his name. The proposed clinic had fallen through and now Spence was saying all sorts of awful things about him.

“TABLETOP”

The son of a Mormon physician, Brown was drafted into the Army where he claimed he did so well on the General Classification Test he was pulled from the clerk-typist pool and sent to medical school. Brown graduated from the University of Utah’s School of Medicine in August 1947. For nearly two decades Brown was a general practitioner in California, Alaska, Hawaii, and the Marshall Islands (nearly losing a patient there). Brown then spent two years at Newark City Hospital as chief resident, and later attended a plastic surgery program at New York’s Columbia-Presbyterian Hospital but failed to achieve certification by the American Board of Plastic Surgery. Authority figures, Brown explained, “turn my brain to cottage cheese.”

Yet despite this rocky start, over the next 25 years Brown claimed to have performed over 600 sex change operations, nearly all without the hindrance of a medical license. In 1977 the California Board of Medical Quality Assurance yanked Brown’s license for “gross negligence, incompetence and practicing unprofessional medicine in a manner which involved moral turpitude.” The Board charged that Brown allowed Spence (who wasn’t a doctor) to perform surgery; Brown allowed transsexual patients to forge prescriptions, diagnose patients, and provide medical care; he misrepresented sex-change surgery on insurance forms, and he exhibited “gross negligence” by failing to perform operations in an acute care facility (Brown just did them in his office, then sent the patient home). In one instant Brown failed to hospitalize a patient who had a “life-endangering, pus-infected wound the size of a softball.” Brown never bothered with medical histories or physical exams before surgery and he performed vaginoplasty on virtually anybody, no matter how physically ill or emotionally unstable.

Yet for all that, the administrative judge who revoked his license apparently did so reluctantly, filing a “memorandum opinion” on Brown’s behalf, claiming Brown appeared to be “a pioneer” who made “innovative contributions” to the emerging field of transsexual surgery.

How innovative a surgeon was Brown? Brown claimed credit for a vaginoplasty procedure that was actually developed by Dr. Georges Burou in 1958. But in the ’70s most of the reputable clinics provided only vaginas and labia to transsexuals. Brown — always willing to experiment on patients — was one of the few back then willing to at least try to construct a clitoris. But plastic surgeon Jack Fisher who personally repaired 12 to 15 of what he called Brown’s”pelvic disasters,” said: “He’s a terrible, appalling technical surgeon. There’s just no other way to describe it. He doesn’t know how to make a straight incision. He doesn’t know how to hold a knife. He has no regard for limiting blood loss.”

There have always been strong opinions about John Ronald Brown. Some patients couldn’t praise him highly enough. —  “He gives you a vagina at a fair price,” one witness said. “Whereas with other doctors you had to take hormones, wait up to six years, live as a woman, undergo psychological evaluations and then pay $12,000 to $20,000 or more, with Brown it was good old-fashioned capitalistic cash-and-carry.”

But Donna Colvin, a transsexual who worked for Brown, remembered a man who shot up with Valium before surgery, who purposely damaged the vagina of a transsexual who angered him, and who left a transman with raw gaping wounds after a botched mastectomy. Author and activist Dallas Denny periodically posted warnings about Brown for years. Among transsexuals he was known as “Table Top Brown” for his willingness to operate on kitchen tables (which sometimes collapsed), as well as in garages and motel rooms. In The Tijuana Experience, Denny wrote: “Some of these people, expecting vaginoplasties, received simple penectomies, leaving them looking somewhat like a Barbie doll. Others ended up with something which looked like a penis which had been split and sewn to their groin –” which is essentially what had been done. Some ended up with vaginas — becoming inflamed and infected. Some ended up with peritonitis, some with permanent colostomies. Some ran out of money and were dumped in back alleys and parking lots to live or die.”

But Brown offered more than surgery. According to another witness named Cheree: “He’d shoot silicone anywhere you wanted it. For $200 he’d do breast surgery. For $500 he’d do cheeks, breasts and hips. After injections you had to lie flat on your back for three days so the silicone wouldn’t go anywhere. He plugged the holes with Krazy Glue.”

The Worst Doctor in America?

Most doctors who lose their licenses find other lines of work. Not Brown. After being barred from practicing medicine in Hawaii, then Alaska, then the island of St. Lucia, Brown returned to Southern California where he became an underground, black market practitioner in gender-reassignment surgery, breast implants, face-lifts, liposuction, silicone injections, and penile implants. To avoid the law, Brown performed the actual surgery in Mexico. (In his advertising, Brown referred to his “international practice.”)

In January 1986, Penthouse Forum magazine published an article about Brown entitled The Incredible Dick Doctor. The article portrayed Brown as a flaky, scatterbrained character who backed into cars and whose pants fell down in the operating room. When he accidentally cut open a penile shaft causing blood to spurt everywhere, Brown casually declared, “I made a boo-boo.”

Then the television newsmagazine Inside Edition took its crack at Brown with an investigative report titled: The Worst Doctor in America. Brown was shown performing a scalp-flap operation to give a transsexual a more feminine hairline. Unfortunately the patient — who should have been under deep sedation — moaned throughout the procedure, which Brown dismissed on camera as “nothing unusual.”

The San Diego District Attorney disagreed and Brown spent 19 months in jail for practicing medicine without a license. Brown had previously been convicted of prescribing narcotics and practicing under a false name after his license was revoked. But jail terms didn’t deter Brown. “I didn’t like some of the things that organized doctors were doing, so I rebelled,” he said. “Later I didn’t like what the government was doing in support of the medical organizations, so I rebelled. I chose to ignore the laws.” Finally a lawsuit by a former patient, Julie Phillips, helped drive Brown to Mexico. That same year in San Francisco Dr. Paul Walker created the Standards of Care for Gender Dysphoric Individuals during the aftermath of the Julie Phillips lawsuit. Dr. Walker and other members of the Harry Benjamin International Gender Dysphoria Association had been instrumental in helping to revoke Brown’s medical license. There’s little doubt that Brown’s butchery played a significant role in establishing the Standards of Care that now determines who has gets access to gender reassignment surgery.

But then things really started going wrong…

Bibliography
The Peculiar Practice of Dr. John Ronald Brown, Paul Ciotti, December 17-23, 1999
The L.A Weekly scored three awards from the Greater L.A. Press Club for this article; Paul Ciotti won first place in Feature Story Competition.
Organ Grinder, Paul Ciotti, San Francisco Metropolitan, March 20, 2000
Murder Case Centers on Amputation Fetish, Randy Dotinga, APBnews.com, Sept. 30, 1999
Out On a Limb, Randy Dotinga, Salon Magazine
How Sex Changed: A History of Transsexuality in the United States. Professor Joanne Meyerowitz
The Tijuana Experience, Dallas Denny, 1992
Dr. Brown Appears to be Back in Business, AEGIS Advisory, June 25,1992
Dr. John Brown: A Surgeon to Avoid, AEGIS Advisory, May 21, 1993
C.A. Upholds Doctor’s Conviction in Botched Mexican Surgery, Kenneth Ofgang, Metropolitan News Enterprise, Monday, August 6, 2001
California Courts of Appeal Reports, PEOPLE v. BROWN, 91 Cal.App.4th 256 (2001) D035066
Information about the Julie Phillips lawsuit courtesy of Susan Stryker. The author gratefully thanks Dallas Denny for her invaluable assistance with this article.

Category: Transgender History