Former cattle town becomes sex-change capital

Trinidad, Colo., owes it all to pioneering surgeon

By James Brooke
New York Times

TRINIDAD, Colo. -- Perched for the last century on the sandstone facade of the First National Bank building here, three impish gargles have watched the changing foot traffic on Main Street, as this small Plaines city reinvented itself again and again.

When cattle was king, this proud building of Romanesque arches was the headquarters of a vast cattle and land empire. When coal was king, the back offices became a health clinic for the United Mine Workers of America.

With tourism now the king in Colorado, the former union clinic receives medical travelers from around the world who have come to consult a surgeon who has made this town known as "the sex-change capital of the world."

"It's a boon to business here," Dr. Stanley Biber, 75, said of his specialty. "They come with families, they stay in the hotels, they eat in the restaurants, they buy at the florists."

Biber has performed 3,800 sex-change operations at the 70-bed Mount San Rafael Hospital over almost 30 years. "The transsexual work means the difference between the hospital being in the red or being in the black," he said.

Trinidad boosters wince at the sex-change label, preferring, in one brochure, to promote their town of 10,000 people as "a pocket of peace, plentiful clean air and pure Western Americana." They talk of the year (1882) that Bat Masterson served as town marshal, of modern Trinidad's four museums and of its red-brick Victorian buildings downtown. Indeed, if ski mountains were near, this town could be another Aspen or Telluride.

But with the nearby Comanche National Grasslands a tepid tourist attraction, some residents are toying with taking the sex-change industry out of Trinidad's closet.

An exhibit on Biber "would be really interesting," said Paula Manini, director of the Trinidad History Museum, adding, "Of course, I am sure other people in the community would think it inappropriate."

Biber came to Trinidad in 1954, fresh from service in Korea in a Mobile Army Surgical Hospital (MASH) unit. He grew up in Iowa and wanted to be a surgeon and a cowboy. So after the Army, he chose Trinidad, on the Purgatoire River, which meanders through 2.5 million acres of range land in Colorado's largest county, Las Animas.

As the coal mines played out, Biber's medical practice with mining families shrank. In 1969, he stumbled on a new line of work.

A social worker, whom Biber knew as a woman, but in fact was a man, asked the surgeon if he could perform a sex-change operation.

With the confidence of a war surgeon, and with drawings obtained from a Baltimore sex-change surgeon, Biber removed the man's penis in an operation known as a penectomy.

Soon, Biber's new practice was booming from word-of-mouth referrals.

"When I did the first sex changes, we kept the patient charts in the administrator's safe," Biber recalled. "Then we realized we had to bring the local people into it."

Meeting local religious leaders, Biber lectured about what doctors now call "gender dysphoria" - the condition of a person who feels trapped in the body of the wrong sex.

From 50,000 to 75,000 people live as transsexuals, or opposite from the sex they were at birth, said Nancy Nangaroni, executive director of the nonprofit International Foundation for Gender Education in Waltham, Mass.

Since George Jorgensen became Christine in a 1952 operation in Denmark, an estimated 25,000 Americans have had sex-changing surgery.

Marsha Botzer, a Seattle counselor of transsexuals, who came here for sex-change surgery in 1981, recalled a friend who arrived clutching Biber's fee in small bills in a paper bag. Biber now charges about $11,000 for the procedure.

"Stan Biber certainly was a pioneer," Dr. Eugene Schrang, one of a handful of American surgeons specializing in sex-change operations, said from his clinic in Wisconsin. "He probably has done more operations than anyone else in the field."

Through the early 1980s, when few surgeons would perform the operations, about two-thirds of the nation's sex-change surgeries were done at Mount San Rafael Hospital, which became a private non-profit hospital in 1972.

In the 1970s, unfavorable publicity about Biber and the procedure led him and other surgeons to draw up guidelines to eliminate sex-change surgery on demand.

Most candidates now must go through two psychiatric evaluations, live and dress in their new role for at least a year, and undergo nine months of hormone treatments - testosterone for women and estrogen for men.

The surgeon said that only three of his 3,800 patients, all men, had been so unhappy in their new sex that they insisted on switching back.

In recent years, he said, there has been a major shift in the sex of his patients, from overwhelmingly male to 50-50 today.

Biber lives on a ranch east of town where he and his wife reared nine children, and he keeps the hospital open despite a 50 percent population drop since the 1950s.

As Trinidad's general surgeon for almost half a century, Biber has performed conventional surgeries on many of the town's residents.

"Dr. Biber's everybody's friend. Everybody knows him," said Janet Scott, a volunteer at the A. R. Museum of Western Art.

"A lot of people begrudge him for making Trinidad, you know, the sex-change capital of the world. But I think he does a lot of good. Those people are very troubled."

Now, as sex-change surgery becomes more mainstream, Biber is cutting back to one surgery a week from three, and younger surgeons are building practices in Detroit, Montreal and Portland.

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