Transgender Surgeons

Transgender surgeons appeal for more surgeons and research

During their visit to the University of Minnesota Medical School, world-renowned genital reconstruction surgeons, Marci Bowers, MD, and Loren Schechter, MD, urged medical students to enter the field of transgender health. The surgeons agreed that there is drastic need for more genital reconstruction surgeons as well as research on transgender youth.

In the United States there is only a handful of skilled surgeons who perform sex reassignment surgeries. Bowers and Schechter encouraged students to consider the profession. Bowers currently performs approximately 140 primary vaginoplasties per year, 50 female-to-male procedures including hysterectomy, scrotoplasty, and metoidioplasty, and about 70 cosmetic procedures for male-to-female clients including breast augmentation and tracheal shaving, which are often coordinated with the vaginoplasty proceedure. Typical surgical wait times for Bowers are generally three months for female-to-male procedures and cosmetic male-to-female procedures and 12 to15 months for the male-to-female vaginoplasties. As a plastic surgeon, Schechter performs approximately 70 to 100 transgender procedures annually. These include primary and revision vaginoplasty, breast and chest surgery, cosmetic facial surgery, liposuction, abdominoplasty, and injectable fillers such as botox and restylane. Typical surgical wait times for Schechter are between two to three months. On training future surgeons Bowers said, “I see so many causes, so many people to help. I feel my future cause may be best served teaching the procedures to other surgeons around the world. I continue to see male-to-females mutilated because of poor technique, not necessarily poor surgeons, and I want to share my techniques. I think, if I have a legacy, it will be that.”

While visiting the Program in Human Sexuality, Bowers and Schechter emphasized the critical need for scientific research on transgender youth. Increased public awareness has led some young people to seek transgender therapies at an early age. The current standards of care set forth by the World Professional Association for Transgender Health, formerly known as the Harry Benjamin International Gender Dysphoria Association, state that an individual must be 18 years old before undergoing surgery. Bowers and Schechter have both been contacted by clients who have met all criteria for surgery with the exception of age. Focused research is needed to examine the best care for young patients. “We are seeing patients who are under the age of 18,” says Schechter. “Asking people to wait a couple of years can be very difficult for the person and his/her family. We are interested in additional research and outcome studies on pediatric patients. Surgery is irreversible; we want to make sure that not only have we made an appropriate diagnosis, but also that the individual understands his/her surgical and non-surgical options.”

Bowers graduated from the University of Minnesota Medical School in 1986. She has since taken over the medical practice made famous by Stanley Biber, MD, who began performing sexual reassignment surgeries in Trinidad, Colorado, in 1969. In July Bowers performed the first ring metoidioplasty in the U.S., which allows for urinary function. Beyond transgender procedures, Bowers recently began to perform female circumcision reversals. Schechter is the surgical director of the Chicago Gender Center, a multi-disciplinary program. The center’s approach focuses on the entire individual offering psychological support with Randi Ettner, PhD, an internationally recognized clinical psychologist, and primary care and hormonal management with Frederick Ettner, MD, a family physician with extensive experience in transgender medicine.

Access the International Journal of Transgenderism , the official journal of WPATH.