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Transgender Americans face dearth of sexual reassignment surgeons

Americans seeking sexual reassignment surgery have found that specialists are few and far between

From the age of 7, Jayden Thai knew he was different. But his differences didn’t make him stand out academically or athletically.

“[In] the second grade, I remember being pulled out by my teacher, saying that I can’t return to school until I start wearing girl’s clothes,” he said. “It was the first time I realized there’s something wrong with me.”

He added: “The world saw me as a girl. What I saw was … I didn’t know what I saw. I just know that it was not that.”

Confused and ashamed, Thai spent the next 16 years struggling to find a sense of self that fit. It wasn’t until 2012, when Thai came out as transgender, that he began to feel whole. A few months later, he says he knew it was time to change his outer appearance to match his inner person.

But little did he know that his journey would mean confronting a medical system ill prepared and often unwilling to embrace transgender patients.

In fact, a Web search reveals just how few American doctors specialize in performing complicated surgeries to change physical and sexual characteristics as part of some people’s gender transitions. TSSurgeryGuide.com lists fewer than 30 physicians who offer sexual reassignment surgery, mostly located on the coasts.

While a few more surgeons might not have been listed, that number is probably in the ballpark, according to medical professionals who told America Tonight that people who are transgender are dangerously underserved by the medical system, especially when it comes to surgical specialties.

‘A lot of learning’

Dr. John Taylor is a plastic and reconstructive surgeon based in New Jersey – and one of the few doctors in the US who specializes in sexual reassignment surgery. 

Dr. John Taylor faced many roadblocks when he first started specializing in sex-reassignment surgery.
America Tonight

“I remember getting a phone call in my office on day from the chief of surgery, who was screaming at me on the other end of the line, saying – and I’ll never forget this – he said, ‘Don’t you even think about bringing those freaks into my hospital!’” Taylor recalled. “So, that’s what I was dealing with when I started this.”

Taylor said medical school and his surgical residency didn’t offer him any training in gender dysphoria and the related surgical issues. Twenty years ago, his practice took a turn after a psychologist friend asked if he’d be willing to see transgender patients in need of surgery.

“I started researching it and became more interested in it, and started to really kind of develop a passion for these patients,” he said. “God has given us the ability to treat disease, whether it’s high blood pressure, diabetes, whatever. You know we have the knowledge and the capability to treat it, so why not gender identity?”

Starting in 2001, Taylor traveled to Canada every few months to observe surgeries and the techniques used. He’d take copious notes in a book that he still keeps in his operating room.

“[It’s] a lot of learning. [There’s] no textbook with this information in it,” he said. “You won’t find it. You won’t find it anywhere.”

A complicated task

Taylor has encountered more roadblocks from the medical community besides that surgical chief, but some of the nation’s largest and most prestigious hospitals are addressing the need for better care for people who are transgender head on.

Dr. Barbara Warren is the director for LGBT programs and policies for the Mount Sinai Health System in New York, where she and others are racing to build a comprehensive system of care to support transgender patients – whether they’re in for a flu shot, hormones or sexual reassignment surgery.

Complicating the task, however, is the recent influx of patients seeking surgeries.

“We really don’t have a system set up to meet how much need there really is,” she said. “There’s a far greater need than there are … people available to do it.”

‘God has given us the ability to treat disease, whether it’s high blood pressure, diabetes, whatever. You know we have the knowledge and the capability to treat it, so why not gender identity?’

Dr. John Taylor

Until last year, people who wanted surgery had to pay out of pocket – roughly $7,000 to $24,000 for male-to-female or possibly more than $50,000 for female-to-male. But changes to Medicare and the Affordable Care Act now allow for some insurance coverage of these procedures.

When word got out about the changes, Mount Sinai was flooded with requests.

“I stopped counting how many calls I got from people in the greater metropolitan area,” Warren said.

Exact numbers are difficult to find because few doctors or hospitals, until recently, had tracked patients based on gender identity – how a person sees him or herself. Still, it’s estimated that there are about 700,000 Americans who are transgender.

One day, Jayden Thai wants to open a gender clinic serving the trans community.
America Tonight

Many others are content on hormone therapy or with varying degrees of surgery. One of those is Thai, who opted for “top surgery” last fall.

“I was able to take my shirt off in private, and look in the mirror,” he said. “This is who I am. This is who I’ve always seen felt that I could be. And here I am.”

Attention to public figures, such as Caitlyn Jenner, have also helped drive acceptance, Taylor says, empowering the transgender community to not be afraid of coming out. As more transgender Americans identify themselves publicly, Taylor hopes they have the full support of the health care industry.

“I’m just hoping that we see more of the scientific community coming out and studying this more from a biological standpoint,” Taylor said. He added: “I hope that the medical community really does embrace it.”

For Thai, whose dream is to be able to open a gender clinic for the trans community, that embrace begins with him. His journey has inspired him to use the Ph.D. he’s earning in psychology to open a specialized clinic — run by and for trans people — to provide comprehensive medical and mental health services.

“I sincerely hope that everyone, whether they’re trans or straight, that they get to walk through this life and this world, authentically,” he said. “Cause everyone deserves to be happy, and everyone deserves to smile, authentically.”

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