Dr. Marci Bowers first tried making the transition from a male to female body when she was 19. Lacking the funds and with little support from her family, she couldn't complete the attempt.
Some 20 years later, with a strong support system in place, she fully transitioned in 1998.
Now Bowers performs the surgery herself, filling a void she once encountered as a teen by aiding transgender patients throughout the process.
As perhaps the only prominent transgender surgeon in the country -- and one of only a handful of distinguished doctors who perform gender reassignment surgery -- Bowers is a popular choice for patients looking to physically make the switch.
"(Being transgender) gives some people the perception that I have more sympathy and understanding," said Bowers, now 49. "I do. I want to do a better job -- it's important."
Trinidad, Colo., is known as "The Sex Change Capital of the World." The dusty old western town, population 9,300, got its name based on the life's work of Dr. Stanley Biber, one of the most well-known gender reassignment surgeons in the United States, who performed an estimated 5,000 surgeries or more than 30 years here.
Bowers already owned an accomplished private practice in Seattle and came to Trinidad to learn the basics of gender-reassignment surgery from Biber. When the 80-year-old Biber's malpractice insurance was not renewed in 2003 because of his age, he needed to find a replacement -- immediately.
So Bowers moved to Trinidad, and her popularity has soared since.
The reason, she said, is her advanced surgical techniques -- and the fact that people feel they can better relate to a transgender surgeon.
Bowers still frequents Seattle to visit her three children and her spouse, whom she married when she was still physically male (the couple is still legally married). But Trinidad, near the New Mexico border in the foothills of the Rocky Mountains, is now her base.
By the time Biber died of pneumonia in January 2006, Bowers already was a success in the town where her mentor's business wasn't expected to survive his retirement.
"She's had a similar impact -- she's very involved in the community and we're lucky to have her," said Trinidad Mayor Joe Reorda. Trinidad has embraced its namesake, the mayor said, and always welcomed both Biber and Bowers. "She's a very visible figure."
She's also an outspoken personality outside of Trinidad's boundaries -- giving speeches, managing her own Web site and appearing in a 2004 episode of "CSI" which focused on a transgender character.
Going to a transgender doctor is the reason Sabrina Taraboletti approached Bowers in 2004.
"I trusted her because I knew she was 'one of us' -- I knew she was transgender," Taraboletti said.
"She would try to do the best possible job for the transgender community because she was part of the community."
Now, Taraboletti is part of Trinidad's community -- she serves as the IT director for Mt. San Rafael and helped start Morning Glow, a recovery home for those who just received gender-reassignment surgery.
Bowers operates at the town's only hospital, Mt. San Rafael, which has seen an increase in revenue since 2003, according to its former CEO Tyler Erickson, who resigned late last month. She said she brings about $1.6 million per year to the hospital, performing an estimated 130 surgeries per year.
Bowers' price tag for only gender reassignment surgery is $17,500 -- but other operations, such as cosmetic surgery, means patients can spend up to $100,000 on total transition costs. Most of the surgical costs come to the hospital in cash, since the majority of gender reassignment surgeries are not covered by insurance.
Much of the town's revenue stems from the hotel industry because gender reassignment patients, along with adjoining relatives and friends, must stay in Trinidad for at least one week for the surgery, said Tom Davis, an administrative assistant for Trinidad's Chamber of Commerce.
"If Dr. Bowers were to leave, it would affect certain aspects of the town," Davis said. "The hotels would take a major cut, and the hospital would take a major hit."
But not everyone is friendly to Bowers' practice -- in 2005, two pastors started a petition to shut it down.
"Our reputation as sex-change capital of the world has brought shame and reproach on the community," Terry Keith, a pastor at All Nations Fellowship, told The Pueblo Chieftain for a story in July 2005. "When I'm in other states and countries and I say I'm from Trinidad, they immediately ask me a question about that.
"A lot of people think that since Dr. Biber retired (two years ago), it's not going on anymore. I felt that to say nothing would be irresponsible," said Keith. The petition ultimately failed.
When she transitioned, Bowers said she was condemned by about a tenth of her co-workers in Seattle before she started her own practice. People lose their jobs, families and friends -- many simply need a confidant, she said.
"Transitioning is like walking on lily pads: you have to be careful with each step or you're going to sink. It takes as lot of money, courage and a certain amount of planning," she said. "I'm just glad I can help."
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