“What do you do exactly?”
“I cut off their cocks and balls. It’s called vaginoplasty, meaning to make a vagina. I use the skin inversion technique. Basically, we skin the penis-deglove it-invert it and sew it into the vaginal cavity. All men have a vaginal cavity, by the way. We open it, line it with the skin of the penis, use the leftover skin to mold a mucosal flap for the clitoris, even give the little darling a hood and Bob’s your uncle. Well, not quite, but that’s the basics. There’s a lot of preparatory work, mostly involving hormone injections and psychiatric tests.”
“Tell me about the tests.”
“Well, like I say, there are psychiatrists who just don’t buy the whole ‘woman in a man’s body’ argument, but they’re considered square. The profile of a true transsexual is really pretty simple. The perception of being the wrong gender starts amazingly young-between the ages of three and five. The need, interestingly, seems not to be sexual. A lot of transsexuals are not interested in sex at all. In the M2F-sorry, male to female-category, which is the only one that really matters at the moment, the desire is simply to be accepted as a normal woman, which is almost perverse, because there is nothing more challenging to normal identities than a transsexual. They are the true revolutionaries of our time, the ones who make even gender a flexible proposition.
“It’s quite sweet really. A gay queen who cross-dresses goes to pubs and clubs to show off-he’s really simply a showman, an extrovert. But a true transsexual cross-dresses and takes the dog for a walk on his own-he really feels more at home in women’s clothes and does all his ordinary things in them. In his dreams he is a heterosexual female, and by the time he comes to me he will do anything-absolutely anything-to live inside the body of a woman. Since these men are often husbands and fathers, the whole thing can mean giving up his kids as well as everything else he’s made of his life as a man.”
“It doesn’t happen the other way-women who think they should be men?”
“Sure, but up to now the operation is much more complex. It’s really quite easy to make an artificial vagina out of a cock, almost impossible to make a fully functioning penis. Generally F2M is pretty messy at present. I have no doubt that once we learn how to produce a full-powered dick and stick it on, they’ll be lining up in the street. This is the age of dissatisfaction after all. Everyone wants to be something they’re not.”
The doctor didn’t look as if he’d ever wanted to be anyone else. He was slightly plump, in his forties, but what impressed most was the golden glow that seemed to emanate, a man for whom poverty was not even a concept. When he spoke of his work his Thai was interspersed with Western medical terms and often American slang as well; sometimes he broke entirely into English, once he saw that I understood.
“And in this case, did she/he satisfy all the requirements?”
An almost imperceptible hesitation. “Of course.” A wave of the hand. “He was shemale when he came to us.”
“Shemale?”
“A horribly trendy-sounding word, I know. We’ve taken to using it, since everyone on the street knows what it means. Basically, a shemale is a man who has taken all the hormone treatment, started to develop breasts, but has no present intention of following through with the operation. The hormones are there to give the appearance of femininity and to make him feel feminine, but he retains his sexual organs for the purpose of orgasm. Naturally, in a homosexual relationship he would tend to take the passive role.”
“And your patient-Fatima-she was in this intermediate condition when she came to you?”
“You can’t call it intermediate, necessarily. A lot of men live their lives like that. They go on taking the estrogen until old age, sometimes.”
“So Fatima might have fit that shemale category? She might not have intended to go through with the operation, except in very favorable circumstances?”
Dr. Surichai frowned, tapped his desk. The desk was almost the only part of the office that wasn’t white or beige. Even the curtains on the windows were beige, the walls were white, Dr. Surichai wore a white coat and his sculpted plastic chairs were white. The desk was light too, of some kind of varnished pine, and the picture rails were picked out in gold. The clinic achieved perfectly the intermediate condition between a modern hospital and a world-class hotel.
“Look, I know what you’re getting at, but what can one do? This is the age of access to knowledge, the Internet. More and more people come already knowing the answers to the questions-they’ve looked everything up on the Net and they know all that I’ve just told you. So someone like Fatima is bound to say: Yes, I first wanted to be a woman at the age of three, and when I cross-dress I don’t go to the clubs to show off, I just go for a stroll in the park.”
“But Fatima was a street kid, a male prostitute with little education?”
Dr. Surichai shrugged. “If you’re asking do I think she was coached, the answer’s yes.”
“By whom?”
“Who d’you think? Like you say, she was a street whore, there was no way she was going to be able to afford me without help. The only way these creatures get the kind of medical treatment she got is by finding a sponsor. Thailand is the world capital of GRS-that stands for gender reassignment surgery. We have the microsurgery here, and some of the best surgeons in that field. People come from all over the world. Montreal is good and there are some fine hospitals in the States specializing in these techniques-Johns Hopkins is world class, of course, but the Anglo-Saxon world is terribly hung up and confused about this sort of thing. The psychological tests are terrifying and last three months. The whole induction process normally takes two years in the U.S. People don’t necessarily want to expose themselves to the men and women in white coats for that length of time, so they come to us. As a result we get the practice. We do a thousand operations where an equivalent clinic in the West would do only a hundred. Naturally our surgeons are more practiced. Also”-a smile-“Thai doctors are rather good at cutting people up. We’re the neatest in the world. Must be those Asian genes. All of which makes our clinic rather expensive to locals-dirt cheap to Westerners of course. Generally, the local business from the street goes down-market to one of the other clinics. The results in those places can be hit or miss.”
“You met him, then?”
This was the first question that seemed to surprise the doctor. “Met him? You mean the marine? You’re not kidding I met him.” I raised my eyebrows. “I saw more of him than I saw of my patient. When he wasn’t here consulting me, he was calling me up on the phone. I made the mistake of giving him my mobile number. I got calls in the middle of the night, as if I was some kind of G.P. or something.”
“Is that unusual?”
“The intensity was unusual. He was a very intense man. A perfectionist. Sometimes he didn’t seem like a soldier at all, but then I would think, Yes, that’s exactly how the very best kind of professional soldier would be, attending to detail, never letting anything slip by him. He had an eye, though, which you don’t usually find on a soldier. My god, he had an eye. He practically designed her, and I have to admit that by the end of the process, he got the perfect product. Without a doubt Fatima is my finest creation.”
“Also his creation?”
“Yes, that’s correct. He looked everything up on the Net, he got professional-class software for his damned computer and would come out with stuff I’d hardly heard of. He mastered all the medical Latin, understood every detail of the skin inversion technique I just told you about, and about the voice stuff too.”
“The voice?”
“That’s the real problem. Sexual organs are not so complex, they hardly vary between us and the other mammals, they’re one of the oldest organs, been around ever since God divided the world into male and female and we know a hell of a lot about them. They’re also rarely modified for social reasons. The voice is something else. I’m not a shrink, but if you want my opinion, the voice is far more important as an identity than whatever you’ve got between your legs. I could cut your bits off and make you the most wonderful pussy, but you wouldn’t be happy if you sounded like a man every time you opened your mouth. The Adam’s apple can be shaved-in Fatima’s case only a little shaving was needed, just a local operation with the teeniest little incision on the anterior neck.”