Dr Marci Bowers has a unique connection to the patients upon whom she performs reassignment surgery – having undergone the life-changing operation herself.
The 59-year-old surgeon, based in San Francisco, became the world’s first transgender doctor to perform the surgery after transitioning to female in the ’90s.
Marci, who is still married to the woman she met as a man and shares three children with, reveals the intricacies involved in the life-changing procedure in an extremely graphic TV first as part of the new documentary for BBC Horizon: Being Transgender.
Cameras followed the surgeon into theatre as she performed male to female reassignment surgery on Vinessa, from Washington, removing the patient’s scrotum sack and testicles and reconstructing the penis to form a clitoris – and explaining the process to viewers as she goes.
Dr Marci Bower was the first ever transgender surgeon to perform a gender reassignment surgery on a transgender patient
In BBC’s Horizon documentary Being Transgender, Vinessa (pictured) receives the male-to-female confirmation procedure
Dr Bower uses skin from Vinessa’s scrotum to create the wall of the vagina which is stitched together using a stint
Dr Bower specialises in the surgery, which can take a patient from female-to-male genitalia or male-to-female – the latter being the more requested of the two procedures – and she performs around 150 per year.
‘The surgery each and every time is very complicated and intricate, to be able to put it all together and make it look pretty it is actually a great honour to do. For me it is like doing body art,’ Marci explains.
Transgender female Vinessa, from Washington, is the latest patient of Marci’s to have the operation, having her penis reconstructed to form a clitoris that will still have sensation for sexual arousal. The scrotal skin is grafted and becomes the vagina and is attached to the inverted penile skin.
Dr Bower first begins by removing the scrotum sack from Vinessa’s genitals, stretching and pinning the skin down for later use.
She then removes the testicles and discards them, joking to camera while in theatre: ‘She’s got a couple of nuts on her!’
Using the head of the penis, Dr Bower constructs a clitoris for Vinessa that she fixes in place with a few stitches.
Dr Bower begins by removing the scrotum skin before severing the testicles from the genitals and discarding them
The scrotum skin is pinned ready to be constructed into the wall of the vagina which will then be grafted on to Vinessa body
‘This is amazing in the sense that our patients are able to have regular sexual activity to the point that most of them are able to orgasm,’ Dr Bower adds.
The next stages of the surgery involve using the rest of the skin of the penis to preserve the nerves and arteries, before creating a ‘tunnel’ for the vaginal cavity which is located between the bladder and the rectum.
Dr Bower explains that it’s the most difficult part because both organs have a serious blood supply that cannot be damaged.
Using the head of the penis Dr Bower is able to construct a clitoris for Vinessa. He then stitiched the skin graft after creating a cavity to act as the vaginal wall
Vinessa is thrilled with the results of the surgery and exclaims when she sees her vagina for the first time: ‘Oh my god that’s amazing. I have a clitoris!’
Marci says performing the surgery is an honour because it means she can help people in her situation.
She explained that when she transitioned it was at a time where it was still ‘shocking’.
‘At the time I was the head of gynaecology at an ob-gyn at the Swedish Medical Centre in Seattle, which is a very high profile position and a very big deal when I transitioned because it just shocked people.
Right, Dr Marci Bowers as a man before she transitioned, with her wife and first daughter who she is still with now
Dr Bowers explained that although her marriage isn’t conventional she shares a sisterly bond with her spouse. When Marci transitioned in the nineties it came as a shock
‘It was a time when it was still very hard to come out like that.
Although Marci doesn’t have a conventional marriage with her spouse, who she met eleven years prior to her transition, she reveals they have a special bond.
‘I am still married to that same person, I would say our relationship has transitioned into more of a sisterhood I would call it, where we’re best of friends but we have three kids together.
‘My spouse and all of my kids have been fantastic from the first day.’
Horizon: Being Transgender is available to watch on BBC iPlayer