In 1975, Dr. Preecha Tiewtranon became the pioneer of sex reassignment surgery by performing the first surgery in Thailand.

A 1965 graduate of Chulalongkorn University, Tiewtranon had studied surgery in the US for eight years. When he returned to work at the renowned Thai university’s plastic surgery unit, he was shocked to see countless transgender patients who had been mutilated by unqualified doctors. He developed his own surgical procedure and has since changed the lives of thousands of patients.

“When I first started off at Chulalongkorn University as a surgeon, I did many corrective surgeries. These are very difficult to perform because of the lack of available tissue. I sat down with the psychiatry department. They told me that they saw a lot of patients who were ready for the operation, but that they couldn’t refer them to a surgeon.”

In 1970s Thailand, transgenders were not well understood.

“Statistics tell us that one out of 30.000 men want to be women, and one out of 100.000 women want to be men. That’s the same the world over. At first, Thai society considered them as psychopaths, as dirty, hiding in the dark to grab the men. They worked as prostitutes. People generally looked down on trans. But after I started operating, that image gradually changed. In the early days, my patients were often working class – beauticians and dress makers. Nowadays, I operate fellow doctors, bankers and engineers. On a family level too, things are easier now. These days, parents take their children for advice on hormones. If you take the hormone early, the transition will be more feminine.”

The first international clients showed up in the early 1980s.

Statistics tell us that one out of 30,000 men want to be women, and one out of 100,000 women want to be men.

Communication was a major challenge. At first Scandinavians, Germans, Italians and Spaniards would get in touch, usually by fax. American clients also made inquiries. There were only ten or so well qualified surgeons in the world who could perform modern sex reassignment surgery safely. The US and Serbia produced brilliant doctors. Here in Thailand, most of the surgeons were my students.”

Dr. Preecha and his colleagues set up associations who meet regularly around the world to exchange information on surgical procedures. He is the director of the largest such organization in Asia – Asia PATH, which was established to explore and document the best practices leading to health-for-all for Asia’s transgender and gender diverse people, taking local barriers and policies across the region into consideration.

By the early 2000s, Dr. Preecha began to connect with patients from the Middle East.

“I remember my first Iranian patient very well. She asked her Ayatollah what to do. She told him that God had given her the wrong body which made her confused. The Ayatollah told her that if she was confused, she would not be able to serve God and it was best to go see a doctor and change. It’s not that easy for the Saudis. They leave home dressed as a man. They arrive in Bangkok dressed as a woman.

When they go home, they dress like a man again. Even as they can’t live as transgender people in public, they’re happy. The part of their body which they so disliked is gone.”

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