Dr. Preecha Tiewtranon: A biography by a Medical student

Tamayo-Chuc, Darwin Ulises*

*4^th year medical student, Division of Health Sciences, University of Quintana Roo, Chetumal, Quintana Roo, Mexico.

› Address: Avenida Erick Paolo Martínez S/N casi esquina con Avenida 4 de Marzo, Colonia Magisterial, Código Postal 77039, Chetumal, Quintana Roo, México. E-mail: darwin.tamayo91@gmail.com Telephone number: 001 52 (983) 835 03 00 Extension number: 241

Overview: As a 4^th year Medical student, I declare myself a passionate of transgender-related medicine. In the next years, I would like to study some specialty linked to the health of this sector of the population. One of the countries with the most experience in this regard is Thailand. I could talk a lot about medicine-focused themes, but in this post, I will focus in the life and times of Dr. Preecha Tiewtranon. This entry marks for the first time my foray into the writing of manuscripts in English, I hope if you can read it, give me your sincere opinion regarding this.

Image 1: Dr. Preecha Tiewtranon.
Source of image: The Beginning Life
Transsexuality Discusion Forums

Preecha Tiewtranon, M.D. (Thai: ปรีชา เตียวตรานนท์)⁽¹⁾ is probably the most famous transgender surgeon of Thailand. He was born near 1942 or 1943.^(2,3) He speaks English and Thai.⁽⁴⁾ Some medical colleagues unfortunately have been mocked him into a pejorative terms for “cutting off organs”.⁽²⁾ However, he has taught the state of art to many Thai surgeons and I think he is the plastic surgeon who has done more affirmation surgeries after Stanley Biber, M.D. (Dr. Biber holds a record of >5,000, compared to the record carried by Dr. Tiewtranon of >3,500 surgeries).^(5,6)

1.1. Medical career

Tiewtranon attended Chulalongkorn University in Bangkok, Thailand. Then, he did his medical residency in General Surgery in USA at three different hospitals: New York Hospital, NY (1967-1968), Providence Hospital, Southfield, Michigan (1968-1970), and Roswell Park Memorial Institute, Buffalo, NY (1970-1973).⁽⁶⁾

In this last one, he began his fellowship in Surgical Oncology (1973-1975). And finally, he did his residency programme in Plastic Surgery at Albany Plastic Surgeons Associates, Albany, NY (1975-1976), and Victorian Plastic Surgery Unit, Melbourne, Australia (1976-1977).⁽⁶⁾

He treated his first case of sex affirmation surgery in 1975 together with Dr. Prakob Thongpeaw.⁽⁷⁾ From 1978 to 2002, he started his own clinic called “Chollada Clinic, Sukumvit soi 1”; then in 2002, Preecha Aesthetic Institute (PAI) was established in Bangkok, in order to offer a wide range of surgical procedures.⁽⁸⁾ His operations were highlighted because they are performed in a single stage –mainly procedures for MtF patients– (See Table 1).^(9,10) He had also performed surgeries at Bangkok Nursing Home Hospital, Bumrungrad Hospital and Piyavate Hospital.^(4,10,11,19)

In December 10^th, 2004, Dr. Tiewtranon performed a live sex affirmation surgery in Bangkok, with 35 worldwide surgeons -leaders in sex affirmation surgery- as spectators.⁽¹²⁾

As of February 2010, he had performed about 3,500 surgeries over 30 years of practice.^(6,9,13) And annually, he performs up to 200 surgeries in his clinic.⁽¹⁴⁾ It is important to say, however, that Dr. Tiewtranon performs surgery less and less at present, leaving such work to colleagues and supervising them instead.^(10,15,16)

Procedure	Cost of Treatment (in USD)*	Recovery time at PAI	Cases treated
Penile Inversion Vaginoplasty	$8,600.(15,16)	10-14 Days.(9,15)	>3500 cases.(6,9,13)
Sensate Pedicled Neoclitoroplasty	Unknown.	Unknown.	250 cases.(6)
Sigmoid Colon Vaginoplasty	$11,700.(15,16)	10-14 Days.(15)	112-350 cases.(6,9) 550 cases (colon transposition for more depth).(9)
Female to male affirmation surgery (Metoidioplasty & Phalloplasty)	Metoidioplasty (with Hysterectomy and Ovary removal): $12,000.(16)	Metoidioplasty: 14 Days.(17)	130 cases.(9)
	Phalloplasty: c. $20,000.(13)	Phalloplasty: It requires 4 stages; each one is required at least 6 month to continue for next stage. -Stage 1 (9 days). -Stage 2 (12 days). -Stage 3 (12 days). -Stage 4 (6 days).(18)

*An extra charged for HIV is 30% from total cost.^(9,16,17,18)

Table 1: Dr. Preecha Tiewtranon’s Sex affirmation surgical techniques information.

1.3. Medical education

1.3.1. As professor

Dr. Tiewtranon is also an associate professor at Chairman Plastic Surgery Unit in King Chulalongkorn Memorial University (Bangkok).^(4,6)

1.3.2. Former medical trainees

Dr. Tiewtranon has trained many plastic surgeons (See Table 2). Many of these Thai surgeons have established their own private clinics. The ones called “shophouses” emerged as cheaper private clinics run by surgeons, who will often rent rooms in private hospitals to perform surgery. Many Thai patients prefer those because the facilities in comparison to the state hospitals.⁽¹⁹⁾

Table 2: Former medical trainees of Dr. Preecha Tiewtranon.
Name of Surgeon	Dr. Chettawut Tulayaphanich(20)	Dr. Juta Jansi(16)	Dr. Sanguan Kunaporn(16,20)	Dr. Saran Wannachamras(16)	Dr. Sattha Siritantikorn(21)	Dr. Suporn Watanyusakul(10,16)
	Source of image: GaboGirl blogspot	Source of image: Health-tourism.com	Source of image: Tranquil Beauty Changes	Source of image: Thailand Med Tourism	Source of image: Health-tourism.com	Source of image: Carla Antonelli's website
Hospital/ Institute	Vibhavadi Hospital	Bangkok Beauty Surgery Center	Phuket International Hospital / Bangkok Phuket Hospital	Saran Cosmetic Surgery Clinic	Preecha Aesthetic Institute	Dr. Suporn Clinic
Location	Chatuchak District, Bangkok Province	Mueang Samut Prakan District, Samut Prakan Province	Mueang Phuket District, Phuket Province	Bangkok	Bangkok	Mueang District, Chonburi Province

1.3.3. Doctor Training Center

The Preecha Aesthetic Institute has a workshop for medical training on transgender healthcare topics —mainly surgical procedures— like perineum anatomy, endocrinal approach and management in transgenderism, FtM and MtF sex affirmation surgery among others.⁽²²⁾

1.4. Documentaries

He appeared in a “SexTV” episode as himself in 2004.⁽²³⁾

“Between Two-Spirit – Becoming a woman at sixty” (original French title: “Entre il et ailes – Devenir femme à 60 ans”), a documentary filmed by French filmmaker Laurence Périgaud, it follows the transition of male-to-female transsexual Christa Muth, a German systems scientist filmed from November 2008 to December 2009, and she continued editing independently for two years.⁽²⁴⁾

In 2014, two documentaries related to his work with transsexual issues were filmed:

▪ “The Cost of Gender”, a 14-minute American documentary, shows the affirmation surgery options in Thailand told by past and potential patients. It is a production by The Seattle Globalist, a social action news publication. It was created by Seattle Globalist editor Sara McCaslin and Austin-based filmmaker Dacia Saenz.^(25,26)

▪ “Unique”, a 75-minute Italian documentary filmed by Gianni Torres was released. It is a compilation of five stories of characters around the world who are involved in different aspects of transgender life.⁽²⁷⁾

“Made in Bangkok”, another documentary focused in the sex affirmation surgery process of the Mexican opera singer Morgana Love, directed by Argentinean filmmaker Flavio Florencio will be released soon.⁽²⁸⁾

2. Publications

▪ Tiewtranon P, Kittisin P. Vaginal reconstruction with the rectosigmoid colon. Paper presented at The Proceedings of the X Congress of the International Confederation for Plastic and Reconstructive Surgery. Madrid, Spain. 28 Jun – 3 July 1992. Plast Surg 1992; 2: 887-9.

▪ Tiewtranon P, Chokrungvaranont P, Jindarak S, Angspatt A, Siriwan P. Sex Reassignment Surgery : Experience at King Chulalongkorn Memorial Hospital. Thai J Surg [Internet]. 2001 Apr – Jun [cited 2014 Jun 12]; 22(2):47-50. Available from: http://www.surgeons.or.th/ejournal/files/Vol22_No2_47.pdf

▪ Chokrungvaranont P, Tiewtranon P, Mahatumarat C, Siriwan P, Angspatt A. Combined Free Flaps for Major Head and Neck Reconstruction. Thai J Surg [Internet]. 2001 [cited 2014 Jun 12]; 22(2):43-46. Available from: http://surgeons.or.th/ejournal/files/Vol22_No2_43.pdf

▪ Chokrungvaranont P, Selvaggi G, Jindarak S, Angspatt A, Pungrasmi P, Suwajo P, Tiewtranon P. The Development of Sex Reassignment Surgery in Thailand: A Social Perspective. ScientificWorldJournal. 2014 Mar 19 [cited 2014 Jun 12]; vol. 2014, article ID 182981. Available from: http://www.hindawi.com/journals/tswj/2014/182981/abs/

3. References

⁽¹⁾ ปรีชา เตียวตรานนท์ [Internet]. Perfect Woman Institute; [cited 2014 Jun 6]. Available from: http://www.perfectwomaninstitute.com/physician-doctors-pfw-th.php  

⁽²⁾ He’s the King of Sex Change Ops. Electric New Paper. [Internet]. 2004 Dec 26. In: Conway, L. [Internet]. Electrical Engineering and Computer Science – University of Michigan; [cited 2014 Jun 8]; Available from: http://ai.eecs.umich.edu/people/conway/TS/SRS/Dr.Preecha.html

⁽³⁾ Asabe, S. Sex Change ~ After the Enforcement of the Law Concerning Special Rules Regarding Sex Status of a Person with Gender Identity Disorder~ [Internet]. Japan: IIJ4U; 2005 Aug [cited 2014 Jun 11]. Available from: http://www.hh.iij4u.or.jp/~asabe/thailand/tlsexchangeen_main.htm#tlaids

⁽⁴⁾ Dr. Preecha Tiewtranon [Internet]. GlobalMedCures; [cited 2014 Jun 15]. Available from: http://www.globalmedcures.com/doctors-bio/thailand/Dr.%20Preecha%20Tiewtranon%20-%20Cosmetic.pdf

⁽⁵⁾ Brady J. Sex-Change Pioneer, Dr. Stanley Biber [Internet]. USA: National Public Radio; 2006 Jan 19 [cited 2014 Jun 15]. Available from: http://www.npr.org/templates/story/story.php?storyId=5163832

⁽⁶⁾ Dr. Preecha Tiewtranon [Internet]. Thailand: Preecha Aesthetic Institute; 2011 [cited 2014 Jun 12]. Available from: http://pai.co.th/dr-preecha-tiewtranon-md/

⁽⁷⁾ Chokrungvaranont P, Tiewtranon P. Sex Reassignment Surgery in Thailand. J Med Assoc Thai [Internet]. 2004 [cited 2014 Jun 12]; 87(11):1402-8. Available from: http://www.transexualia.org/SANIDAD/sexreassignment.pdf

⁽⁸⁾ About PAI [Internet]. Thailand: PAI; 2011 [cited 2014 Jun 12]. Available from: http://pai.co.th/about/

⁽⁹⁾ Sex Reassignment Surgery [Internet]. New Zealand: Beautiful Escapes; [cited 2014 Jun 15]. Available from: http://www.beautifulescapes.co.nz/wawcs0126914/idDetails=187/Sex%20Reassignment%20Surgery

⁽¹⁰⁾ Talbot M. Nip, Tuck, and Frequent-Flier Miles. The New York Times [Internet]. 2001 May 6 [cited 2014 Jun 15]; Archives. Available from: http://www.nytimes.com/2001/05/06/magazine/06TOURISM.html?src=pm&pagewanted=1

⁽¹¹⁾ S. GRS with Dr. Preecha at Bangkok Nursing Home Hospital [Internet]. [cited 2014 Jun 14]. Available from: http://www.annelawrence.com/preechaaccount.html

⁽¹²⁾ Thais to perform first live sex change operation [Internet]. China: ChinaDaily; 2004 [updated 2004 Dec 10; cited 2014 Jun 12]. Available from: http://www.chinadaily.com.cn/english/doc/2004-12/10/content_399282.htm

⁽¹³⁾ Ehrlich RS. Everything you always wanted to know about sex… changes [Internet]. USA: CNN; 2010 Feb 24 [cited 2014 Jun 12]. Available from: http://travel.cnn.com/bangkok/play/everything-youve-ever-wanted-know-about-sex-changes-379486

 ⁽¹⁴⁾ Mason M. Bangkok a Mecca for Sex-Change Surgeries [Internet]. USA: The Washington Post; 2006 Aug 23 [cited 2014 Jun 12]. Available from: http://www.washingtonpost.com/wp-dyn/content/article/2006/08/23/AR2006082301222_pf.html

⁽¹⁵⁾ Sex Reassignment Surgery at Bangkok’s pioneering PAI gives patients a new lease on life [Internet]. My Med Holiday; 2014 Mar 20 [cited 2014 Jun 15]. Available from: http://www.mymedholiday.com/blog/2014/03/1389/sex-reassignment-surgery-at-bangkoks-pioneering-pai-gives-patients-a-new-lease-on-life/

⁽¹⁶⁾ Dr. Preecha SRS/GRS Guide: [Internet]. TSSurgeryGuide. 2013 [cited 2014 Jun 15]. Available from: http://www.tssurgeryguide.com/Dr_Preecha.html

⁽¹⁷⁾ Metoidioplasty for Female to Male [Internet]. Thailand: Preecha Aesthetic Institute; 2011 [cited 2014 Jun 15]. Available from: http://pai.co.th/metoidioplasty-for-female-to-male/

⁽¹⁸⁾ Phalloplasty (Female to Male Surgery) [Internet]. Thailand: Preecha Aesthetic Institute; 2011 [cited 2014 Jun 15]. Available from: http://pai.co.th/phalloplasty-big-penis-for-female-to-male/

⁽¹⁹⁾ Aizura AZ. The Romance of Amazing Scalpel: “Race”, Labour, and Affect in Thai Gender Reassignment Clinics [Internet]. In: Jackson PA. Queer Bangkok. Hong Kong: Hong Kong University Press; 2011 [cited 2014 Jun 15]. Available from: http://arenaizura.com/uploads/aizura_romance_scalpel.pdf

⁽²⁰⁾ Transition in Thailand [Internet]. USA: Transsexual Road Map; 2012 Mar 6 [cited 2014 Jun 14]. Available from: http://www.tsroadmap.com/international/thailand.html

⁽²¹⁾ Hopkins J. Boys will be Girls – In Bangkok, the ‘Sex Change’ Mecca [Internet]. Australia: Gender Centre; 1998 Oct [updated 2013 Oct; cited 2014 Jun 14]. Available from: http://www.gendercentre.org.au/resources/polare-archive/archived-articles/boys-will-be-girls.htm

⁽²²⁾ Doctor Training Center [Internet]. Thailand: PAI; 2011 [cited 2014 Jun 15]. Available from: http://pai.co.th/about-training-center/

⁽²³⁾ Preecha Tiewtranon [Internet]. USA: IMDb; [cited 2014 Jun 12]. Available from: http://www.imdb.com/name/nm2708327/

⁽²⁴⁾ BETWEEN TWO-SPIRIT – Becoming a woman at sixty [Internet]. Transexualia; 2012 May [cited 2014 Jun 13]. Available from: http://www.entreiletailes.com/wp-content/uploads/2012/05/Press-Kit-Between-Two-Spirit-english.pdf

⁽²⁵⁾ The Cost of Gender [Internet]. USA: Seattle Globalist; 2014 [cited 2014 Jun 15]. Available from: http://www.costofgender.com/

⁽²⁶⁾ Sarko M. The Cost of Gender: Seattle Globalist launches transgender film [Internet]. USA: Capitol Hill Times; 2014 Apr 8 [cited 2014 Jun 15]. Available from: http://www.capitolhilltimes.com/2014/04/cost-gender-seattle-globalist-launches-transgender-film/

⁽²⁷⁾ UNIQUE – A Gianni Torres Documentary [Internet]. Italy; 2014 [cited 2014 Jun 15]. Available from: http://www.uniquedocfilm.com/index.htm

⁽²⁸⁾ Opera singer finds her true voice [Internet]. Thailand: Bangkok Post; 2012 Nov 25 [cited 2014 Jun 12]. Available from: http://www.bangkokpost.com/lite/topstories/322966/opera-singer-finds-her-true-voice

You can see this blog entry at Google Docs here.