Dr. Marci Bowers on Gender Identity and Progress in Trans Visibility

Dr. Marci Bowers is not your average doctor. About 20 years ago, when working as an OBGYN, she began performing gender affirmation surgeries for transgender patients. This career choice was personal for her, as Dr. Bowers is a transgender woman herself–and the first trans woman worldwide to perform gender affirmation surgeries. Check out our first interview for my National Geographic documentary, Gender Revolution, and read our conversation below to learn how trans visibility has progressed since Caitlyn Jenner came out, and how a simple story about Pop- Tarts can help kids (and maybe adults too!) understand gender identity…

Katie Couric: You started your career as an OBGYN. At what point did you decide to focus on gender confirmation surgery?

Dr. Marci Bowers: OBGYN’s are surgeons- we don’t just do caesarian sections but hysterectomies, bladder repairs, and that sort of thing. So I had a fairly lengthy amount of experience there- I practiced for 12 years before I met Dr. Stanley Biber, the physician who really pioneered gender affirmation surgery. It was Dr. Biber who woke me up to realize hey, maybe this is a field that you should explore. He was already 78 years old when I met him, and the other surgeons who were doing these surgeries weren’t a whole lot younger, and there were only about five doctors really actively doing these surgeries in the US. So I realized that this was a phenomenon that wasn’t going to go away, and I could really help a lot of people, and maybe it was a positive change to make in the middle of my career.

You’ve been performing these surgeries for almost 20 years, but the general public’s awareness of transgender issues has really skyrocketed over the past couple of years. As the visibility of the trans community continues to grow, have you found that more people are seeking you out now that they have the language to explain what they’re experiencing?

Oh, no question. It’s recently become much more accepted to come out and identify as trans. I met a lot of people who were very lonely in the early days when I started practicing, because they felt like, “there’s nobody else out there who’s like me.” In the early 2000s I performed confirmation surgeries on patients who had transitioned [meaning: begun living their lives as the gender with which they identify] in the 80’s or 90’s, and those people felt so isolated. They were just so happy to meet someone who had had a similar experience just so they could talk. But then Caitlyn Jenner came out as trans, and she brought so much visibility to the community, although we’d been doing work publicly for more than a dozen years before she came out. Her name brought with it a certain amount of credibility, because of her status as an Olympic hero.

Thanks to the internet, and trans people being portrayed positively in the media, and news organizations covering stories of trans experience… it’s not so socially scorned anymore. That means that families are staying closer, so children are less likely to abandon a transgender parent, spouses are less likely to leave a transgender partner- we are seeing a record number of couples who remain married through transition. We’ve never seen this many spouses stay supportive, and loving…. I mean talk about a test of your marital vows! Those connections are so helpful in keeping trans people grounded and stable, and to keep them from crashing and falling.

Is there any advice you have for parents who want to talk to their kids about gender identity?

I can borrow a story that was told to me by Jo Olson (another doctor who specializes in gender confirmation surgeries) about a young child that was transitioning and needed help explaining this to her classmates. She said, imagine that you’re an apple Pop- Tart, and you know you’re an apple Pop- Tart, but someone accidentally puts you in a cherry Pop- Tart box. How would you feel? People might think you’re a cherry Pop-Tart because you’re in the wrong box, but you know that you’re an apple Pop-Tart. And it’s a cute story, but it really connects with children, and they seem to grasp the idea that “oh ok, what you see is just on the outside, but what you feel inside might be totally different.” Those kind of simple, relatable stories can be really effective.

What do you think are the biggest misconceptions that people still have about the trans community?

I think the biggest misconception is that we have anything near equality. There are still scores of murders of trans people every year, most of them women of color. There is still tons of employment discrimination. Now trans people aren’t even allowed to serve in the military. So the idea that trans people already have a level playing field simply isn’t true. These are people who have been capably serving for years, really skilled people.

The other misconception is that trans people have medical costs that are tremendous, and that they need lots and lots of medical care for their whole lives. That’s simply not supported by facts. Of course there is a basic cost for the surgery for those who decide to have it, but once that’s done most people just live normal lives. They don’t have ongoing treatments, any more than anyone else. They’re just normal people. Barring complications- and there are more with female to male surgeries- once the surgery is done you really don’t need anything else.

What’s your response to those who reject the idea that individuals can choose their own gender identity?

I think some people are scared that transgender people somehow represent a breakdown in morality- that God made you a man or a woman- but the fact is that every single measure we know of in biology is punctuated by diversity. No matter what. So the idea that gender would only have two choices just runs contrary to the laws of nature. I mean we’re all so diverse- look at skin color, or eye- color. Look at intelligence- can you imagine if there were only two levels of intelligence? Senses of humor, the size of your feet, your height… there are never just two choices. I think allowing people to safely explore the spectrum of gender identity is a much more honest, relieving, cathartic way for society to move forward. We’re getting there, but progress is slow.

I do think that where we’ve had social change, the thing that leads the way is laughter. Like we saw Billy Crystal in the 1970’s playing a gay character on Soap, and that show was actually really funny, and it was the first time a lot of people had seen a gay character of TV. And then after that gay/ lesbian visibility really started taking off. I think if we can laugh a little bit about it all, that kind of takes the edge off. If you can laugh at something first, then maybe afterwards you can look more seriously at it and judge its merits, and maybe you’ll be less afraid and more open to things that you weren’t aware of.