Sun, surf and surgery
My passenger giggles and shrieks as the jeep rattles down a steep jungle pass through an afternoon storm. Her tattooed arms flex as she picks at a chip in her nail polish. The road is slick and treacherous, and it takes all my concentration to carry on our conversation while peering through the maelstrom, dodging the crazed speed-freaks and half-drunk holidaymakers who have turned the Thai resort island of Phuket into something resembling a demolition derby.
Our talk ranges over the bitchy antics of the San Francisco goth scene, high-speed runs to Tijuana to load up on female hormones, and the ineffable oddity of knowing you have just 16 hours left as a man.
When she wakes up tomorrow morning, Samantha Hellstrom - former United States Marine, bodybuilder and security guard - will be wheeled into the operating theatre of the Phuket International Hospital, given a general anaesthetic and an epidural, then during six gruelling hours will have her penis peeled apart and transformed into a passable-looking and functional approximation of a vagina.
'Nervous? Sure, I'm a bit nervous about the surgery, but not the end result,' she says, as we pull into the leafy surrounds of the hospital. We've just been for a walk along Karon Beach, a quiet spot half an hour from the hospital and just south of the sex-and-booze mayhem of Patong Beach. It will be Samantha's last real chance to stretch her legs for at least a week. 'All I want is to be as complete a woman as medical science can make me at the present time. That's all I can hope for.'
Samantha is one of a growing number of transsexuals from around the world opting to have their 'sex-reassignment surgery' performed in Thailand. She has chosen Dr Sanguan Kunaporn, an affable, gangling young doctor who is fast approaching his 400th sex-change operation and is challenging his mentor and teacher, Bangkok-based Dr Preecha Tiewtranon, 57, as the kingdom's top plastic and reconstructive surgeon. The pair operate almost exclusively on patients from overseas. They are rated among the best in the world, and certainly among the cheapest. Each will take on sex-reassignment surgery for about US$5,000 (HK$38,950), which includes up to two weeks stay in hospital. Breast augmentation is another $2,000 or so. In the West, expect to pay three or four times that, unless you are prepared to risk the cowboys. Cheap as these prices may sound to those with hard currency, however, they are well out of range of most local katoeys (ladyboys), who must make do with lesser surgeons and less-than-satisfactory results or remain in the sexual netherworld of the she-male.
Like many others, Samantha was lured by the island's promise of 'sun, surf and surgery' and by Dr Sanguan's growing reputation in the transsexual community. 'Welcome to Phuket, the most famous holiday destination in the Southeast Asian region,' gushes his Phuket Plastic Surgery website. 'Our services range from breast implants, tummy tucks, liposuction, face-lifts, eyelid surgery to sex-reassignment surgery.' Of course, the combination of sand, salt water and painfully raw and tender nether regions may not hold the same appeal for all potential patients.
'Medicine is a big business in Thailand now,' acknowledges Dr Sanguan. 'We target people to come here for plastic surgery and to stay for a holiday. Last week, I did a facelift for a 65-year-old American man, who said it was cheaper here and he got to stay in paradise. We usually offer a package. People want exact prices. So, for example, if someone comes for liposuction, they pay about $1,500 for surgery and the hospital stay, then we can organise a hotel room, anything from $15 to $100, in town or on the beach. I don't know if in the future we will be a hub for cosmetic surgery in the world, or in Asia. But I think there's a good chance.'