The Lovely Ladies of Doctor Sanguan
A Report by M. Blackburn
Illustrations by Angelo Loperfido

Nestled in the tropical forest of Phuket is one of Thailand's best kept secrets-an international hospital which turns men into lovely women. Meet Doctor Sanguan, a mild mannered Thai surgeon whose incredible skills give hundreds of transsexuals the most beautiful female genitalia in the world-transforming them from freaky she-males into gorgeous real women. Read all about how one gentle caring man changes the lives of hundreds of lost souls and in doing so, makes a contribution to his own country and fellow compatriots. A fascinating expose on a remarkable human being!

It is often referred to as the "Pearl of Thailand". Phuket is an island in the south of Thailand. It is a tropical paradise with a climate, influenced chiefly by monsoon winds that vary in direction according to the season. It is a land rich in culture, tradition and history. Phuket has a population of 200,000. The main centers of population are on opposite sides of the island. Phuket Town, with a population of about 63,000, is located on the east side and Patong Beach, whose population varies widely depending on the time of year, is located on the west side. The residents are Thais who migrated from the mainland, Chinese who arrived to work the tin mines, Muslims of Malaysian extraction - many of whom come to work the rubber plantations and Chao Nam or sea gypsies - who may have occupied the area for a millennium or more. The Chinese now comprise 35 percent of the island's population. They differ from those who settled in Bangkok and many other areas of Thailand in that they came from the Hokkien region of China, as did those who settled in Singapore and Malaysia. As elsewhere in Asia, many of the Chinese have made the transition from providing cheap labor to being merchants. The Chinese have intermarried with native Thais and have largely been assimilated into Thai culture.Today the descendants of the early Chinese settlers are responsible for much of the trade and commerce that take place on the island. The influence of Indonesian-Malaysian culture is still apparent today in the ethnic made up, language, art, and religion of the southern Thais. About 35% of the Thais living on Phuket are Muslims. Concentrated mostly around Surin and a few other big villages, they work as rice and rubber farmers. In addition to Thai and Malay languages many also speak 'Yawi', an ancient dialect of the Malayan language.

    One of the most interesting groups of people who have lived on Phuket are the Chad Nam (or Sea Gypsies), traditionally nomadic people who traveled from cove to cove, staying until the fish and other resources were depleted. They then moved on, allowing the cove to re-establish its former ecological balance before returning to repeat the cycle. Their history and cultural lifestyles are hard to trace as they do not have a written language. Sea gypsies are said to have originated in the Andaman and Nicobar Islands between India and Burma. They are generally darker skinned and heavier with curly black hair. They speak their own language and follow their own animistic religion. Sea Gypsies consist of three groups. The Mokens still prefer their ancestral sea nomad-style of living and are commonly found occupying the islands north of Phuket. The Orung Laut and the Moklens have settled on coastal areas. There are three Sea Gypsy villages in Phuket. The one located at Rawai is thought to be the oldest and is visited by bus loads of tourists everyday. Another village is located 8 km north of Phuket Town at Sapam Coast and a third village is located on Siray island which is accessible by bridge from Phuket Town. 

    Thailand has a royal family. The King, Queen and the Royal Family are genuinely respected by the Thais. Most homes and businesses, have one or more photographs of the King or the royal family prominently displayed. Showing any form of disrespect to the Royal Family is not appreciated by the Thais and could cause you serious problems. If you were to attend a cinema during your stay, when the portrait of the King is shown on the screen during the national anthem you are expected to rise and remain standing for the duration. 

   Thailand is known as the "Land of Smiles", and for its tolerance and hospitality. The simple rule is that if you smile people will like you. A smile is an easy way to say 'thank you' and can also be used to 'excuse yourself' for small inconveniences. A smile is the proper response to acknowledge the wai (or greetings) of small children, and with hotel and restaurant staff. Most of us were raised with the "Golden Rule" and that will work for you as well in Thailand as it does at home.

    Visiting Buddhist Temples is one of the more interesting cultural activities in Thailand. Visitors are welcome and discreet photographs may be taken. Shoes must be taken off before entering a temple, wearing shorts or other revealing clothing is frowned upon. Monks are the most important people in Thai society and must be treated with respect at all times. 

    A monk's vow of chastity prohibits him from touching or being touched by a woman. Women are usually advised to smile and slightly bow when encountering a monk and maintain enough distance to prevent any contact with the monk or his robes. Temple fairs are held during the cool season (November through early March) to raise money for temple maintenance. They are great fun. There is a carnival atmosphere lots of good food and a chance to see normal Thai people enjoying themselves. If you get up early (sunrise) for a walk, you are likely to encounter monks making their rounds for offering of food. Monks carrying a bowl will be approached by Thais (usually women) who will offer food to the monks (merit making). Thailand is a Buddhist country and this ritual can be seen every day all over the country. 

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    It is Buddhism and its very philosophy that brings many transsexuals each and every year to the small tropical island. The very kind, nurturing and non-judgmental nature of the Thai people make it possible for the many lost souls to seek gender reassignment surgery in Phuket. There to help them on their transitional journey is Doctor Sanguan Kunaporn. Dr. Sanguan was born and raised in Bangkok. After graduating from Chulalongkorn University he trained under Dr.Preecha Tiewtranon (one of the best known gender reassignment surgeons in Asia) and Dr. Charan Mahatumaratna. In 1991 Dr. Sanguan went to North American where he studied and broadened his surgical experience. He also worked with Dr. Mutaz Habal, one of the finest craniofacial surgeons in the world, in Tampa, Florida. Before leaving for Thailand Dr. Sanguan attended the annual meeting of the American Association of Plastic and Reconstruction Surgery in Seattle. There he met with Dr. Q.R. Son-hing, a Chinese - Canadian Plastic Surgeon who is famous among both oriental and Caucasian clients in Vancouver, Canada. Finally, after the extensive experience gained in the U.S.A. Dr. Sanguan settle in sunny Phuket in 1991 and opened up his now well established Phuket Plastic Surgery Center. The center performs both Plastic Surgery and Cosmetic Surgery for the native people of Phuket as well as foreigners.

    But it wasn't until several years after he began to perform "sex-change" operations that Dr. Sanguan became know on the international front. Sex-change operations are nothing new. They first were performed in Denmark, with the American Christian Jorgensen being the most famous transsexual to first undergo the surgery. Thailand itself is known as the "sex-change capital of the world". What is different about sex-change surgery in Phuket with Dr. Sanguan is that he is so damn good at it! Until not too long ago most foreigners went to Bangkok to see Dr. Sanguan's teacher and mentor, Dr. Preecha Tiewtranon. Dr. Preecha had gained a reputation for not only doing hundreds of sex-reassignment surgeries each year, but for doing them in record time - 90 minutes (the average time is 4 hours)!

    But Dr. Sanguan's careful refinement of the procedure, known as a "penile inversion", has earned him fame and respect among transsexuals and his peers.

   In many ways Dr. Sanguan is the antithesis of his teacher Dr. Preecha. Preecha, a man who is outgoing and cordial, exudes confidence and charisma. In contrast, Dr. Sanguan is a soft-spoken mild mannered person who is reserved almost to the point of being shy. But, like his mentor, Sanguan displays a quiet confidence that is both reassuring and commanding.

   Dr. Sanguan performs all his sex-change surgeries at the Phuket International Hospital, a private hospital owned by a Thais consortium. When a prospective patient first arrives at the Phuket International Airport he is greeted by Dr. Sanguan's driver who immediately whisks them off to the small modern hospital. Upon arriving patients can expect a nice warm cup of tea and to be pampered as though they were at a five star resort. After the nurses have taken all the particulars the patients are greeted by Dr. Sanguan. The lean six foot man is tall for a Thai man and remarkably handsome. One can not help but notice his fine delicate hands which look both nimble and adroit.

    Though all patients are required to have proper support documents, (ie. letters for psychiatrist, endocrinologists etc.) Dr. Sanguan insists on making his own evaluation as to whether or not a patient is suitable for gender reassignment surgery - and he has turned away some! 

    Beneath his mild-mannered exterior he is straight-forward, honest and to the point. He will tell a patient what he can and can't do for them. Once Dr. Sanguan has accessed that a patient is suitable he checks them into the hospital to prepare them for the surgery. 

    The night prior to have a sex-change operation a patient's bowels must be cleared and clean in order that there is no contamination during surgery. Patients are given a small glass of clear tasting laxative three hours apart.

    Unlike North American hospitals, Dr. Sanguan does not dope his patients up prior to surgery. Instead he likes them awake and lucid. The doctor uses an interesting mothod to anesthetize his patients. Instead of using high doses of a general anesthetic he opts to put a needle in the patient's back and freeze them from the waist down. He then uses a very light anesthetic to help the patient sleep through the procedure. This prevents the usual sickness associated with general anesthesia and enables the patient to recover much quicker.

    Dr Sanguan uses a modified and very refined version of the "penile inversion". Basically he makes a vaginal canal slightly above the anus and lines it with penile skin. When the penis is too small, Dr. Sanguan uses the excess scrotal skin, attaches it to the penile skin and lines the vaginal cavity.

    What makes Sanguan's technique so remarkably different is that all his patients remain orgasmic after their operations. He has developed this by learning to identify the delicate nerve bundles in the penis which enable the patient to be the orgasmic. He then takes a small piece of the head of the penis and, along with the nerve bundles forms a clitoris and relocates them. The result is that not only are his patients orgasmic, but they can even ejaculate! This happens because he leaves in a small gland which is called the "Cowper's Gland". This tiny gland provides lubrication for the new vagina and ejaculate; a wonderful and ingenious little trick.

    What is also amazing about Dr. Sanguan's technique is the fact that the female genitalia he creates is aesthetically very beautiful. He is able to take an ugly male penis and transform it into the most beautiful labia and vagina imaginable - he is only outdone by God himself.

    Part of the good doctor's success is the fact that he will take up to 9 hours to perform the surgery. Unlike most North American doctors, Dr. Sanguan usually insists on performing two separate operations. The first one to construct the actual labia and vagina. Then he will leave his patient to heal for up to a week and then perform a second operation where he takes prepared scrotal skin (from which he has removed all the hair and fat and extend the depth of the vagina.

    Sanguan's success is also due to his diligent attentiveness to his patients. He visits each and every day following surgery. His personal touch is not only reassuring for the already emotionally vulnerable transsexual, but it also prevents most complications.

    The nurses at the hospital are equally as attentive if not more. We tend to think that Canada has a good health care system, but compared to Phuket we are a third world country!

    Once a patient has had sufficient time to heal, Dr. Sanguan removes the packing and catheter from the neo vagina and shows the patient how to care for the new equipment. Patients are given four dilators of various sizes. They must dilate every day for at least six months to insure the canal does not close up. As well, the regular dilation make the vagina deeper.

    When all is done the lovely ladies of Dr. Sanguan are fully functional women, and only their gynecologists will ever know! 

    Dr. Sanguan's contributions go far beyond helping the transsexual community. It is true that he makes a tidy dollar performing these surgeries. But he also has a philosophy "Always give more than you take" and he puts his words into practice.

    The busy doctor takes time to go around to community hospitals where he volunteers his skills free of charge to those less fortunate in need of his services. He attends accident victims, burn victims, children with cleft pallets and those who would otherwise be unable to afford the fees of a world class plastic surgeon. For his transsexual patients Dr. Sanguan is a skilled surgeon who ends life long suffering, for the many accident victims he helps he is a surgeon who prevents a life of suffering. And for all those who meet and know him he is a remarkable human being who has learned the delicate balance in life between give and take.

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