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The price and the pain on the road to transformation

By MEGAN SCOTT
Published February 25, 2005


photo
[Times photos: Douglas R. Clifford 2004]
Jennifer awaits her surgery, which took five hours to complete, in January 2004. The surgeon, Dr. Harold Reed, told her it was one of the best procedures he had ever done.

  photo
Moments after her surgery in January 2004, Jennifer calls her mother, Olga Kozlowski, to tell her the news: “It’s a girl.”
Related story:
In midlife, a rebirth
For four decades, Ed Kozlowski tried to fit the mold, but nothing worked - until he changed his name, his body and his life.

MIAMI BEACH - Jennifer wanted to be a woman. A real woman.

She spent more than $8,000 on the surgery alone, and insurance did not cover any of it.

"I want a body and mind that are in synch with each other," she said before the operation. "This is the cure."

Jennifer represents one of every 3,000 people who have a gender identity disorder, according to Dr. Kathleen Farrell, a psychologist who counsels transgenders. Of those, 20 percent go on to have some gender-altering surgery.

Few transgenders go through with reassignment surgery because it can cost as much as $25,000 and is irreversible, said Michael Hendricks, a psychologist in Washington, D.C.

"A small percentage of people end up having regrets," Hendricks said.

That is why prospective patients cannot have a sex change until they meet certain requirements.

The first is having passed the "real life test," or cross-dressing 100 percent of the time as a member of the opposite sex for one year. Usually, people go on hormones to help them look the part.

Then they must receive two letters of recommendation from therapists. One of those therapists has to have a doctoral degree and must have known the patient for an extended period. The second therapist is asked to provide a letter of concurrence.

Jennifer spent more than a year living as a woman, undergoing hormone and laser treatments, and learning how to dress and apply makeup properly. She received her recommendations for surgery from Farrell and Pamela Epps, both psychologists in the Tampa Bay area who specialize in transgender issues.

"I think Jennifer has known precisely what she was, what she wanted to do, for a long time," says Farrell.

On the recommendation of other transsexuals, Jennifer chose Miami Beach urologist Harold Reed to perform her surgery. He offered outpatient surgery to keep the costs down and told her she could stay at a hotel nearby while recovering.

The operation took five hours. Jennifer was asleep the entire time. Reed removed the testes. (Jennifer wanted to keep them in a jar, but he wouldn't allow that.) He removed the penile skin and inverted it to create a neovagina, which he placed in a space between the bladder and the rectum.

He took out the neurovascular bundle, which provides sensitivity, and the glans (the head of the penis). He scaled the glans down in size to form a neoclitoris.

Some of her scrotum was used to create the outer labia, and a sweep of the inverted penile skin became her vulva.

Reed created two separate openings above her new vagina for the attachment of the shortened urethra and the clitoris.

When Jennifer woke up, she writhed in pain and shivered as the nurse placed a pink blanket over her body. She squeezed the hand of her lover, Sandra Orlando, a transgender woman, asking for morphine.

Reed told her it was one of the best vaginas he had ever done.

Jennifer was released the next morning. She stayed at a nearby hotel for nine days.

During her four-month recovery in Gulfport, she came down with a bladder infection, but that was her only complication besides the pain.

[Last modified February 24, 2005, 10:20:04]


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