Just behind the desk of Dr. Sherman Leis is a photo of Albert Einstein—appropriate, considering that, lately, he’s looking more and more like a genius. Firmly established as a general plastic and cosmetic reconstructive surgeon for more than 30 years, Leis has been carefully converting his practice. These days, he’s booked months—even years—in advance.
At the Philadelphia Center for Transgender Surgery in Bala Cynwyd, Leis has assembled a team of surgeons, psychologists, endocrinologists, aestheticians, speech therapists and legal experts—all dedicated to serving a community like no other. Without question, Leis has extended himself to the transgender population. And once the recession hit and elective plastic surgery took a hit, his own transition as a surgeon took flight.
“To my patients now, it’s not optional elective surgery; it’s a matter of life and death,” says Leis in a deep voice as distinctive as his monogrammed lab coat.
Transgender men and women have an extremely high proclivity for depression and various psychiatric conditions. Seventy percent have suicidal thoughts, says Leis, and 40 percent try to kill themselves at some point. With surgery and a successful transition, such tendencies can shrink to one percent. “Lives are being saved,” he says. “We’re making people happy. We’re giving them the life they want.”
Dis-ease. Leis uses the hyphen and second-syllable emphasis to explain a transgendered person’s condition. “It’s a disorder between the brain and the body,” he says. “Certainly, the patient is not at ease, so it’s a dis-ease. Our job is to get people away from discomfort and create ease in their lives.”
In the process, Leis and just a handful of other surgeons like him in the country are initiating trends, even shaking up the insurance industry. About five percent of own patients are now covered. If a genetic link is substantiated, it’s a medical problem insurance companies can’t ignore.
Transgender issues are also driving federal antidiscrimination legislation, and conferences on the subject are becoming more popular. There’s the Mazzoni Center’s spring Trans-Health Conference in Philadelphia, and the Keystone Conference in Harrisburg every March. Next month, the Southern Comfort Conference comes to Atlanta, and Boston has an event in January. The next World Professional Association for Transgender Health is slated for February 2013 in Thailand. “I didn’t create or drive these conferences, but now I’m an integral part of them,” Leis says.
When 47-year-old Angelina Cornell first consulted with Dr. Sherman Leis, she’d already begun transitioning from male to female. Leis handled her genital reassignment surgery in 2008, after she raised funds by selling a house she once shared during a 16-year marriage that produced two daughters. She’s since lost contact with both of them.
A year later, Cornell went to Leis for a breast augmentation and a facial feminization, moving into an apartment a mile away in Wynnewood. “A lot of the transgenders I knew are dead,” Cornell confides. “They killed themselves or OD’d on drugs
after their families disowned them and work colleagues had abandoned them.”
Angelina Cornell is not a real name. To reveal who she was at birth, or even her current identity, would defeat the purpose of living “life as me,” says Cornell, who’s also not interested in labeling herself an outed transgender or socializing in that community. “Like I’ve told Dr. Leis many times, once you’re out, it’ll be that way forever,” she says. “I could never, then, be recognized as a female. I would always be that crazy transgender down the street—that freak or whack job. The old people in Narberth who knew me before? You’ll never change their perceptions.”
The problem with the transgender community is that it lacks numbers and power. Most would rather hide than become poster children. The gay and lesbian communities disassociate with transgenders, who become invisible pending successful transitions. Potential role models generally disappear.
“The easiest way to explain it is this: A husband and wife are walking down the street and see two guys, Bill and Jack, who own the hairdresser’s shop,” says Cornell. “The couple says, ‘They’re gay.’ They see two women, and the wife turns and says, ‘Those are the two lesbians who own that kennel.’ But when some dude in a dress comes down the street looking like a football player, they say, ‘What the hell is that?’”
Blue-collar and Italian, Cornell was a welder in a steel mill for 20 years. She now works at a trash-to-steam plant and has an HVAC side business. When she came forward at her current job, “all hell broke loose.” They tried to get her fired. “They’d give up, then try again,” Cornell says. “They just couldn’t handle it.”
When she asked the School District of Philadelphia to change the name on her diploma, “they pried and pried until I finally said, ‘If you really need to know, I was once a man and now I’m a woman.’ From that moment on, I was treated differently. I became weird.”
Cornell was dressing in Mom’s clothes at 8, then later in his high-school-sweetheart wife’s garb. “I didn’t know why the hell I was doing it,” she says now. “I was still a guy. I had all my parts. But she’d go out with the kids, and I was dressing in her clothes.”
Once, Cornell considered taking her own life. She was 275 feet in the air, calibrating instruments on a trash-to-steam stack. “I looked down and thought, ‘Man, if I jump off from here, I won’t have any worries.’ But then I thought, ‘F— these people. I’m not giving in.’ It lasted 30 seconds.”
Cornell never cross-dressed in public—there was always a work uniform, and it could’ve cost him HVAC jobs. His ex-wife’s father, a veteran Philadelphia cop, once caught him passed out in one of his daughter’s outfits. Much like Cornell’s parents, his father-in-law was supportive but realistic: He predicted the end of the marriage.
At the trash-to-steam plant, there are three women among 50 employees. Cornell says she looks 10 times better than the other two combined—and they hate her for it. At six feet and 160 pounds, with a 36-inch double-D bust, the natural redhead arrives at work in tight jeans and boots before changing into a fire-retardant suit and hard hat. “I could take off my clothes, and you wouldn’t know the difference,” says Cornell. “Sherman did a phenomenal job.”
Cornell couldn’t believe Leis was in Bala Cynwyd. They talked for hours. “I was still afraid,” she says. “I asked a crazy question: Is it going to work … like, work sexually? He said it would—and it does. That’s a good thing. I didn’t want to walk around as an ‘it.’”
Cornell would marry again if she finds the right guy—and she could do so, since all gender markers have been legally changed. She’s had a fling, even asking the man if everything was OK. He said it was. “I never said anything more,” she says.
Cornell also keeps her transition a secret at Bala Cynwyd’s St. Matthias Parish, where she attended Sunday school in the early 1970s. Members there think she’s new. “If they knew my history, they’d kick me out the door,” Cornell contends. “They’d have searchlights and be waiting with dogs.”
On the third Saturday of every month, anywhere from 30 to 60 people meet at the office of Wayne therapist Michele Angello. All are members of Renaissance, a 25-year-old education- and-support group for the local transgender community. Afterward, many gather for fun at Blue Pacific, a sushi restaurant in King of Prussia.
Angello acknowledges that, for some Main Liners, there is a disconnect. Yet many educated liberals are comfortable with transgenders, and she predicts that her practice—like the movement—will continue to grow.
Today, 95 percent of Angello’s clients are transgender. Increasingly, children as young as 4 are experiencing gender identity confusion—adamant that they’ve been born in the wrong body, that a “mistake” was made and a “change” necessary. As an adjunct professor at Widener University, Angello teaches “Clinical Issues in Transgender Communities.” Begun six years ago, it was the first graduate-level course of its kind in the nation, and it’s since been replicated.
As a graduate student in the mid-’90s—first at the University of Pennsylvania, then at San Francisco’s Institute for the Advanced Study of Human Sexuality—Angello had transgender friends. Her 2000 dissertation focused on transgender identity issues just as the movement caught on in the media. Angello appeared on Larry King Live, Dr. Phil and other shows.
In a counseling environment, the primary clinical issue is fear—fear of violence, fear of losing family, friends, a job or a spiritual community. “They’re trading everything for a sense of authenticity,” says Angello, who spoke at 14 related conferences last year. “It can be an incredibly lonely experience. The most common question: Will anyone love me, especially if they know my secret? But, at what point do you share your history?”
Alas, it might mean starting a new life in isolation—one without a history. Many transgenders endure a second adolescence in their 30s or 40s—only in a “harsh world surrounded by bigots.”
Evolving over the past six years, Sherman Leis’ revamped practice is enough to occupy three surgeons. It’s been driven by word of mouth and social media—basically proud patients wanting to share. “They’re putting pictures up every day after their surgeries of their faces, chest and genitals,” he says.
A converted house on Montgomery Avenue, Leis’ facility includes four studio apartments where patients can recover (at $50 a day) for a week or two. Many live here. For those from Australia, England and elsewhere, he houses them. There are
current inquiries from South Africa, China and Vietnam.
The modern era of transgender surgery dates to the 1950s and ’60s. French surgeon Dr. Georges Burou first employed the penile-inversion technique, in which the skin of the penis is used to line a new vagina. Others in Europe followed.
In the United States, surgeries began in the 1960s. New York City endocrinologist Dr. Harry Benjamin may well have been the first to study and treat patients with hormone therapy before referring them to a transgender center. At Johns Hopkins and Stanford universities, gender-identity clinics developed, each equipped with surgeons, psychiatric services, social workers, even clergy. Benjamin dubbed the predicament “gender dysphoria” and wrote the first comprehensive textbook on the subject.
Meanwhile, Trinidad, Colo., was on its way to becoming the transgender hub that both Philadelphia and San Francisco are today. There, general surgeon Dr. Stanley Biber began performing sex-change operations with skills learned at Johns Hopkins and Stanford. By the early 2000s, some 6,000 patients had flocked to this tiny town 90 minutes from Colorado Springs. When he turned 80, Biber was unable to renew his liability and malpractice insurance. But he’d trained a young surgeon, who was also a transgender. Dr. Marci Bowers assumed her mentor’s practice, recently moving it to San Francisco.
Leis paid her a visit in 2005. Thirty years earlier, a Northeast Philadelphia woman had asked for his help. “She sat in that chair,” Leis recalls from behind the California redwood desk in his posh office. “She wanted me to make her male genitalia.”
Leis pledged to meet her needs—if he could learn how. By then, China had developed a one-stage reconstructive procedure that would allow sensation in a new penis, but not the ability to stand to urinate. Leis’ patient had been using men’s rooms for years, choosing a stall and sitting. She didn’t need to “show off by standing.”
There was an engagement in the mix, and the two wanted the surgery to occur before the marriage. The fiancée’s parents paid for the procedure, which was performed in 1976 amid a buzz at Springfield Hospital, where Leis was then the chief of plastic surgery. The patient’s mother and father offered, “Now, we have a son.” Jewish, they suggested a bris. Currently living in Florida, the couple has two children by artificial insemination.
It was decades before Leis did another such surgery. Now, he averages three or four a week, whether it’s facial feminizations, breast and chest constructions, or genital reassignments. He responds to 10 new inquiries a week. For procedures that require fewer than four hours, he works out of two surgery centers in Bala Cynwyd. For genital reassignment, he operates at Lower Bucks Hospital in Bristol.
Leis still comes across resistance at many hospitals—even those where he’s on staff—like Mercy Suburban, which won’t allow any transgender surgeries. “It’s gross discrimination, and they would probably lose a suit if it was brought by a patient,” he says.
Certainly, there are other rough patches and dicey situations, including a recent one with a patient staying in the Bala Cynwyd facility’s third-floor studio apartment. During our interview, Leis was summoned on an emergency call.
Upon his return, Leis is honest. The patient just had a hysterectomy, a phalloplasty (with a new scrotum and testicular implants) and a clitoral disposition, among other procedures. He “looks good,” Leis says. But when his partner failed to return from the drugstore with pain medication soon enough, he had a meltdown and threw a wine glass against the wall.
Money is often a problem, too. Leis says genital reassignment surgery runs $20,000, plus hospital and anesthesia bills. Facial feminization ranges from $5,000 to $25,000; a chest procedure requires $5,000-$7,000. While under Leis’ care, many will also have a tummy tuck or other improvement. “If you want to be a woman,” he reasons, “you want to be the best-looking woman you can be.”
Patients like to call it genital confirmation surgery. “They’ve always known what gender they want to be,” Leis explains.
Before agreeing to a “bottom” surgery, Leis requires that the patient receive 12 months of hormone therapy, live full-time in the preferred gender for at least a year, and submit two letters of support from independent mental health professionals.
Leis gets many strange requests, but he isn’t “in the business of creating abnormal human beings.” He won’t be “a technician to meet an end”—especially when that end is a request for double genitalia. “If I write a book, I’ve already decided that the last chapter will be a list of the strange requests from all those late-night conversations,” says Leis. “There are whores in the medical world, but I will not be one. I’ve spent my life trying to make people normal.”
For more, visit thetransgendercenter.com.