Nearly 36 years into her medical career, Dr. Marci Bowers has achieved something no other surgeon has yet to accomplish, having completed over 2,000 deliveries and 2,000 vaginoplasties, bringing new life into the world while giving some the opportunity to live as they truly are. 

“The joy you bring to new parents feels really similar to the joy you bring to people whose genitals don’t match their bodies. Bringing them that gift is really momentous,” said Bowers who has been performing vaginoplasties for nearly 17 years. 

Known as a pioneer in the field of gender confirmation surgery, Bowers has just completed her 2,000 vaginoplasty on Tuesday, July 14. The procedure, also known as type of bottom surgery, involves meticulously transforming the genitals of a male into that of a female while ensuring functionality. 

Her notoriety in the field has built her practice substantially and transgender men and women from all over the world wait up to four years to have her perform either a vaginoplasty or the male equivalent of a phalloplasty on them. 

“She doesn’t rest on her laurel. She’s always trying to make things even better and get these outstanding results and make things even better,” said Dr. Mike Norris, a plastic surgeon at Mills Peninsula Medical Center in Burlingame where Bowers practices. “I’ve watched some of her surgeries and as a surgeon myself I marvel at her skill and her meticulous surgical technique.” 

Personal touch 

Bowers has a special connection to her work, being one of the few surgeons in the field who has undergone a similar procedure to the one she performs. She transitioned as the Obstetrics and Gynecology Department chair of the Swedish Medical Center in Seattle, a move that earned her “bits of grief” but was overall well received by her colleagues and patients. 

“I had respect, that’s one thing going into it. There was a likeability factor with patients and colleagues and to my surprise my practice grew,” said Bowers.  “I didn’t advertise as anything, just a female practitioner.” 

Despite her continued success, Bowers said she felt she was “swimming upstream” after having been swimming down her whole life. She found herself being drawn toward a career change which was solidified when she encountered Dr. Stanley Biber, an innovator in the field himself who completed his first gender confirmation surgery in 1969. 

“Ultimately it was meeting Dr. Biber that planted the seed. Looking at the time, there were only a handful of surgeons doing these surgeries across the United states let alone the world,” said Bowers.

She originally honed her skills with the procedure with Biber as her mentor and in 2003 she went on to fill Biber’s role in Trinidad, Colorado. Bowers practiced for eight years in Trinidad, known as the “Sex Capital of the World” due to Biber’s work, continuing his legacy. 

“He was larger than life. He was not a tall man but he had a huge presence in the community there. It was not easy filling his shoes,” said Bowers who added the practice grew substantially when she took it over.  

Innovating the field 

Over her years of performing the surgery, Bowers felt compelled toward pushing the procedure forward. She felt sensations could be stronger. The look of the final work could be most aesthetically pleasing to the eye. 

“I faced skepticism within the community of doctors who do practice what I do because I was pushing the quality of the procedure. I felt it could be better. ... I was met with pretty fairly significant resistance,” said Bowers. 

Typically, bottom surgery had been completed in two sessions, an unnecessary way of performing the procedure in Bowers opinion. While working on shortening the procedure to a single session, she also focused on strengthening sensations felt during sexual arousal. She also worked on innovating the transmasculine procedure, developing the Simple Metoidioplasty in which the clitoris is freed from its labia attachments and formed into a penis. 

Bowers said she still finds the world of trans medicine fascinating and looks forward to where the conversation around gender will be viewed in hundreds of years. Going into any surgery, Bowers said she always feels the same, realizing the importance of each procedure. 

“You don’t treat anyone differently whether they’re someone on Medicaid or they’re poor or a CEO or anything else. You get in a place of respect and focus and you realize that although you have done many surgeries, this is the most important one you’ll do in that person’s lifetime,” said Bowers. 

Pushing forward 

While working to advance bottom surgery, Bowers has also made efforts to ensure the knowledge she’s acquired can be shared with surgeons across the globe. She has started programs at Sheba Medical Center in Tel Aviv, Israel, Mount Sinai in New York City, Denver Health in Colorado, and Women’s College Hospital in Toronto, Canada. 

“Often now, I’m teaching it so that now when I’m gone there are programs that will endure,” said Bowers. “It’s gratifying to see so many young medical students, nursing students and PAs trying to get into the field of transgender care.” 

Bowers no longer delivers babies, having performed well over 2,000 deliveries and bringing over 100 sets of twins, four sets of triplets, and one set of quadruplets in the world before ending that side of her practice. When she’s not performing gender confirming surgeries, she works pro bono providing reconstructive surgery to victims of female genital mutilation. 

“[The surgeries she performs] are very difficult. That’s part of her meticulous approach and what I appreciate. She doesn’t try to hurry and handles things very carefully. When you’re dealing with that anatomy there’s a lot of room for potential complications and with her tech, skill and experience she avoids potential complications,” said Norris, a colleague of 10 years. 

Looking forward, Bowers said she sees access to affordable health care within a single-payer system as one of the most important issues facing the transgender community. While recent moves by the federal government to strip away medical rights from the trans community is worrisome, Bowers expressed optimism and said she looks to the words of Civil Rights leader Dr. Martin Luther King Jr. 

“The arc of the moral universe does go in the right direction,” she said. “When people of all minority backgrounds hold hands suddenly they’re not a minority anymore.”

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