His last patient was 62 years old, married with two kids. He showed up wearing his wife's underwear, having come from the US to Thailand to make his life-long dream come true.
"I make my patients happy. That's my job," says Greechart Pornsinsirirak, a plastic surgeon at Thailand's most famous hospital for sex change operations.
Long accepted here but still a relatively rare procedure abroad, Thailand has become the global destination of choice for people around the world haunted since birth by feelings they should be of the opposite sex.
Like popular tourist attractions, the entrance of Yanhee Hospital in Bangkok welcomes visitors in six languages including Arabic, Chinese and French while young female staff on rollerskates scurry past.
While sex change operations are far less common than breast implants or nose jobs, Greechart says the number of foreign patients seeking gender reassignment surgery in Thailand is no doubt rising.
"Unlike my Thai patients, many foreign patients are married and middle-aged. When they came to me, they said `I can't hide it anymore,'" Greechart said, adding over 95 percent of sex change operations are from male to female.
Comments from foreign patients are posted across Greechart's office wall, with many thanking the doctor for changing their lives.
In addition to Thailand's reputation for quality, Greechart said foreign patients come here for sex change operations because the price is much cheaper than in more developed countries.
To undergo a sex change operation, a patient must have taken female hormones for at least two years and pass a psychiatric evaluation.
But most importantly, patients must have felt like a girl since their childhood and have lived like a woman for at least one or two years, said another renowned surgeon, Prayuth Chokrungvaranont, who teaches plastic and reconstructive surgery at Chulalongkorn University.
The doctor, who has performed 300 sex change operations, in addition to 600 cosmetic surgeries, says a gender reassignment operation is the last hurdle for patients to become a full woman.
"They all say `I want to be a complete woman. Please get rid of my penis.' or `I want to have normal sexual activities with my boyfriend,'" Prayuth said.
Among the most common concerns of sex change patients is whether they will be able to reach orgasm after their operations, said Yanhee's Greechart.
"I told them `Yes, but only if you have good emotions for your partner,'" he said.
Prayuth said he has also received more than 50 requests for penis enlargements. But he refuses to perform the procedure.
"It's myth. Men believe a bigger penis can improve their sex life. But the size doesn't matter. It depends on your partner, your relationship and foreplay. The result of penis enlargement is questionable," he says.
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