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Why Did He Cut Off That Man's Leg? 

The Peculiar Practice of Dr. John Ronald Brown

Wednesday, Dec 15 1999

Twenty-five years ago, when I was a junior reporter and stringer for the San Francisco bureau of Time magazine, I came across the greatest story I never wrote, which was actually a pretty smart decision at the time, given that the story had no ending, I didn’t know how to write such a story then, and even if I had written it, Time wouldn’t have run it. It wasn’t merely that the story was too bizarre. Time was a news magazine, and this wasn’t news. It was, rather, a glimpse into the darker corners of the human spirit, the kind of thing you naturally gravitate to late in the evening, when, tired of films and politics, you’d say to your friends, "Do you want to hear something really sick?" And there’d be a silent, collective "ahhh," like that of children snuggling in for a bedtime story, knowing they were about to hear what they’d been waiting for all night.

I first came across the name John Ronald Brown in the late fall of 1973 in the San Francisco Chronicle when I saw an item in Herb Caen’s column about a doctor down on Lombard Street who was "lopping" people’s penises off. As it was my (self-appointed) job for Time in those days to cover the more raggedy edges of the ongoing paradigm shift, I called up the clinic and found myself talking to Brown’s partner at the time, Dr. James Spence, who, despite some reservations, invited me to see him.

Spence struck me as a bit of a hustler, far less polished than one would expect of someone with a medical degree — if he had a medical degree. To some people he gave business cards reading "Dr. James Spence." But to me he said he’d earned his medical degree in Africa and thus couldn’t practice here. (I later heard he was an ex-con who claimed to be a veterinarian, but that degree was phony, too.)

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The clinic wasn’t much — just a few rooms on a busy street, it seemed more like a real estate office than anything else. Sensing my skepticism, perhaps, Spence invited me to an upcoming formal dinner at his hilltop home in Burlingame, where he and his partner, the renowned plastic surgeon Dr. John Ronald Brown, would be explaining his new operation to a group of urologists, proctologists and internists, some of whom, Spence hoped, would join him and Dr. Brown in setting up the finest sex-change facility anywhere in the country.

A week later, I drove to Burlingame and discovered that Spence had a splendid home — if it was his home — overlooking the distant San Francisco Airport and, beyond, the bay. It was a surreal evening. Dinner was served by half a dozen attentive transsexuals who were undergoing hormone therapy while awaiting surgery.

At first, the other doctors seemed quite intrigued by Spence’s proposal for a full-service sex-change clinic. I remember sitting at one end of a long dinner table, watching Spence cut up a pear with a pocket knife while another doctor earnestly asked how he would select candidates for surgery. "It takes one to know one," Spence told his startled guests. "We let other transsexuals make the decision. They can tell best when someone is a true transsexual — a woman trapped in a man’s body."

After the fruit and cheese, we adjourned to the kitchen, where one of the waitresses lay back on a butcher-block table and casually flipped up her skirt. A gooseneck lamp was produced, and all the doctors proceeded to examine the kind of work currently being done by Dr. Brown’s competition.

I’m no expert in female anatomy, but the waitress’s genitalia didn’t look like those of any woman I’d ever seen. There was no clitoris or anything resembling a vagina. It rather looked like someone had taken a pickax and neatly poked a small, square hole, an inch on a side, directly into her groin — either that or like an aerial photograph of a Manitoba iron-ore mine taken from 20,000 feet. In contrast, Spence maintained, Brown had developed a revolutionary technique that would give transsexuals fully orgasmic clitorises and aesthetically pleasing vaginas.

Later, Dr. Brown and I stood around the kitchen table while he displayed what to me were ghastly photographs of his surgical technique. One picture showed a gauze noose holding up the head of a bloody penis while Brown sliced away at the tendrils of unwanted erectile tissue (the capora cavernosa).

Unlike some other gender-reassignment surgeons, and contrary to what Herb Caen had written, Brown didn’t exactly lop off the penis. At least in later years (his process was continually evolving), he carefully split the penis, then, after saving the nerves and blood supply, positioned the glans penis under a fleshy hood to create the clitoris. With the leftover penile skin he made the labia majora. Finally, after removing the fat and hair follicles, he used the scrotal skin as lining for the new vagina.

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