Why Did He Cut Off That Man's Leg?

But the thing that most bothered Cheree, she says, was Brown’s "brusque" attitude. After surgery, he would grab the dried, blood-clotted bandages and rip them right off. He was always so disheveled, too. "His hair went in different directions. His shoes were scuffed and worn down. I remember him walking down the hall eating raw weenies right out of the package. A fucking package of weenies!"

In one case, says Cheree, who spent 11 days at Brown’s clinic caring for her (new) sister, Brown operated on an HIV-positive patient who still had pins in her arm from an auto accident (she used the insurance settlement to pay for her surgery). In another, he used too much erectile tissue to construct genital outer lips. As a result, whenever the girl got excited "her labia got hard."

But despite Brown’s flaws, says Cheree, there was a reason why so many "girls" went to him — "He gives you a vagina at a fair price." Whereas with other doctors you had to take hormones, wait up to six years, live as a woman, undergo psychological evaluations and then pay $12,000 to $20,000 or more, with Brown it was good old-fashioned capitalistic cash-and-carry. Anyone, says Cheree, could ã raise the necessary $2,000 or $3,000 Brown used to charge (in the ’80s) by turning "a couple of tricks." The word would go out that Brown was coming to town. "He’d shoot silicone anywhere you wanted it. For $200 he’d do breast surgery. For $500 he’d do cheeks, breasts and hips. After injections you had to lie flat on your back for three days so the silicone wouldn’t go anywhere. He plugged the holes with Krazy Glue."

There wasn’t any indication in Brown’s early years that he’d one day end up as an itinerant peddler of silicone injections. The son of a Mormon physician, he found academics so easy that he graduated from high school before he turned 16. When he was drafted by the Army in World War II, he did so well on the General Classification Test (scoring higher, Brown says, than any of the previous 300,000 people who had gone through the Salt Lake Induction Center) that the Army pulled him out of the clerk-typist pool and sent him to medical school. He graduated from the University of Utah School of Medicine in August 1947. But after two decades as a general practitioner in California, Alaska, Hawaii and the Marshall Islands (and after nearly losing a patient when he got in over his head during a thyroidectomy), Brown decided he needed formal surgical training. He spent two years at Newark City Hospital as chief resident, he says. Later, he attended a program in plastic surgery at New York’s Columbia-Presbyterian Hospital, but in what would become the first great professional disappointment of his life, he was never able to achieve certification by the American Board of Plastic Surgery (and with it staff privileges at major hospitals).

"I passed the written part of the exam without cracking a book," he says. The problem was the orals. As a result of having grown up with a "domineering" father, he tended to fold when confronted by authority figures. "My brain turns to cottage cheese."

Ten years later, in 1977, in what was the second great disappointment of his life, the California Board of Medical Quality Assurance, in part as a result of his association with James Spence, revoked his medical license for "gross negligence, incompetence and practicing unprofessional medicine in a manner which involved moral turpitude." Among other things, the board charged, Brown allowed Spence to hold himself out as an M.D.; he allowed unlicensed people, including other transsexual patients, to write prescriptions under his signature, diagnose patients and provide medical care; he misrepresented sex-change surgery on insurance forms as corrective surgery for "the congenital absence of a vagina"; he exhibited "gross negligence" by failing to perform sex-change operations in an acute-care facility (Brown did them in his office on an outpatient basis); he unaccountably failed to hospitalize a patient who had a "life-endangering" and "pus-infected" wound the size of a softball where his penis used to be; he failed to take medical histories or do physical exams before surgery; and he did sex-change surgery on virtually anyone who asked for it, regardless of whether they were physically or emotionally stable enough to cope with it.

Despite the medical board’s harsh denunciation of Brown, the administrative judge who recommended that his license be revoked apparently did so reluctantly, as he also filed a "memorandum opinion" on Brown’s behalf, pointing out that the doctor, despite his "difficulties," appeared to be "a pioneer" who made "innovative contributions" to the emerging field of transsexual surgery. Perhaps a better resolution to the problem, wrote Judge Paul J. Doyle, would have been to limit Brown to doing surgery in a "medically recognized organization," while denying him any responsibility either for determining the eligibility of prospective patients or for their post-operative care.

Most doctors, when they have their licenses revoked, give up, leave the country or find another line of work. At first Brown did try to work outside the continental United States. But after successively losing permission to practice in Hawaii, Alaska and the island of St. Lucia ("I don’t know what you have to do to lose your license in the Caribbean," says UCSD’s Jack Fisher), Brown returned to Southern California, where he started what would eventually become an ambitious underground practice in gender-reassignment surgery, breast implants, face-lifts, liposuction, ã silicone injections, penile implants and penile enlargement. To avoid legal problems, he lived in Chula Vista but did his surgery in Mexico. (In his advertising brochures, Brown referred to this as his "international practice.")