John Ronald Brown (1922 - 2010) surgeon - Part I

 I wrote a shorter version of this in August 2007.   This version goes into more details, about his legal troubles, his patients etc.   



John Brown was born in 1922, the son of a Mormon physician. He grew up in Arizona and Utah. He was drafted in the Second World War, and, excelling on the General Classification Test, was sent by the army to medical school. He graduated from the University Of Utah School Of Medicine in August 1947. His first wife ran off with his best friend; his second died of cancer. After twenty years as a general practitioner, he took a program in plastic surgery at New York’s Columbia-Presbyterian Hospital, passed the written exam easily, but failed the oral.

From 1966-8 almost all transgender surgery in the US was done in university gender identity clinics. Georg Burou’s penile inversion technique that he pioneered in Casablanca was becoming better known, and in 1968 Stanley Biber, a doctor-surgeon at the Mount San Rafael hospital in Trinidad, a mining town in Colorado, who had had extensive surgical experience with the US Army during the Korean War, started doing vaginoplasties, using diagrams that he had obtained from Johns Hopkins Hospital based on Dr Burou’s technique.

February 2-4, 1973, saw the Second Interdisciplinary Symposium on Gender Dysphoria Syndrome sponsored by the Divisions of Urology and Plastic and Reconstructive Surgery at the Stanford School of Medicine. Its principal architect and chairman was Donald R. Laub, M.D., Chief of the Division of Plastic and Reconstructive Surgery. A highlight was the presentation of his techniques by Dr Georges Burou; John Brown also made a presentation, that was well received, doctors at that time not being aware of the idiosyncrasies of his practice. Vern Bullough: “the case of John Brown, who Zelda Suplee, my wife Bonnie, and myself at least halfway encouraged to do transsexual surgery, a recommendation we quickly regretted”.

John Brown set up business as a doctor-surgeon in San Francisco. His assistant was James Spence who had a criminal record but no medical training. Julie approached Brown and Spence about breast implants, and they, assuring her that she would be a ‘perfect woman’, talked her into a full operation. This was one of Brown’s first vaginoplasties; he was assisted by Spence. However unlike Dr Biber, Brown did not have surgical experience and he did not have operating room privileges. However he did network with trans activists.

Another trans woman, Wendy Davidson, who was attempting to organize peer clinics run by transsexuals, also worked with Brown for a while, as did Donna Colvin. Colvin later reported that he shot up valium before surgery, performed on kitchen tables and in hotel rooms. Brown also met with Angela Douglas, who later explained: “‘He wanted to help aid me and came up with several thousand dollars cash to help publish Mirage Magazine. In exchange, I promoted him considerably’.

In October Brown’s work was mentioned sarcastically in Herb Caen’s column in the San Francisco Chronicle. Journalist Paul Ciotti followed up and was invited to a dinner party where a pitch was made by James Spence to a group of urologists, proctologists and internists. Spence was hoping to establish what he projected to be the finest sex-change facility anywhere in the US. Dinner was served by several transsexuals, who were awaiting surgery. When asked how candidates would be selected for surgery, Spence replied: “It takes one to know one. 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." His surgical method centered on using the glans penis to form a clitoris, and lining the vagina with scrotal skin. Ciotti says of Brown: “he came across as genial, knowledgeable and obviously quite proud of his technique. There was a certain naiveté (and even passivity) about him that struck me as surprising in a surgeon”.

However by January 1974 Brown and Spence were at odds.

In 1977 Brown performed vaginoplasty on Angela Douglas who paid around $600. She described him as one who "fed, housed, paid and helped hundreds, and gave free or nearly free surgery to at least two hundred of us". Another patient that year was Nicole Spray.

Later that year, the California Board of Medical Quality Assurance revoked Brown’s medical license for "gross negligence, incompetence and practicing unprofessional medicine in a manner which involved moral turpitude". This was partly based on his practice of doing vaginoplasty on an out-patient basis, not in a properly equipped surgical theater, and having patients work as medical assistants as part of their barter for their own surgery. He also misrepresented transgender surgery on insurance forms as "the congenital absence of a vagina". Despite this, the judge also filed a memorandum opinion that Brown was a pioneer making innovative contributions in transsexual surgery: perhaps a better resolution would be to include Brown in a medically recognized organization, with others selecting the patients and providing post-operative care.

In 1979 Julie sued, saying that the operation had left her neither male nor female. She sued for $7 million, but settled out-of-court for significantly less, but “enough for psychiatric care help for the rest of Julie’s life and a new operation”. Brown’s lawyer made the offer after psychiatrist Kathleen Unger testified that the patient would be a mental cripple for the rest of her life.

Brown worked and successively lost permission to practice in Hawaii, Alaska and St Lucia. In 1981, in St Lucia, he, then 59, contracted an arranged marriage to a 17-year-old, who did not speak English. He taught her the language, and they had two sons.

He then returned to southern California and began an underground practice operating in Tijuana. Tijuana was already a known destination for transsexual surgery. The most eminent surgeon was Jose Jesus Barbosa who worked with Harry Benjamin, and who was the surgeon for Canary Conn and Lynn Conway.

Most of Brown’s patients were trans women who could not afford Dr Biber or Dr Barbosa, or did not meet the requirements re time on hormones, psychiatrist’s referral etc. One patient at this time was Monique Allen, who had vaginoplasty at age 22, and came to Brown for enhancements. She would continue with various other doctors, and eventually had over 200 plastic surgeries.

Patrice Baxter, a cis woman, also had a surgery business in Tijuana. She met Brown, and became a long-time friend and business partner. She also went to Brown for a tummy-tuck, a face-lift and breast implants. Several of her friends and relatives were also operated on: her granddaughter had her ears fixed so that they did not stick out. Brown used Baxter’s home in Mexico for patient postoperative care. By this time he was charging $2,500 for a vaginoplasty – although many of his patients never paid. Baxter was quoted by Ciotti: “"He was brilliant, but he had no common sense. He would walk through plate-glass doors. He couldn’t balance his checkbook." Sometimes in the middle of a conversation he’d just pick up a magazine and begin to read. His bedside manner was no great shakes, either. "He tended to mumble. He didn’t hold your hand." But so what? She asks. "He wasn’t a general practitioner," he was a surgeon.

In 1985 a then-19-year-old had surgery that was so successful that her husband never guessed her past. She later became a manager for an airline. Ann, a traumatized Cambodian who had fled the Khmer Rouge was also pleased with her surgery and became a stripper in Las Vegas’ Chinatown.

On the other hand it was estimated that at least 70 of Brown’s transgender patients ended up with permanent colostomies. UC San Diego plastic-surgery professor Jack Fisher repaired 15 or so of Brown’s disasters: “"He’s a terrible, appalling technical surgeon. There’s just no other way to describe it. He doesn’t know how to make a straight incision. He doesn’t know how to hold a knife. He has no regard for limiting blood loss."

Brown started offering penis enlargements – he did this by cutting the suspensor ligament holding the penis root to the pubic bone. He ran advertisements in The Advocate, and in 1984 he held a seminar in San Francisco – entrance fee $25 per person. He was arrested for medical fraud. However it took four years to come to trial.

Meanwhile, in 1986 Penthouse Forum featured this as a cover story "The Incredible Dick Doctor”.  The article portrayed Brown as an inattentive driver who backed into other cars, and whose trousers fell down in the operating room. The television news magazine Inside Edition followed up with an investigative story on The Worst Doctor in America. Brown actually co-operated with the film crew.

Brown pleaded no contest to the fraud charges in 1989, was fined $1,000 and sentenced to four months in jail, but served only 30 days.


In transsexual circles Brown came to be known as 'Butcher Brown', but patients still came.

After the broadcast of the Inside Edition program, the San Diego District Attorney’s Office launched an investigation that led to Brown’s conviction in 1990, and a sentence of three years for practicing medicine without a license. Several trans woman, ex-patients, showed up to express support for previous work. His wife, the one from St Lucia, now divorced him, although they remained on good terms. He served 19 months.

Continued in Part II.