This story contains candid discussion about sex, genitals and medical procedures.
When Rhona Stace walked through the ‘passengers only’ arch of Auckland’s International Airport, a hugging scrum of a family paused their farewells to stare and point.
Look at that lady. She’s famous, eh?
Rhona is not a celebrity, she’s a policewoman that her two kids still call ‘Dad’. But she’s also a six-foot blonde in a miniskirt who was being followed by a cameraman.
She’s chuffed to be seen as a lady. She’s more chuffed to be travelling with that discreet little ‘f’ for female on her passport for the first time in her 49 years. This transgender cop is off to Thailand to get her genitals aligned with the gender she feels she already is — and some breasts thrown in to boot.
“A lot of people have said I’m leaving New Zealand a man and returning as a woman, but it doesn’t feel that way to me,” she says. Instead, Rhona sees gender reassignment surgery (GRS) as the final hurdle before reaching her “point of comfort”, to get over a body-soul disconnect and on with everyday life.
That point is different for everyone suffering gender dysphoria — the distress of identifying as a sex different to that of one’s genitals. Some find it impossible to overcome, so suicide rates within trans communities are high around the world, even after genital realignment. Some can just don a frock and be done with it, as Rhona puts it.
I know I’ll never be a woman. There is currently no-one who can wave a magic wand and take away [my] having been a male for the majority of my life.
Before filling out her departure card, Rhona had a stiff drink at the airport’s Downunder Bar to steady quaking nerves. She’s nervous about the surgery, but also hates the thought of being without her kids and pets for three weeks.
So she practices a bit of last minute Thai to distract herself: she’s sure sawasdee is ‘hello’, but worries she’s mixed up the words for ‘please’ and ‘thank you’. Rhona already feels grateful to Thailand for the accessibility of its GRS and reckons “it’d be rude not to learn a bit of the lingo”.
While she could have joined our Ministry of Health waitlist for publicly funded surgery, she decided to go private in Thailand. Her savings allowed her to skip a decades long wait.
An outdated quota
The Ministry of Health funds up to two male-to-female and one female-to-male surgeries every two years. As New Zealand had been without a surgeon trained in genital reconstruction since 2014, the latest operations have been performed overseas. A Kiwi surgeon returned from studying GRS in January, but has yet to operate on anyone here.
There are currently 102 people on the waitlist, 76 of them for male-to-female surgery like Rhona’s. Since 2015, 39 GRS seekers were added to the list but only two people have been financed for operations.
The main argument against raising the quota is that GRS is considered voluntary cosmetic surgery, meaning it doesn’t directly save lives like heart transplants do. As its funding comes from the same ‘high cost treatment pool’ as organ transplants, money funnelled into GSR could be considered money funnelled away from life-saving operations.
In defence of raising the quota, transgender advocates point to their community’s high suicide rate, although Swedish studies have shown that’s true even for post-surgery transgender people. The quota is also undeniably outdated. It was determined by the Ministry of Health based on demand for GRS 13 years ago, when 10 people were on the waitlist. Back then, it would have taken eight years for each male-to-female transitioner on that list to get surgery. It would take almost ten times that before the last person on today’s male-to-female list had surgery.
Tommy Hamilton, a Wellington-based LGBTI advocate, wryly notes that 80 years is longer than the remaining life expectancy of most people waiting for publicly funded GRS. A female-to-male transitioner himself, he reckons the more sustainable way of shortening the list would be for society to “just accept there are multiple ways to be a gender”.
Then instead of thinking ‘I’m trans so I must take hormones and I need surgery’, someone might decide, ‘actually I’m cool like I am’.
“Right now I think people feel too much social pressure to present as male or female — so for people born trans, that’s pressure to have expensive and risky procedures.”
Regardless, Hamilton says New Zealand’s health system needs to adjust to the increasing number of people identifying as transgender and seeking health services such as hormone therapy and counselling, as well as GRS. He points to an Otago University study, published in January’s New Zealand Medical Journal, that showed a more than 400 per cent rise in transgender Wellingtonians being referred to the Wellington Endocrine Clinic for hormone treatment between 2011 and 2016. The study reflected findings from other developed nations around the world.
From Rohan to Sergeant Rhona
Rhona was born Rohan, a boy who loved wearing dresses fashioned out of fabric from his nana’s drapery business. By age seven, he had sensed the hobby was something to hide.
I liked that kind of dress-up too much, and it was something I couldn’t let people know about because I was supposed to be a boy. So in my little mind I decided I should get on with the business of being a boy.
Bouts of cross-dressing continued in secret. Through Rohan’s time at university, foray into acting, decision to join the police, marriage, rise to senior police prosecutor for Auckland’s Waitemata District, and divorce: “It was purely and simply the only opportunity to have a wee bit of time as girl,” Rhona says.
Life decisions became shadowed by Rohan’s dread of being outed as a crossdresser. Playing a role on top of a role might make him lose himself, so he canned a promising career in acting. Policing, on the other hand, appealed for its macho-ness. It also led to his first contact with the trans community, but Rhona says despite “a kind of fascination working with them, a kind of jealousy”, Rohan still didn’t join the dots.
“That’s just an indicator of how committed I was to the role I’d chosen for myself,” she says.
I never thought that I could go that way. But I look back now and think ‘how dumb’.
In the end, Rhona came out in 2013, by traumatic blessing in disguise.
She — then he — had her children over for the weekend, fell through a glass coffee table, and ended up in hospital. Her — then his — ex-wife came to pick up the kids, and in doing so somehow discovered Rohan’s secret penchant for wearing dresses.
Rohan sought counselling, got diagnosed with gender dysphoria, began taking feminising hormones, and started living privately as a woman.
Two years later, Rhona came out to her police colleagues. She cries as she remembers how unfazed they were, testament, she believes to New Zealand’s huge strides in accepting gender diversity over the last decade.
With butterflies in her stomach, Rhona — as Rohan — sat them down on a Friday to explain that on Monday she’d be coming to work as Rhona. She asked if there were any questions and only one person raised their hand: “Will we still get the eggs?”.
Rohan kept chooks and their eggs were popular at the police station.
Upcycling the penis
On November 6, 2017, Rhona woke up from a day-long operation at the Phuket Plastic Surgery Institute (PPSI) with her groin a mass of medical tape. She spent the next two weeks in hospital — self-doubting, sore, and profoundly home-sick — as her new genitalia and C-cup breasts healed.
Down the road from the hospital was a yellow wall spray painted with a towering phallus; a tribute, sort of, to the fallen penises of Phuket.
Thailand is known as the global hub for affordable cosmetic medicine. Phuket Town is dotted with signs advertising procedures from a crudely painted ‘BOTOX’ above a convenience store, to ‘Best Breast Surgery!!’ in flashing neon, to the vast gold ‘PPSI’ acronym.
Up until the 1930s, male-to-female gender reassignment surgeons would simply chop off the penis, remove the scrotum, and reroute the urethra; there was no attempt at carving out a vagina. Rhona’s operation was far more finicky.
Her penis was delicately peeled, its skin put on ice to later be inverted as her vaginal canal. Membrane from the small intestine and skin grafted from the thigh can also be used to line a neo-vagina. Scrotal skin is sculpted into a labia and the nerve-rich penis glans gets upcycled into a clitoris.
Male-to-female GRS patients’ new genitalia is, if surgery goes according to plan, sexually functional. It self-lubricates and is capable of achieving orgasm. The fleshy shaft and testes are the only bits of the old genitals discarded — though Rhona jokes she’d been tempted to smuggle her gonads back in a jar of formaldehyde, because she knew a few people who “might need to borrow some”.
Rhona’s surgeon Dr Sanguan Kunaporn is the former governor of Phuket and has been creating vaginas for over two decades. He trained as a plastic surgeon and spent his residency at the only hospital in Thailand performing GRS in the late ‘80s.
Before the internet arrived ten years later, when the hospital began advertising its services online to the world, his patients were all Thai citizens. These days, 99 per cent are foreigners — either on their own, like Rhona, or visiting via a medical tourism company.
Orgasms: better as a woman
Rhona spent her final week in Thailand, during the tail end of its rainy season, in a hotel suite. With her trusty bible on one side of the bed and a set of six glass dilators — “though let’s be frank, they’re dildos” — on the other, she had her spiritual and physical bases covered for recuperation.
The dilators are to stop the vaginal canal from shrinking shut and must be inserted three times a day for the first six months after surgery. The process gets compared to a fresh ear piercing — if you take the earring out too soon, the hole will close.
Does she miss her penis? “No, this is right,” she says. “He was in the wrong place and he had to go. I’ve grieved for the little fella and moved on.”
Transitioning between genders is more than physical, says Rhona, who has found walking in both male and female shoes to be “really interesting”.
Orgasms, she declares, are better as a woman.
“That started before you even started mucking about with junk you’ve got down there,” she says.
Once you get off the testosterone and get the estrogen going in your system and you’re letting your female self out, sex changes straight away.
Early in her transition, Rhona was convinced she was a “plain old heterosexual woman”. One motivation for the GRS was to be able to have heterosexual sex. But since developing feelings for a fellow transgender woman, just before flying to Thailand, she’s been thinking perhaps genitals matter less than the quality of the relationship.
“If that’s good, healthy, caring, honest, supportive … well, let’s say I’m learning that historically we’ve been too obsessed with the genders of who the people involved are.”
Feeling perkier and pleased with her new bits, Rhona wanted to experience Phuket before going home (she desperately wanted to go home). So she went hunting through night-markets for elephant trinkets “with the trunk up, ‘cause that’s lucky” for her friends, ate skewered squid at street-food stalls, rode a motorbike-taxi sidesaddle — like a local girl — and bought a ticket to a ladyboy show at the Aphrodite Cabaret.
At the Aphrodite Cabaret
The Aphrodite Cabaret is one of Phuket’s most famous shows, located a few hundred metres from PPSI, Rhona's hospital. Its cloying odour of cat piss is a stark contrast with the airy hospital; the lithe Thai ladyboys with bouncy round breasts bursting through sequins and feathers are equally at odds with the Western women — some born boys — at PPSI for their tummy tucks, face lifts, or genital reconstruction.
Chinese, Russian, and English songs blare at high volume, perhaps to make up for performers’ dead-eyed dancing. Countless Tripadvisor reviews attest to the show’s joylessness — yet each night the theatre gets packed with thousands of tourists eager to tick ‘ladyboy show’ off their Thailand to-do list. The dancers look very, very feminine up on stage and Rhona says they messed with her “usually finely tuned tranny-dar”. She loyally notes however, that as far as dance moves go they couldn’t hold a candle to her drag queen friends on Auckland’s K Road.
After the show, in front of the theatre, the ladyboys behave like mythical sirens and lure tourists into selfie shoots. They then demand money, twisting smiles into snarls if the tip isn’t enough, grabbing at limbs and screaming.
Rhona, however, was treated differently.
“No money!”, squealed one bejeweled performer in excitement, having identified a fellow ladyboy. Her name was Apple Srirhat, a veteran dancer at the Aphrodite in her 40s. She was intrigued to learn Rhona was a transgender policewoman from New Zealand.
Apple explained that the cabaret was one of very few employment options for ladyboys in Thailand, and that they needed the tips to survive. While all of her fellow dancers had breasts, she said few could afford genital surgery; their penises were strategically tucked into costumes. Apple, however, didn’t want GRS: she said she was “happy as a different kind of woman”.
Life of a ladyboy
Thailand’s attitude towards trans people is “complex and contradictory”, according to United Nations Development Programme (UNDP) studies.
It is a place where trans people like Rhona get life-changing operations virtually inaccessible to them at home. And transgender Thai, like Apple, have historically been more visible than their counterparts overseas.
But the UNDP reports this image of a transgender paradise is more the result of Thai tourism authorities pandering to the so-called pink dollar than a national respect for transgenderism.
The reality is that, trans Thai wind up in tourist havens like Bangkok and Phuket for low-wage jobs in cabarets, at beauty parlours, or as sex workers when they’ve been rejected by their families. Local attitudes are “somewhat tolerant”, notes the UNDP, so long as ladyboys stick to those social confines. Tourists, meanwhile, tend to objectify or fetishise: there are screeds of sleazy webpages advising ‘how to spot a ladyboy’, then either have sex with or evade them, which is somewhat dehumanising.
Transgender Thai cannot legally change their gender and most can’t afford to go to Western-style hospitals like PPSI for their GRS. Instead, says Dr Sanguan, they get surgery using “archaic techniques” from cheaper, unregulated clinics.
Rhona was a little disillusioned with Thailand after speaking with Apple. She says her mind was awhirl with ways to improve Thai access to the internationally sought after surgery on their doorstep.
It also made her appreciate the point in time she had come out as transgender in New Zealand. In February alone our sporting bigwigs defended transgender weightlifter Laurel Hubbard’s right to compete against women at the Commonwealth Games; the country’s biggest bank stopped enforcing gender-specific uniforms in order to make transgender staff more comfortable; Prime Minister Jacinda Ardern cut the ribbon opening Auckland’s 2018 Pride Festival; and a south Auckland newspaper hired a transgender columnist.
But the body of 21-year-old Zena Campbell, a transgender Wellingtonian, was also found in a car on February 11. Paddy Jonathan Woods has pleaded not guilty to the charge of her murder. The National Council of Women has used the tragedy to highlight New Zealand’s lingering transphobic undercurrents.
While being photographed in Phuket for this article, Rhona said she felt more awake to limitations she would have faced had she come out at an earlier era in Auckland. She felt that posing in an narrow alley, wearing her red high heels, was a nod to the streetwalking history of transgender womanhood.
Baptism of fire
Two months after arriving home from Thailand to the chooks at her north Auckland lifestyle block, Rhona isn’t quite sure if she’s reached her point of comfort yet. There have been both physical and psychological setbacks to her GRS recovery.
She was struck by thrush, bacterial vaginosis, and a UTI — uncomfortable parts of a woman’s life she hadn’t given any thought to prior to surgery. The fragile lining of her new vagina ripped during a bouncy trip in a rickety ute and needed stitches, sparking concerns about follow-up care when your surgeon’s on another continent.
Rhona also admits she’s had a few “dark, bizarre” moments of feeling like a man in a woman’s body and that she’s back on antidepressants to help her get through this rough patch.
But there have been achievements too: she’s readied her house for sale, written a series of sonnets, and figured out how to answer the curious kids who ask about her gender. Rhona now tells them, ‘well, I was a boy but now I’m a girl’ - a description they seem to easily accept and that she’s only just come to accept herself. The temptation to bury her decades as a man and destroy any photographic reminders had been strong.
It occurred to me it’d just be swapping one secret life for another, which would be a bit of a bugger as I’m really over secrets.
So, was the surgery worth it?
“That’s the million dollar question,” she replies. “I do think sometimes that I could have done without it. But when you take stock of where you are and what lead you there, you realise this is the right path, it’s just a bit tough at the moment. [When] I think back to how I felt before going to Thailand, that really was intolerable.”
Amanda Saxton and Lawrence Smith travelled to Thailand with financial support from the Asia NZ Foundation.