LAS VEGAS (KTNV) — Nearly half of transgender adults have experienced mistreatment or discrimination in the healthcare system, according to a study by the Center for American Progress.
A trailblazer in healthcare wants to change that in Nevada. Dr. John Brosious, a board certified gender and reconstructive surgeon in Las Vegas, has become the first in the state to perform gender-affirming genital surgeries.
Right now, there are about 100 surgeons in the United States who perform gender-affirming genital surgeries according to TransHealthCare.org. Most of them are near Los Angeles, San Francisco or New York.
Until Dr. Brosious began his work in Las Vegas, there were none in Nevada. That left trans patients in Nevada without many options.
"A transgender person doesn't wake up and decide to be trans. They wake up and decide to be happy or to lie to themselves,” said Percival Chase, who says he realized he was transgender when he was 14 years old.
Chase underwent top surgery when he was 20 years old in July of this year. He scheduled the surgery on his birthday, calling it a “rebirth.”
"I didn't ever think it was possible to be this happy. I can vividly remember assuming that there was never going to be a time in my life where I felt comfortable looking in the mirror and seeing myself,” said Chase.
Dr. Brosious performed Chase’s surgery.
"Dr. Brosious treats me like I'm a patient trying to get an issue solved, and not like I am a freak.…and that is one of the most meaningful things that can happen to a transgender person,” Chase said.
Dr. Brosious recently opened Vegas Plastic Surgery Institute(VPSI) with his partner, Dr. Joshua Goldman.
He says trans patients aren’t always treated with care, and that’s part of the reason he started offering this specialty in our valley.
His first transgender patient years ago cried during their consultation.
“I thought for sure I had offended her in some way. And so I apologized and said, you know, what did I say? I'm really sorry. This is my first consultation with a trans patient. And she said, no, you didn't offend me. These are tears of joy that you're the first doctor that ever took me seriously and was willing to do my surgeries in the whole city,” said Dr. Brosious. “That broke my heart, actually, you know, seeing that there's you know, there's this whole entire community that health care is just kind of left behind.”
Dr Brosious says it didn’t take long before many patients from the transgender community arrived seeking chest surgeries, but there weren’t any doctors, including himself, who could perform genital surgery.
To fill that need here in Nevada, Dr. Brosious did years of research and observed surgeries across the country to study technique. He expanded his practice to include the specialty in 2020.
"There's a lack of formal training because this is a relatively new area within plastic surgery,” he added.
Training wasn’t the only hurdle. Dr. Brosious battled with insurance companies to ensure surgeries are covered. He’s also had to find hospitals that will allow the genital procedure.
“Before they offer a new service line like gender surgery, they want to look at the historical data. Are these procedures going to make us money or lose this money?” Dr. Brosious said.
There’s also wrap-around care needed.
Dr. Brosious has had to find doctors to prescribe necessary hormones and mental health professionals to do psychological evaluations before surgery.
"It basically controls my whole life. You know, these are major operations that I perform, and I'm the only person who knows how to do the surgeries and the only surgeon who knows how to handle those complications,” Dr. Brosious.
All of those costly obstacles, along with the knowledge gap among physicians, explains why there are very few surgeons doing gender-affirming surgeries.
There is also backlash that can come from this line of work. That’s something Dr. Brosious says he ignores.
"You can probably tell just by looking at me, and I'm not someone who typically cares what people think about me. I'm just myself. And I do what I think is right,” Dr. Brosious said.
It’s that psychological groundwork that makes the world of difference.
“Many of these patients are suicidal. They suffer from what's called gender dysphoria, and that's basically the incongruence between their brain and their body,” said Dr. Brosious. “No matter how hard these operations are, no matter how stressful it makes my life. I'm saving lives.”
His life work is helping patients like Chase feel hopeful for the future.
"I do think that there is a time that is coming where you can just go to the doctor and say, I know that I'm trans. Can you help me? And they will just say, yes,” said Chase.
Dr. Brosious also trains resident physicians at UNLV, passing his knowledge along to future generations.
Dr. Goldman, who is Dr. Brosious’ partner, also performs facial feminization surgeries among his other specialties.
Eventually, they would like to expand their work to include phalloplasty for transgender men and wrap-around services with mental health professionals, hormone doctors and social advocates all under one roof.
