TRINIDAD, Colo. (AP) â€” The young waitress examined her customers as she refilled their coffee and haltingly asked whether anyone wanted more tea.
There was Elise, a buxom brunette in a crop top and hip-huggers. Kate, a Harvard graduate writer in khakis, hand-knit sweater and pearl earrings. Thea, a graphics designer sporting chic suede boots. And Jackie, a towering figure in trousers and blazer.
In the lunchtime crowd of merchants, housewives and farmers at the Main Street Bakery and Cafe, the four stuck out like fashion models on a pig farm. Retreating to the kitchen, the waitress pulled her boss aside and stammered, ``Those women I'm waiting on? They're men!''
Hardly anyone else gave the foursome a second glance. Not in Trinidad. Not in the so-called ``Sex Change Capital of the World.''
Repeat that phrase to almost any of the town's 9,500 souls and you're likely to be get a lecture on what the southern Colorado hamlet should be known for â€” its idyllic scenery, comfortable climate and friendly people.
But most don't mind that more sex-change operations have been done in their town than anywhere else (about 4,500 to date); they just hate that nickname.
``Nobody cares,'' says Monica Violante, owner of the Main Street Bakery. ``It's just a part of Trinidad.''
Although no formal statistics are kept on the number of sex reassignment surgeries, experts in the field agree that Trinidad's Stanley Biber â€” because of the year he began and his age â€” has performed more than anyone. The International Foundation for Gender Education lists only 14 surgeons in the United States and Canada that do the procedure and, as spokeswoman Sara Herwig points out, ``Biber's been doing it longer than most.''
What makes Trinidad unique is not that it's the sex-change capital of the world, but the fact that this former mining town has come to accept its destiny, depend on it and even embrace it.
In 1969, Trinidad was a town in transition. Coal had been king in these parts since the turn of the century, but after World War II the mines began closing, and by the late '60s only a few remained. Families left and Main Street, once a bustling collection of department stores, car dealerships and restaurants, became a lifeless shell of shuttered storefronts.
Yet Biber was thriving from his fourth-floor office inside the First National Bank building. As Trinidad's only general surgeon, Biber did it all â€” from delivering babies and removing appendixes to reconstructing the cleft palates of poor children.
An Iowa native who once wanted to be a rabbi, Biber moved here in 1954 after serving as a MASH surgeon in Korea and finishing a stint at Camp Carson in Colorado Springs. A friend had told him about a mining town near New Mexico that needed a surgeon, and when he arrived to find mountains where he could hunt and lakes where he could fish, he never looked back.
In those first 15 years, Biber built a comfortable life around a practice he loved and a town he adored. In 1969, he encountered the patient who would forever change both.
A social worker Biber had met through his welfare cases asked him to perform her surgery.
``Well of course,'' he told her. ``What do you want done?''
``I'm a transsexual,'' she replied. And Biber said simply, ``What is that?''
After consulting a New York physician who had done sex reassignment operations and obtaining hand-drawn sketches from Johns Hopkins University, Biber agreed to do the surgery.
``She was very happy,'' he recalls. ``And then it started spreading all over.''
With less than a handful of doctors performing the procedure, Trinidad became THE place to come for a sex-change operation, and Biber was THE man to do it.
The town's sole hospital, Mt. San Rafael, was run by Catholic nuns and Biber hid the charts of his first transsexual patients. But he knew he'd eventually need the approval of the hospital board and his neighbors.
Biber explained his work to the sisters and local ministers.
``I went through the psychology of it all. They decided as long as we were doing a service, and it was a good service, that there was no reason we couldn't continue doing them,'' he says, adding that while some were opposed, others began counseling his patients.
Soon, Biber was lecturing to the hospital staff and the public.
``We figured that's his way of making a living; more power to him,'' says Linda Martinez, 54, a lifelong patient of Biber's.
Not all agree. The Rev. Verlyn Hanson, pastor of the First Baptist Church for the past three years, says the town turned a blind eye to Biber's work because of the economic boost it provided.
``The love of money is the root of all evil, and people will overlook a lot of evil to have a stronger economy,'' he says.
At one point Biber's operations brought about $1 million a year to the hospital, according to his estimates. The basic procedure costs about $11,000, with the hospital taking in a little more than half.
``It certainly has been a substantive piece to the financial jigsaw puzzle,'' says hospital chief executive Paul Herman.
At the height of his practice, Biber performed about 150 transsexual operations a year. His patients brought families and friends who remained in town during their loved ones' eight-day hospital stay.
Whether or not people liked what Biber did, they liked the squat, balding doctor who wore jeans and flannel shirts to work and always said hello.
``He's such a good doctor in all the other ways we accept it and shrug it off,'' says Virgil Micek, who for 30 years has run a music store a few doors down from Biber's office.
At 77, Biber has scaled back his transsexual business to about 100 surgeries a year. The majority of his practice remains tending to the ills of Trinidad's citizens. But he knows retirement may not be far off, and he's in search of a surgeon who will come to Trinidad and continue his work.
``It started here, and I want the hospital to continue with it,'' he says.