Exclusive excerpt from “Going to Trinidad”: A patient arrives at a gender-confirmation crossroads

Martin J. Smith, a veteran journalist and former senior editor of the Los Angeles Times Magazine, is the author of five crime novels and four previous nonfiction books. He has won more than 50 newspaper and magazine writing awards, and his novels have been nominated for three of the publishing industry’s most prestigious honors, including the Edgar Award, the Anthony Award, and the Barry Award.

The following is an excerpt from “Going to Trinidad: A Doctor, a Colorado Town, and Stories From an Unlikely Gender Crossroads.” Available in book stores April 15.

In this excerpt, patient Claudine Griggs arrives in Trinidad to prepare for gender confirmation surgery under Dr. Stanley Biber, whose practice in the southern Colorado town became a crossroads for thousands.

Chapter 5: The Elevator

Five days before her thirty-eighth birthday, Claudine Griggs and Carolyn, her companion and lover at the time, entered the side entrance to Trinidad’s First National Bank building. Griggs was nervous, terrified actually, as she boarded the narrow, rattletrap elevator to Biber’s private office for her 9:30 a.m. evaluation appointment. She didn’t notice that the renaissance revival building’s imposing sandstone facade along East Main and South Commercial streets is little more than that—a facade. While those edifices convey the sober seriousness of a key financial anchor for the community, the other two sides of the structure, the back and the east-facing wall, are ordinary painted brick. From one angle, the building looks like a First National Bank building should, with its gracefully arched front entrance, modern windows, and blocky stone. From another, the flecking paint, window air conditioners, and zig-zagging grey metal fire escape say nothing so much as “New York tenement.” The building where Biber chose to locate his private office—the epicenter of Trinidad’s downtown for nearly a century and a half, starting with serving pioneers along the Santa Fe Trail in 1875—itself has some identity issues.

By then, Griggs had the hardened psychological armor of a lifelong transsexual. She’d mistrusted doctors since her earliest attempts to find a capable and compassionate surgeon, and stepping into the elevator was the biggest and scariest step she would ever take. Amplifying the anxiety of the moment was her general mistrust of men, for reasons stemming from a brutal experience when she was twenty-one years old. She recounts the incident without tears—not detached exactly, but in a tone from which the anger and bitterness seems to have been leached. What’s left of the story more than four decades later is like a river rock, smoothed by time and without hard edges.

It happened just months after she first began living as a woman. She’d finished high school as Claude and served a year and a half as a journalist and broadcaster in the US Air Force until her career there began to wobble. She was struggling with her gender identity, though she never mentioned that to her Air Force psychiatrists. She was suicidal, though, and was sent home for eighteen months to recover. She returned from that hiatus prepared to complete her tour of duty, but confided in a psychologist handling her evaluation that she was transgender and that she eventually planned to undergo gender confirmation surgery. The psychologist was sympathetic and considered her mentally stable, she recalls, but predicted correctly that Air Force policy at the time would prevail. She was honorably discharged six weeks later. Still just twenty, she was uncertain about her future, but absolutely certain of her gender identity.

As Claude, and taking advantage of her GI Bill education benefits, she’d begun studying at Chaffey College in Alta Loma, California. While not trying to pass as female at that point, she easily could have. Griggs had no visible body hair and very little facial hair, and she’d begun to develop small breasts long before she began hormone therapy. Those ambiguous physical characteristics, combined with her slight five-foot-five, one hundred-twenty-pound frame, promised a relatively seamless transition from male to female. She took off one quarter from college, began hormone therapy in May 1974, and began living as a woman on July 1 that year. She reentered Chaffey that summer as Claudine.

As a transgender coed with a secret, the slight, attractive Griggs and had no trouble drawing the attention of male classmates. Her studio portrait as a high school senior in 1971 shows a handsome young man with short hair and kind eyes, with a toothy grin she now says was forced, masking the depression and inner torment she experienced as a transgender teenager. It’s a striking contrast to the 1977 portrait of her as a student at California State Polytechnic University in Pomona, from which she graduated with a Bachelor of Arts in English in 1978. That later picture shows a confident young woman in the unisex style of the era, with long, middle-parted blond hair and a maroon turtleneck sweater. The smile seems infinitely more genuine.

It was that way from the start of her transition. “Within a week or two, people were asking me out, and I was very surprised,” she recalls. “I didn’t expect anybody (to do that) because I thought I was too ugly. I thought I was the most hideous woman around, and I couldn’t understand that other people didn’t see me that way.”

Within a couple of months of her reentry to Chaffey, one of those courtships led to her first sexual encounter with a man who she says seemed comfortable with her in-between gender status. But not long after that, things took a dark turn. She’d called his house and was told by her boyfriend’s roommate that her boyfriend was out. The roommate invited her over, assuring her that her lover would be back shortly. But the boyfriend was not there when she arrived. The roommate invited her in. A second man was hiding behind the door as she entered, she says, and “things went downhill from there.”

She remembers one of the men gesturing to a coffee table, where she saw a large knife she compares to the one featured in the shower scene of Alfred Hitchcock’s Psycho. She knew at that moment she was in trouble. The mood shifted. Just twenty-one, her goal suddenly became survival, nothing more, and she was immediately convinced that cooperation gave her the best odds of getting out of the apartment alive.

The assault lasted several hours, and she remembers having the same classic out-of-body experience described by many rape victims. At one point, one of her assailants struck her. She doesn’t remember feeling it, but she remembers hearing it and thinking, “Oh, he just hit me.” At another point, one of the men burned her with a lit cigarette “when I wasn’t enthusiastic enough.” She remembers thinking, I sure hope a child is not the one who finds my body in the dumpster somewhere. She still recalls one of her assailants’ parting words when the ordeal was over: “Since you want to be a woman, you should thank me for this.”

She apparently drove herself home, though she has no memory of that. She does remember crawling up the stairs to her apartment, humiliated and wracked by pain. Her instincts told her to call the police, but her experience with discrimination as a transgender woman convinced her otherwise. She thought, No, the police will rape me too when they find out I’m trans.

Instead of making the call, she drew a bath, almost intolerably hot, and climbed in. She scrubbed her skin until it hurt, trying to rid herself of the smell of her attackers. Then she went to bed and allowed herself to cry. In the sometimes absurd, hall-of-mirrors reality of growing up transgender, she recalls being angry with her mother for never warning her that men could be such predators. But of course, her mother had raised what she thought was a son, and so the precautionary mother-daughter conversation about dating had never happened. So Griggs tamped down her pain and anger, never reported the crime to the police, and kept the secret even from her therapist for more than two decades—until she alluded to it in the published 1996 journal of her transition.

To this day, she doesn’t know whether the man she was dating was aware of the rape plan. But he never called her after that, so she suspects he knew—an unfathomable betrayal by her very first lover, a scar that has never faded.

Her experiences were hardly unique, of course. Among transgender men and women back then, and even now, hostility, violence, and desperation are daily realities. She’d read articles about people like her being beaten to death in jail while guards looked on, about paramedics who allowed someone like her to bleed to death at a car accident scene, joking as it happened. Someone once anonymously mailed Griggs a copy of an article about a transgender woman in Great Britain who died after being bound with chains and weights and then dropped into the sea. She’s still not sure if the sender’s scribbled message—“Be careful, Claudine”—was a warning or a threat.

On top of those personal horrors was her general disdain for herself as a transsexual, which she later described this way: “Transsexualism is a bad accident on the other side of the freeway. No matter how horrible it may be for the people involved, bystanders must inevitably slow down to take a gander. It’s not malicious; it’s just a kind of horrific show that’s too good to pass over. They think, ‘What a mess! I’m glad I’m not involved,’ and step forcefully on the accelerator to speed past once they’ve had a good look. Real tragedies remain, however. Those affected must pick up broken lives and carry on, if they are able, occasionally noting the glances of those who drive by.”

She also compared her options as a transsexual woman to choices that always seemed to involve the lesser of evils. She hated trying to live as a man, but found the idea of surgery no less repellent.

Martin J. Smith in “Going to Trinidad”

She also compared her options as a transsexual woman to choices that always seemed to involve the lesser of evils. She hated trying to live as a man, but found the idea of surgery no less repellent. Surgery, or suicide? “The great sleep might have been preferable,” she remembers thinking. “How does one judge?”

So Griggs was carrying a lot of emotional baggage as she stepped anxiously into that claustrophobic elevator. And yet she did so with unwavering resolve. “I was so used to being treated badly when people knew I was transsexual. I was used to being mistreated in life-threatening ways, sometimes. Whenever I was the center of attention, it usually meant violence was coming, or insults, or something bad was going to happen. So coming from that background, where being trans could get you killed, to be in a place where they knew and were actually trying to help, it was remarkable to me.”

For the appointment, Griggs decided to forego her preferred jeans and sweatshirt for dress slacks and a white blouse—what she later described in her journal as “at least a modest attempt at femininity.” She was second-guessing a lot of things, worried that if she didn’t look feminine enough Biber might conclude that she hadn’t adjusted well to living as a woman. She and Carolyn were joined in the small elevator by a woman who turned out to be Biber’s secretary, who a few minutes later would conduct the first part of Griggs’s screening interview.

During that conversation, the secretary had Griggs sign a consent form, do some paperwork related to her name change, and turn over the results of her AIDS test. She then asked Griggs for a cashier’s check made out to Dr. Biber for the agreed-upon $4,350 and wrote out a receipt for that amount plus the $500 deposit that Griggs already had paid. Then, some post-op instructions: Griggs was to drink lots of fluids, avoid heavy lifting, and promise not to return to work for six weeks after surgery. She also told Griggs to visit a local adult bookstore before the operation to purchase what she called a large dilator—you probably know it by the less clinical term “dildo”—to be used to help dilate and expand the interior of her new vagina, which Biber would fashion from the somewhat elastic, nerve-packed skin of her severed penis. The hospital would provide two smaller dilators to keep the vagina open while it healed, the secretary explained, but the larger one would be needed to deepen it, making it functional for sexual penetration.

The interview didn’t last long, and the secretary reminded Griggs that she was due back at the office at 11:00 that morning for her evaluation meeting with Dr. Biber, “one of the most important persons in my life, someone I have never met before, someone I will probably never see again after I leave Trinidad,” she later wrote in her journal. “But I will carry the results of our meeting for the rest of my life. I am excited. I am terrified.”

The terror subsided when she met her surgeon, who had just arrived at the office after performing a morning surgery at Mt. San Rafael. Biber seemed warm and upbeat, and proceeded quickly through a series of questions intended to gauge Griggs’s fitness for the operation. They were familiar; Griggs answered many of them in the written social history she’d mailed to Biber six months before, as requested: How long have you lived as a woman? Do you consider yourself happy? How long have you been taking hormones? Any adverse effects from the hormones? Does your family support this decision? Ever been married? Children? 

One of Biber’s questions in particular sounded off-key to Griggs: How many times have you attempted suicide? Why didn’t he ask whether she had ever attempted suicide? Not that she hadn’t considered ending her life. She had. Still, his phrasing struck her as presumptuous. But Biber had met a lot of transgender patients since he began doing the surgeries in 1969. Maybe it was the breadth of his experience, or perhaps the intuition upon which he seemed to rely, but he phrased the question the way he did without explanation or apology.

When he finished, Biber invited Griggs to step into an adjoining room for a physical examination. Like the rest of the office, the room was spartan: an exam table, a chair, a storage cabinet. Griggs noticed that the single window had no curtains, and Biber told her not to worry about being seen, since they were on the top floor of the tallest building in town. Before excusing himself for a few moments, he asked her to completely undress.

Griggs hesitated and took several deep breaths. Revealing her whole body, with what she describes as its “disturbing incongruity” of developed breasts and male genitalia, was always a trauma. “I still hate that part of my body which is explicitly male,” she would later write in her journal. “Even its diminished size and functional capacity, from years of estrogen therapy, have not tempered my enmity toward this organ.” But eventually she began to disrobe. Biber returned just as she finished removing her panties and bra.

“He was very casual about it, and that casualness was one of the most reassuring things,” she remembers. “That was later reinforced as he treated me. His whole team was reassuring that way. Everybody talked about Biber as, ‘Don’t worry. Everything is gonna be fine.’ But having met him there in that office, I felt like, ‘OK, I’m going through with this.’ And that was good to know. He was a mixture of Genghis Khan and Huck Finn—he had the decency and honesty of Huck Finn, but he also had that imperious confidence, which is probably something I needed more than anything else at that time.”

Biber slipped a pressurized sleeve onto Griggs’s arm and conducted a blood pressure test—it was a little high— and concluded that it was probably because she was nervous. He checked her eyes, ears, throat, and heart. He examined her breasts, and together they agreed there was no reason to consider breast implants. She remembers his examination of her penis as a little rough, a practical and unceremonious handling by a tradesman. She knew he was considering the organ as a seamstress might consider a piece of fabric. Is there enough material to make what needs to be made? For some male-to-female surgical candidates, Biber needed to supplement the penis skin with a swatch of skin taken from the buttocks in order to create a fully functional vagina. But doing so risked complications, and Biber preferred to avoid the skin graft whenever possible. In Griggs’s case, it was a toss-up. The surgeon estimated there was enough skin to create a vagina that would be three to three-and-a-half inches deep, and says if Griggs is consistent with her painful daily dilations, her vagina depth could expand to five or six inches during the six to eight months after surgery. The decision, he said, was hers.

Griggs chose the less risky option, foregoing the skin graft. (“I have been patient all of my life. Like Siddhartha, I learned to wait,” she says.)

He asked a few more questions, proclaimed “Tomorrow is your day! Everything is going to be fine!” and then launched into a litany of possible complications from the surgery.

Martin J. Smith in “Going to Trinidad”

With that, the physical exam was over. Biber left the room as Griggs got dressed, and she found him at his desk in the main office scribbling notes. He motioned for her to sit, and she did. He asked a few more questions, proclaimed “Tomorrow is your day! Everything is going to be fine!” and then launched into a litany of possible complications from the surgery. There was the potential for death, of course, and the risk of infection common with any surgical procedure.  Also, he told her, you may lose parts of your newly built labia (fashioned from scrotum skin) and clitoris (made from sensitive, nerve-rich skin at the head of the penis). A hole might develop between the vagina and the rectum, the most serious potential problem other than the death thing.  Oh, and depending on the breaks, you may never achieve orgasm. But Biber added that, after more than 2,000 surgeries, he’d pretty much worked out the kinks. “Most of the problems occurred in our early surgeries, while we were still learning how to do it,” he said, predicting Griggs would do just fine and walk out of Mt. San Rafael after nine days feeling like, well, a new woman.

Thus informed, Griggs consented.

After taking a few 35mm photographs of the fully clothed Griggs for his records, Biber directed her to the nearby hospital for admission.

The afternoon passed in a blur of paperwork, blood testing, additional money exchanges (for the hospital and anesthesiologist fees), room assignment, and a quick tour of the facilities. At one point, near the end of a hallway, Griggs passed a double door with a sign that read: “Surgery—No Visitors.” Projecting herself beyond those doors, her emotions begin to swirl. When she finally reached her assigned room, Room 444, she collapsed into a small upholstered chair at the end of the bed. She recalled the moment in her journal:

“For almost 15 years, after I gave up trying to find a surgeon, I disclosed to almost no one that I am transsexual; I’ve existed at work, at home, at school, in the shopping mall, grocery store, bowling alley, golf course, library, on the freeways, on the sidewalks, every place but the bedroom and the doctor’s office, Mondays through Sundays, year after year, with no one apparently knowing that I’m not just a girl down the street. Now, in the last couple of days, I’ve had to confront the fact that I am transsexual with a dozen people I’ve never previously met, and soon I’ll have to face that situation again.”

The surgery promised to make things different, she knew, the only “livable path” before her. But she also understood it was not guaranteed to make things better. “Tomorrow, I remain transsexual, and my body will ache as well. A predictably rotten alliance.”

But in the quiet of her hospital room, with no one asking questions, no one examining or probing, she felt a momentary relief. Griggs knew her long effort to maintain her privacy was a choice, her choice, and that this relatively public stage of her transition was probably more difficult because of that. She found herself wishing she’d been able to better deal with the self-loathing about her life as a transsexual woman. That’s not something she could change, but during her first twenty-four hours in Trinidad, she later wrote, she’d been surrounded by people who constantly reminded her that “I am what I hate.”

It was exhausting.

Her respite didn’t last long. More staffers, more questions. Allergic to any medications? What hormones are you taking? Diabetic? Previous surgeries? A rattling cart was rolled into the room. It contained a small television and a videotape player. She was instructed to watch three videos, two of which were standard for all hospital patients, and a third created strictly for patients like her. It included an interview with Dr. Biber, and a recap of his role in making Trinidad a world center for gender confirmation surgery. An attendant assured her that “It’s nothing gross,” and indeed Griggs found it comforting.

As the day before her surgery drew to a close, the ever-literary Claudine Griggs found herself thinking about a Tom Joad quote from The Grapes of Wrath: “It don’t take no nerve to do somepin when there ain’t nothin’ else you can do.” She had arrived at a point where she felt like she had no options. “And I really looked for the third option,” she recalls. “I wanted something else. And I wanted it even before I changed my name back in 1974. I said, ‘OK, I know I have a feminine gender identity. I know that I’m male. What alternative is there besides suffering with it, or going through sex reassignment?’ I’d read everything I could find, every psychological monograph, every microfilm at the college, looking for articles. I read about suicide rates among transsexuals. And I wanted the third option, something that didn’t involve either living as a man, or going through a sex change. If you find it, tell people about it. I don’t know what it is.”

She had concluded surgery was the best road possible, even though it was still horrible, even though she wasn’t convinced she’d survive it. The idea of living as a woman with male genitalia disgusted her. And she also knew surgery would not solve all her problems. She already could pass as a woman among anyone who saw her clothed. But her situation was so much more complicated than that. She’d still have to figure out how to deal with being a transsexual woman for life. There’d still be family issues, relationship issues, medical issues. Those are things no surgery could remove. “If I worked and got twelve PhDs, I’m still gonna be trans,” she recalls thinking. “It really bothered me that there was no way to get over that.”

She thought, too, of the psychologist she saw years earlier, someone with whom she once discussed her options during a deep depression. “When I was desperately depressed and told a psychologist that I really didn’t want to go through a sex change—it’s just horrible, the idea of it—he said, ‘Well, you can try it, and if you don’t like it, you can always still kill yourself and you’ll be at the same place you would have been.’ And that was the perfect logic for me.”

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