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After three decades as the Sex-Change Capital of the World, Trinidad might have to find a new nickname. Dr. Stanley Biber, who has performed some 6,000 sex-reassignment operations in the southern Colorado town, has set aside his scalpel after failing to find insurance.

"I didn't retire -- I was forced to retire," grumbles the eighty-year-old physician, who's been a general surgeon for five decades. "I'm in great shape. I work out every day; I out-lift the kids. But they wouldn't insure me."

St. Paul's Insurance Co. had covered Biber under a $40,000-per-year policy, but the firm left Colorado last year, and when his one-year extension expired this summer, Biber found himself without affordable malpractice coverage. Although the father of nine has never been sued, insurers still placed him in a high-risk category that carries premiums of up to $300,000 annually. Assuming his sex-change practice had caused the hike, Biber applied for general-practitioner insurance. Only one company offered to insure him -- for a starting rate of $75,000.

"Hell, I can't afford that," Biber says. "I went to almost every company in the United States -- and even some offshore -- and I kept getting back, 'You do not meet our criteria.' Well, what the hell is the criteria? They wouldn't tell me. But it's because I'm eighty years old. Has to be."

He plans to keep seeking insurance, but he isn't optimistic. "It's a shame," says Biber, who hasn't performed surgery in three months. "Hell, if I'd decided to retire, that would have been fine. But for them to tell me to retire -- that really pisses me off. What can I do? You can't fight city hall."

Biber's insurance woes are sending the Mount San Rafael Hospital -- Trinidad's only hospital -- scrambling to replace him as a surgeon. In May, the hospital had to close its obstetrics unit because Trinidad, like other small, rural towns, can't attract and retain physicians. "Patients are having to leave town," Biber says, "and I don't blame them. Until we can get a general surgeon, we have a problem. But we're working on it."

But the transgender community will still be covered. Earlier this year, Biber trained Marci Bowers, an OB/GYN from Seattle, to handle his sex-change business. As of October, she had performed 25 male-to-female surgeries from her new office in Trinidad.

"It is indeed the end of an era with Dr. Biber retiring," says Angela Gardner, executive director of the Pennsylvania-based Renaissance Transgender Association Inc. "But the transgender community can be assured that Dr. Bowers is more than qualified."

Since his first surgery in 1969, Biber has claimed two-thirds of all transgender operations worldwide. Trinidad has had mixed views about the so-called Biber Girls and the attention they have brought to the mining and ranching town ("Sex Machine," August 27, 1998). But after learning about the physician's retirement, the city proclaimed October 10 "Stanley Biber Day."

"As far as I'm concerned, any publicity is good publicity," says Kim Pacheco, executive director of the Trinidad & Las Animas Chamber of Commerce. "And I don't think something like, 'Sex-Change Capital of the World' will every completely go away. I think the community here understood his commitment. He certainly was a forward thinker. And pretty much everyone has seen Dr. Biber for one thing or another, so obviously, we do not feel badly toward him. If the nickname goes away, that will be kind of sad, but this community takes the good with the bad."

Biber, however, is having a little more difficulty. "I'm not used to not doing something," he says. "I work on my ranch; I go to the gym. I still come to the office and take care of friends who won't sue me. But my car automatically goes to the hospital."

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Harrison Fletcher