Thailand's Thep Vejvisit may be God to his customers, but to critics he's Satan. His name pops up each time there is news about the surgical removal of male genitalia. His first name actually does mean "god", but you won't catch him acting like one when he's doing a sex-change operation. In a heartfelt interview, Thep says he just wants to make his patients happy with their new identity.

What made you want to be a doctor, and particularly a gender-reassignment surgeon?

When I was young, my mother had to pay a lot of money when she took my brother or me to the doctor's. We were a rich family, but other families didn't have enough to pay for medicine. I always told myself that some day I would help people to get cheap treatment.

I think gender reassignment as a discipline can make unattractive people happy with a new appearance. I run a beauty clinic in the Pratunam area of Bangkok, and I help a lot of people to improve the quality of their lives. One of my patients contemplated suicide because of her ugly face, which she blamed for losing her a job. I operated on her, and now she's been able to get a job with a high salary.

The meaning of your name is "god". Do you play God when you do gender reassignment? Religious people would say only God can change human appearance.

I never think that. I just know I'm doing what my patients want me to and that they're pleased with it. Maybe I'm Satan.

How many sex-change operations have you done? Have you ever made a mistake?

I've operated on about 500 patients in the past 10 years. Some were locals and some foreigners. Of course, all doctors make errors, and I'm no exception. The point is how to deal with them. Experience can tell you how to deal with an unprecedented problem that medical schools and medical textbooks never told you about. I've learnt from experience and by searching the Internet. You have to make a surgical plan and think it over again and again until you come up with the answer.

As a doctor, you need courage. At first I was afraid that when I removed patients' penises, they would change their minds and want them back. In my whole career, only one has, though when he first came to see me, he'd shown me two psychiatrists' certificates. Even so, I couldn't give it back to him.

How do you decide on gender-reassignment surgery, and why do you turn down some patients?

I diagnose by myself. I have to talk to them to find out whether they really want to be a woman and will not change their mind. They have to persuade me that they want a feminine appearance and want to spend their life as a woman 24 hours a day. If they come into my clinic dressed like a man and ask me to cut off their testicles or do a sex-change, I refuse, because they're still not sure about themself, and some day they will change their mind.

Do you have any prototypes of human parts for your patients?

No. The surgery is like cooking: there is no fixed formula you have to follow.

Have you ever felt disgust about gender reassignment?

No, never. It's a duty I do.

Have you ever thought about having surgery yourself?

Yes. My eyelids are drooping, but I wouldn't trust a Thai doctor. If I want them seen to I'll go to the States.

The Medical Council of Thailand has taken away your licence four times. Why do you still operate your own clinic and provide sex-change operations?

Like anybody, I need a job and money to support my family and myself. It's my responsibility as head of the household.

By Pongphon Sarnsamak, Jintana Panyaarvudh

SUNDAY XPRESS

chequered career

» Dr Thep Vejvisit, 54, opened his clinic 21 years ago after his wife, a nurse, gave birth to their son.

» The Medical Council took action against him over claims in advertisements about his surgical operations. He lost his licence four times for sub-standard treatment.

» During one suspension from practice he studied law at Sukhothai Thammathirat University and graduated in two years