Doctors disagree on Karr's plans

Stories conflict over possible sex change

Ann Imse, Rocky Mountain News

Published August 22, 2006 at midnight

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BANGKOK, Thailand - The strange tale of John Mark Karr's exploration of sex-change surgery took another twist Monday when one Bangkok doctor publicly supported the tale and another denied he had ever verified it.

Dr. Settharkarn Attakonpan said that he and his technicians gave four laser treatments to the suspect in JonBenet Ramsey's death in recent months, to kill the roots of some of his facial hair. He said Karr wanted the procedure because he was beginning hormone treatments to become a woman.

But Attakonpan, a medical doctor and dermatologist, said that when he saw Karr on March 9, he saw no signs of the physical changes that hormone treatments would produce.

He did not see Karr again. His technicians handled the next three treatments, ending in July.

In all, Karr paid 15,000 baht, the equivalent of $417, to have facial hair removed in Attakonpan's operating room.

Attakonpan said he has seen men have their beard hair removed for other reasons, such as simply being too lazy to shave.

Meanwhile, Dr. Thep Vechavisit, a plastic surgeon and well-known sex-change doctor at the Pratunam Polyclinic, denied that he told The Associated Press on Sunday that Karr was his patient. Vechavisit said he never would reveal the identity of a patient or any details of his medical history.

Vechavisit then turned to the Internet and pulled up a story from the New York Daily News that said "records indicate" Karr had work done at Vechavisit's clinic. The newspaper couldn't possibly know that, he said.

Vechavisit insisted that he had not revealed any such records and that he had not looked up Karr in his files. Then he described how Thai police might have found such records in Karr's belongings.

The allegations of a sex-change surgery began with the New York Daily News reporting that it had obtained phone records from Karr's guesthouse, which show that he made nine calls to facilities with cosmetic surgeons. That raised the possibility that Karr was seeking to change his appearance rather than his sex.

Vechavisit said it is conceivable that Karr was one of the many people who have called in response to his regular ad in the English-language Bangkok Post. But "most of the people who call us never show up," he said.

He also does all kinds of plastic surgery, so a phone call would be no indication that Karr had called about a sex change, he said.

Vechavisit pulled out a wallet card he gives to patients after they come in for a consultation. It contains a tiny notation of the person's diagnosis and a list of appointments. If Karr had been a patient, Vechavisit theorizes, Thai police might have found such a card on him and leaked it to the news media.

Vechavisit indicated Monday that he would have refused to do surgery on Karr in any case, given how masculine he still looks in recent photos.

Most of the doctor's patients "are on hormone therapy for 10 years before they come here" for the surgery, he said.

By the time they seek his help, the hormones have already softened the skin, reduced its goose-skin texture, shrunk muscles and reduced arm hair, he said.

"Most transvestites dress and work as a woman from when they are very young," he said. "And once you have lived like this for five or 10 years, then you can have surgery."

But across the packed streets of downtown Bangkok, Attakonpan is equally certain that Karr told him he wanted his facial hair roots burned out with a laser in preparation for a sex change.

That notation is even scribbled in Attakonpan's handwriting in Karr's chart.

"He wanted to prepare himself for such a change," said Attakonpan, who runs the Siam Swan Cosmetic Clinic.

Karr had his hair follicles burned off only in the area of the sideburns, down his cheeks and under his chin, Attakonpan said. He didn't know why Karr left alone other areas of his face, including above his upper lip and chin.

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