Marci Bowers and transgender people

Marci Bowers is an American gynecologist, surgeon, media personality, and activist. Bowers is one of the transgender community’s most notable surgeons.

Background

Marci Lee Bowers was born January 18, 1958 in Wisconsin.

After earning a bachelor’s degree from University of Wisconsin-Madison in 1980, Bowers earned a medical degree from University of Minnesota Medical School in 1986. Bowers completed an OB/GYN residency at the University of Washington in 1990, then worked at Swedish Medical Center. Bowers has licensure in Washington, California, New York, and Colorado.

Bowers was chosen by Stanley Biber to take over Biber’s Colorado practice in 2003. In 2010, Bowers relocated to Burlingame, California.

Bowers has completed many medical missions to Africa to make surgical revisions to the organs of women subjected to traditional genital cutting. Bowers is an elected board member of WPATH and has served on the board of directors for both GLAAD and the Transgender Law Center.

Media appearances

Bowers has appeared frequently in the media, including TransGeneration, Sex Change Hospital, Trinidad, The Tyra Banks Show, I Am Cait, and I Am Jazz.

2021 60 Minutes interview

Bowers was a source for a 60 Minutes piece on “detransition” by Lesley Stahl, Alexandra Poolos, and Collette Richards titled “Transgender Healthcare” on May 23, 2021. That report was described by GLAAD thus:

Tonight 60 Minutes / Lesley Stahl aired a shameful segment fearmongering about trans youth. Parents of trans youth could walk away with the false belief that young people are being rushed into medical transition. That is simply untrue. As the piece noted, every major medical association supports affirming, age-appropriate care for trans youth and the guidelines for that care are safe and well-established. And yet, the majority of the story was devoted to ‘raising concerns’ about youth accessing that care. [60 Minutes] heard concerns from several trans leaders and, after spending months on the segment, they delivered a piece which still promulgates the same anti-trans dog whistles that we hear from anti-LGBTQ activists and in state legislatures like Arkansas.

Bowers’ appearance has been cited in reporting critical of the transgender rights movement, including Fox News, The Daily Signal, and The Federalist.

Later that year, Abigail Shrier also interviewed Bowers and Erica Anderson about their views.

2021 Abigail Shrier interview

In October 2021, Bowers and USPATH officer Erica Anderson chose to express their concerns about healthcare for gender diverse minors to Abigail Shrier, one of the most prominent anti-transgender activists.

When asked whether children in the early stages of puberty should be put on blockers, Bowers said: “I’m not a fan.”

When I asked Bowers if she still thought puberty blockers were a good idea, from a surgical perspective, she said: “This is typical of medicine. We zig and then we zag, and I think maybe we zigged a little too far to the left in some cases.” She added “I think there was naivete on the part of pediatric endocrinologists who were proponents of early [puberty] blockade thinking that just this magic can happen, that surgeons can do anything.”

I asked Bowers whether she believed WPATH had been welcoming to a wide variety of doctors’ viewpoints — including those concerned about risks, skeptical of puberty blockers, and maybe even critical of some of the surgical procedures?

“There are definitely people who are trying to keep out anyone who doesn’t absolutely buy the party line that everything should be affirming, and that there’s no room for dissent,” Bowers said. “I think that’s a mistake.”

The problem for kids whose puberty has been blocked early isn’t just a lack of tissue but of sexual development. Puberty not only stimulates growth of sex organs. It also endows them with erotic potential. “If you’ve never had an orgasm pre-surgery, and then your puberty’s blocked, it’s very difficult to achieve that afterwards,” Bowers said. “I consider that a big problem, actually. It’s kind of an overlooked problem that in our ‘informed consent’ of children undergoing puberty blockers, we’ve in some respects overlooked that a little bit.”

Nor is this a problem that can be corrected surgically. Bowers can build a labia, a vaginal canal and a clitoris, and the results look impressive. But, she said, if the kids are “orgasmically naive” because of puberty blockade, “the clitoris down there might as well be a fingertip and brings them no particular joy and, therefore, they’re not able to be responsive as a lover. And so how does that affect their long-term happiness?”

Shrier called the article “probably the most important piece of my career thus far.” Bowers’ views were once again widely reported in the conservative press, including the Daily Mail, the Christian Post, The Federalist, and the Patriot Post.

In response to Bowers’ ill-informed decision, USPATH and WPATH released a joint statement:

The United States Professional Association for Transgender Health (USPATH) and the World Professional Association for Transgender Health (WPATH) stand behind the appropriate care of transgender and gender diverse youth, which includes, when indicated, the use of “puberty blockers” such as gonadotropin releasing hormone analogs and other medications to delay puberty, and, when indicated, the use of gender-affirming hormones such as estrogen or testosterone. Guidelines for the assessment of transgender and gender diverse youth, as well as for the use of pubertal delay and gender affirming hormone medications have been published by reputable professional bodies, including the Endocrine Society, the World Professional Association for Transgender Health, and the American Psychiatric Association.

USPATH and WPATH support scientific discussions on the use of pubertal delay and hormone therapy for transgender and gender diverse youth. We believe that such discussions should occur among experts and stakeholders in this area, based on scientific evidence, and in fora such as peer-reviewed journals or scientific conferences, and among colleagues and experts in the assessment and care of transgender and gender diverse youth. USPATH and WPATH oppose the use of the lay press, either impartial or of any political slant or viewpoint, as a forum for the scientific debate of these issues, or the politicization of these issues in any way. Furthermore, individual decisions about gender affirming interventions and treatments for transgender and gender diverse youth should be made only among the patient, their parent(s) or guardian(s), their medical and mental health provider(s), and any other identified stakeholders on a case-by-case basis, and opposes any attempts to dictate or restrict, by statute, judiciary, or otherwise, access to such treatment when recommended according to accepted standards and guidelines.
Joint Letter from USPATH and WPATH, 2021 (PDF)

Anderson resigned from USPATH and WPATH, and Bowers posted a letter about the Shrier interview online in November 2021:

I remain disappointed by the tone and intent of the article. My comments were taken out of context and used to cast doubt upon trans care, particularly the use of puberty blockers. Worse, Jazz Jennings was disrespectfully and erroneously portrayed as a puberty blockade failure, based solely upon her television portrayal.

[…] What I hope for, most of all, is that my out-of-context comments will not be excerpted to weaponize ongoing attacks upon transgender persons.
Bowers, 2021

2023 New York Times guest essay

In 2023, the New York Times published a piece by Bowers critical of the wave of anti-transgender legislation in America. Bowers touched on transgender youth medicine, low rates of regret and “detransition,” the history of WPATH and trans healthcare, then urged lawmakers not to interfere in medical decisions made by doctors with their patients.

To be sure, worthwhile questions about how best to address gender diversity, adolescent mental health and teens’ expectations about gender remain. But answers to them will not be found in legislation that will harm — not protect — children, families and their health care providers. We must ask ourselves: Why are legislators and politicians making medical decisions for patients and families instead of doctors?

[…]

Anti-treatment bills will not protect children, and they will not help the medical community provide better care for patients in need. We should instead take anti-transgender legislation for what it is: thinly veiled cruelty to a specific minority population of the country. These bills are symptoms of a larger problem, where belittlement and bullying are reminders of what many trans people endure as children, teenagers and young adults.

References

Bowers, Marci (April 1, 2023). What decades of providing trans health care have taught me. New York Times https://www.nytimes.com/2023/04/01/opinion/trans-healthcare-law.html

Bowers, Marci (November 2021). Dear colleagues, clients and friends. Marci L. Bowers, M.D. https://marcibowers.com/transfem/dear-colleagues-clients-and-friends/

WPATH (October 12, 2021). Joint Letter from USPATH and WPATH. (PDF) https://www.wpath.org/media/cms/Documents/Public%20Policies/2021/Joint%20WPATH%20USPATH%20Letter%20Dated%20Oct%2012%202021.pdf

Winters, Kelley (October 9, 2021). Transgender Affirmation in Retrograde. Trans Policy Reform. https://transpolicyreform.wordpress.com/2021/10/09/transgender-affirmation-in-retrograde/

Shrier, Abigail (October 6, 2021). Why Marci Matters: Dr. Marci Bowers’ and Dr. Erica Anderson’s Candor Could Help Thousands of Families. The Truth Fairy. https://abigailshrier.substack.com/p/why-marci-matters

Shrier, Abigail (October 4, 2021). Top Trans Doctors Blow the Whistle on ‘Sloppy’ Care. Common Sense with Bari Weiss. https://bariweiss.substack.com/p/top-trans-doctors-blow-the-whistle

See the response on reddit for a sense of how this was received

Zubrow, Keith (May 23, 2021). Inside the 60 Minutes report on transgender health care issues. 60 Minutes Overtime https://www.cbsnews.com/news/60-minutes-transgender-health-care-issues-2021-05-23/

Smith, Martin J. (2021). Going to Trinidad: A Doctor, a Colorado Town, and Stories from an Unlikely Gender Crossroads. ISBN 9781917895101

Publications

Bradley-Springer L (2010). Interview with Marci Bowers, MD. J Assoc Nurses AIDS Care. 2010 May-Jun;21(3):186-91. doi: 10.1016/j.jana.2010.02.008

Doo FX, Khorsandi A, Avanessian B, Bowers M, Somwaru AS. Gender Affirmation Surgery: A Primer on Imaging Correlates for the Radiologist. AJR Am J Roentgenol. 2019 Dec;213(6):1194-1203. doi: 10.2214/AJR.19.21686

Kvach EJ, Hyer JS, Carey JC, Bowers M. Testicular Seminoma in a Transgender Woman: A Case Report. LGBT Health. 2019 Jan;6(1):40-42. doi: 10.1089/lgbt.2018.0173

Atkinson HG, Bowers M, Mishori R, Ottenheimer D. Comments on “Female Genital Mutilation Reconstruction: A Preliminary Report”. Aesthet Surg J. 2017 Oct 1;37(9):NP111-NP112. doi: 10.1093/asj/sjx096

Gaither TW, Awad MA, Osterberg EC, Murphy GP, Romero A, Bowers ML, Breyer BN. Postoperative Complications following Primary Penile Inversion Vaginoplasty among 330 Male-to-Female Transgender Patients. J Urol. 2018 Mar;199(3):760-765. doi: 10.1016/j.juro.2017.10.013

Gaither TW, Awad MA, Osterberg EC, Romero A, Bowers ML, Breyer BN. Impact of Sexual Orientation Identity on Medical Morbidities in Male-to-Female Transgender Patients. LGBT Health. 2017 Feb;4(1):11-16. doi: 10.1089/lgbt.2016.0097