Gender surgery: Tampa's newest medical trend
Tampa Bay Business Journal - by Gary Shepherd Health Care Editor
Dan Greenwald, 39, a family man and board member on the Hillsborough County Hospital Authority, has a strong, conservative resume.
He graduated cum laude in biology from Princeton University, a classmate of Tampa General Hospital CEO Dr. Bruce Siegel. Greenwald went to Yale University School of Medicine for his M.D.
After initial surgical residency, he won the first-ever research scholarship grant from the Plastic Surgery Education Foundation and worked at University of Chicago Medical Center. Greenwald's two-year residency in plastic and reconstructive surgery was also there.
Then came another fellowship in hand and microvascular surgery at Harvard School of Medicine. Greenwald worked at Massachusetts General Hospital, and arrived at the University of South Florida in Tampa in 1993.
He started as a clinical associate professor, and became director of USF's hand program in 1995. He left USF in 1997 to start a private practice in Hyde Park.
There, Greenwald works in quarters formerly occupied by psychiatrist-sexologist Dr. Bonnie Saks, a key member of the Greenwald-led gender team.
Greenwald's first love is delicate hand surgery, which occupies about half his practice time, and he also does plastic-cosmetic work. Transgender work, including hormone therapy and medical management, is only about 7 percent of his office and operating room time, Greenwald said.
He first learned about penile reconstruction in Chicago while working with plastic surgeons and urologists. They did phalloplasties to correct cancer-, trauma- and genetic-induced defects.
His first potential Tampa transgender patient, a 50-ish male, came to Greenwald shortly after he arrived at USF. "He said, `I'm a man and I need to be a woman,' " Greenwald recalled.
The patient ultimately found relief through nonsurgical therapy, as a fair number of gender dysphoria patients do. But Greenwald reckoned there was a real need for a gender reassignment surgeon in Florida.
While he explored the issue, he also met someone who has helped propel him into the national limelight.
Tony Barreto-Neto is a Hillsborough County Sheriff's Office deputy formerly named Sheila Maycelle. An aggressive national transgender campaigner, Barreto-Neto is Executive Director of TOPS (Transgender Officers Protect and Serve) and chairs Gender PAC, a political action committee.
In 1995, Barreto-Neto was one of Greenwald's early phalloplasties. Barreto-Neto said he told Greenwald, in essence, that if the surgery went well, he'd send a lot of referrals to Greenwald. All went well.
Also, said Barreto-Neto, "the fact that he ... does the surgery from his heart and not his bank book" spread Greenwald's reputation in the transsexual community. For work similar to his, said Barreto-Neto, one California surgeon charges about four times as much.
"I think in the years to come, Tampa's going to become a large center for transgender" activity, said Barreto-Neto.
Greenwald, who does more female-to-male surgeries than vice versa, said he's never had any ethical problem with his work, despite the obvious societal and religious prohibitions and restraints.
However, Greenwald said, he ran into some resistance among colleagues at USF, where it was sometimes hard to find doctors willing to provide post-surgical "coverage" -- to check patients when Greenwald was off duty.
At TGH, Greenwald had to point out that not doing such surgeries there could result in possible discrimination suits.
In any case, he now does the work mostly at Vencor Hospital-Central Tampa, partly because patients were concerned their procedures would become public knowledge at gossipy TGH. He performs two or three surgeries per month.
Female-to-male surgery is particularly expensive. Including hospital charges, Greenwald's fee is about $35,000 for a radial artery forearm-flap phalloplasty, in which a phallus is created from tissue removed from the patient's forearm, following a hysterectomy and other related work.
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