For years, Trinidad, Colorado has been known as the “sex-change capital of the world.” due to Dr. Stanley Biber, a pillar of the Trinidad community, who performed thousands of the operations. For the uninitiated, trans-gender surgery is not a simple elective procedure.

Most candidates now must go through two psychiatric evaluations, live and dress in their new role for at least a year, and undergo nine months of hormone treatments – testosterone for women and estrogen for men. The surgeon said that only three of his 3,800 patients, all men, had been so unhappy in their new sex that they insisted on switching back. In recent years, he said, there has been a major shift in the sex of his patients, from overwhelmingly male to 50-50 today.

This week the good doctor announced he is closing up shop. He’s 81, and can no longer obtain malpractice insurance.

Dr. Biber ceased operating on patients a year ago but continued to see patients with “minor ailments” in his office. He’s now been advised by the state Board of Medical Examiners that he must have insurance to practice medecine. Biber says he will go back to work at his ranch:

“I guess I’m too old to practice medicine but I’m healthy enough to go do the physical labor on a ranch,” he said.

Among those praising Dr. Biber is Trinidad’s former mayor, Harry Sayre.

“I consider him probably one of the outstanding leaders in Trinidad of the last century,” Sayre said. “He and I had our battles many years ago, but I consider him a real true friend.”

Dr. Biber leaves a successor, Dr. Marci Bowers.