DENVER, Colo. — If you want to hide out in Trinidad, stay away from the Hot Spot at the Savoy. Every single customer — and there were more than a dozen — who stepped into the long, narrow downtown diner during a recent lunch hour was greeted by name or backslapped or fussed over by somebody already inside.
Everybody knew somebody in the diner. And they were well aware that the town's marquee personality, gender-reassignment surgeon Dr. Marci Bowers, had left for good.
"And everybody has an opinion about it," said Hot Spot owner Diana Velarde.
"I think it's too bad," said Mike Gerardo, one of Velarde's customers, who sat in overalls polishing off a plate of spaghetti. A former coal miner, Gerardo knows about the impact of a business shutting down.
"She brought a lot of money into the community," Gerardo said.
Bowers is known the world over for turning men into women (and occasionally the other way around). She didn't make Trinidad, Colo., the sex-change capital of the world; she merely made it world famous as that.
But this fall, after months of fighting with the hospital that was the home base for her practice, she packed up her instruments and headed to the San Francisco area, ending an era that helped define Trinidad for decades.
It may not be the greatest cataclysm the town of about 10,000 has weathered. Mines have closed. Railroad hubs have moved.
But regardless of its eventual place in Trinidad history, Bowers' departure reverberates now, in ways big and small, throughout this rugged town in the Purgatoire River valley.
Gender-reassignment patients didn't fly in and out overnight. Their procedures kept them in town for days, if not weeks.
That's why restaurants, hotels and gift shops will all be hurt, said Karin Murray, co-owner of Hometown Pharmacy & Medical on Main Street.
Murray's business has been hit too.
"All her patients needed prescriptions," she said.
They also needed a place to stay after they got out of the hospital. For the past couple of years, Carol Cometto provided that at the Morning After Guest House.
Cometto, Bowers' former partner, said she hoped to keep it running, with a few changes, in the post-gender-change era.
"My slogan was going to be 'instead of coming to Trinidad for a sex change, come to Trinidad for sex for a change,' " she said.
But last week, Cometto, a Trinidad native, hauled out the last empty wine bottle, swept the dust out of the five guest rooms and locked up the Victorian guesthouse for good.
Now she's managing Trinidad's swanky new wine shop.
Michelle Miles, the owner of the Tire Shop Wine & Spirits (located in an old tire store), is a transplanted New Yorker and a transgender woman.
Miles came to Trinidad as a patient and never really left.
"I'm part of the legacy. I wouldn't be here if it weren't for Marci," Miles said.
Miles remembers when, five or six years ago, a letter writer to the Trinidad Chronicle News called sex-reassignment patients sinners who should be run out of town.
The author was slapped down by letters that were pretty much variations on a theme: mind your own business.
Miles sees that Western live-and- let-live philosophy all over town.
"Trinidad learned to respect their privacy," Hot Spot owner Velarde said of the transgender patients. "Generations grew up knowing that's just what happens in Trinidad." Mike Gerardo, like most Trinidadians of his era, was ushered into life by Bowers' predecessor, Dr. Stanley Biber. Doc Biber, as he's known, wasn't from Trinidad. He was Jewish in a town that, back then, was overwhelmingly Catholic. But somehow he fit in so well that the community didn't just embrace Biber. It celebrated him.
"He could diagnose you just by looking at you," Gerardo said.
Biber started the gender-reassignment thing in Trinidad but not intentionally.
He was an Iowa boy who showed up in Trinidad after serving as a surgeon in a Korean War MASH unit, said Ella Biber, his fourth wife, whom he was married to for 24 years.
He came because Trinidad's coal miners needed care, Ella Biber said.
"According to Stanley, he said one day someone from Trinidad came in asked him if he could do her surgery. She said, 'I'm transsexual.' He had no idea what it was. So he started to investigate and found a doctor trying this surgery," she said.
The doctor, from Johns Hopkins University, sent drawings of the procedure, and with not much else to go by, Biber did the surgery. It was a success, and slowly other patients began seeking him out.
At first, Biber did the surgeries in secret.
When word got out around town, religious leaders yelled.
"He had to get them all together and told them, 'It's no different than somebody being born with a cleft lip that needs fixing,' " Ella Biber said.
Biber died in 2006, and by then Bowers — who first came to Trinidad as Mark Bowers — had taken over the practice.
Bowers, though, had no intention of being quiet about it.
Her work has been recorded in documentaries, magazine articles, TV shows — attention she has welcomed, even courted.
Mt. San Rafael Hospital, not so much.
Bowers views the publicity as part of her work.
"It's important. It educates people," Bowers said.
The hospital viewed it as an intrusion, an inconvenience and a royal pain. Crews dragging cameras, wires and microphones through the 24-bed hospital disrupt patient care and cost money, said chief executive Jim Robertson.
That prompted an unusual policy. Media must get hospital permission 60 days in advance before visiting and pay for access.
It was that policy, Bowers said, that drove her away.
"In September, I finally said, 'Look, if I'm going to stay here, we've got to address this media policy,' " she said.
The hospital and its board weren't about to do that.
"There are many residents of Trinidad who would like to have the city known for something other than gender-reassignment surgery," said board member Dr. Jim Colt.
Bowers is convinced that one thing town leaders would prefer to be known for is the Cougar Canyon Golf Course.
The course opened in 2008 to raves. Then, the economy crashed, taking the market for golf-course homes with it.
Golf-course backers, including some on the hospital board, may worry that potential residents wouldn't be enthusiastic about relocating to a transgender mecca, Bowers said.
Colt said the development was irrelevant.
"As far as I know, the golf course wasn't part of our discussion at any time," he said.
In any case, the town has a chance to re-create its image.
Residents are excited about the New Elk coal mine reopening and bringing hundreds of jobs in an area where unemployment is 8.3 percent — and where those with jobs make about one-third less than Colorado's average annual salary.
Mt. San Rafael has hired a gynecologist and started doing cardiac diagnostic tests, said Dr. Ron Dalton, the hospital's new chief medical officer.
Those new services, plus other additions hospital officials plan, will help make up for the revenue generated by Bowers' 100 or so surgeries a year, revenue that constituted about 5 percent of the hospital's net, Robertson said.
Bowers contends the figure is much higher.
"This town will miss Marci and does already. But there's more to Trinidad than Sex Change Capital of the World," Miles said.
That's undoubtedly true.
On the other hand, Trinidad's association with gender-blurring goes way back — to 1872, when an African-American woman named Cathay Williams moved to town and set up shop as a seamstress. Despite rules barring women, Williams had served in the Army from 1866 to 1868.
She did it by posing as a man.