Date Published: March 10, 2021
Jess Ting, MD, has learned to thrive without road maps. As a kid, he taught himself to play the upright bass and went on to study at Julliard. Now he’s blazing new trails in transgender medicine and surgery. “It’s a great field because it’s so young,” Dr. Ting says. “There’s lots of room to innovate.” Among Dr. Ting’s innovations—a completely new approach to vaginoplasty, called the Peritoneum Vaginoplasty. In this audio portrait, Dr. Ting talks about how innovation happens and what he’s learned from his transgender patients.
Dr. Ting is Director of Surgery at the Mount Sinai Center for Transgender Medicine and Surgery.
Dr. Ting: 00:00
The oldest patient we had operated on was a 77-year-old woman. And, I will never forget, I saw her right across the street in that building. And when she first came in she was so nervous. She couldn’t really talk. And at the end of the consultation, I’m like, “Okay, great. Why don’t you go see Elsa and she’ll give you a surgery date.” And she was just almost in tears. She was like, “Well, I thought you were going to turn me down for surgery and tell me that I was too old.” And she was like, “Well, Dr. Ting I’ve waited my whole life for this. I’ve wanted this since I was five. And I’m now 77.
My name is Jess Ting and I’m a plastic surgeon and I’m also the Director of Surgery at the Center for Transgender Medicine and Surgery at Mount Sinai. How I became a transgender surgeon is almost accidental. I was a plastic surgeon for 15 years. And in 2015, Mount Sinai decided to start a program. To me, it sounded fascinating. So I did the training, and in the beginning I was just going to do a little bit of this operation. It was just going to be a part of my practice. But once we started doing the operations and just seeing how transformative they were for patients, I was like, wow, there is no way I can go back to doing plastic surgery. When there are this many people waiting for surgery and can have this kind of change in their lives from it.
As you may or may not know there’s an extremely high suicide rate in this population. And that’s because transgender people, when they have to exist in these bodies that they feel are not suited to their gender, it causes a lot of distress and pain and trauma. And before we started our program in New York City, there were no places to get gender-affirmation surgery in New York, in New York State. It’s been almost four years now. I’ve done about 1500 surgeries.
They’re terrifying operations. It’s not like plastic surgery. In these operations, if you make a mistake someone can get—they can die. They can bleed. And the operations are more difficult. And at the same time, they’re not as well-developed. I probably shouldn’t say this, but, you know, I get nervous before almost every case. I’m always thinking about everything that could go wrong. And how do I avoid that from happening? And what do I do if this happens? How do I get out of that trouble? So that’s at a granular level and at a higher level, a lot of times when I’m operating, I’m like, why do we do that? Why did I just do that? I think we could do it this way instead. And I think that’s going to work a lot better. Sometimes they’re little incremental improvements and changes that we make and sometimes there are big ones.
So before I was a doctor, I was a musician. I grew up in Queens, went to public school, and there was an orchestra class. And the teacher’s like, “Okay, who’s going to play the bass? You, Jess, you’re tall, so you play the bass.” And I was like, “Okay.” And I just, I loved it. It’s very deep and sonorous. And when you play it just vibrates the floor, vibrates your whole body. My family didn’t have the resources to pay for a teacher, so on the one hand not having a teacher was a handicap, but on the other hand, it freed me to do things in my own way. And it’s the same way with these surgeries. It’s a great field because it’s so young. So there’s a lot of room to innovate, to expand, to invent.
About three years ago, a patient came to me and brought me a scientific article about this operation. It was an old operation that GYN surgeons would do to create a vagina in women, cis women who were born without one. And this patient asked me if I could do this operation on her. And I looked at the article and I was like, “No, no, it wouldn’t work because the female anatomy is different.” But when I went home that day, I couldn’t get that thought out of my mind. And one day like three weeks later in the shower, I was like, you know, actually there is a way we can take an aspect of that operation and apply it to what we do in vaginoplasty. It was a way of creating a more life-like lining of the inner vagina using a tissue called peritoneum that we take from inside the abdomen. So that idea is something that we do now almost in every operation. And I think has improved our outcomes and changed the way that I do the operation.
You can be a very, very good musician just having the techniques and having the hands. But to be a great musician—and I’m not saying I’m a great musician—but to be a great musician, I think you have to have the attitude that you’re doing it for the greater good, you’re playing for an audience. It’s all about communicating. And I think the same applies to being a great physician. Ultimately what we do is for the greater good. Moments of greatest satisfaction are seeing the changes in our patients and what we do. A patient will come back after surgery. And they’ll just say, “Wow, this is incredible. This has changed my life.” That is really cool. And that happens a lot. Looking back on the person who I was, seeing myself through the lens that I have now, I just realized I was a much more rigid person. Just didn’t have a full understanding of the human experience, no understanding of what the trans experience was and how horribly trans people are treated. If I had a billboard in Times Square, I think that the message I would put on it would be: love thy neighbor. Be willing to accept people who are not like yourself.