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Karr had facial hair removed; theory of sex change surgery hazy

By Ann Imse, Rocky Mountain News
August 21, 2006
BANGKOK, Thailand — The strange tale of John Mark Karr’s exploration of sex-change surgery took another twist Monday when one Bangkok doctor publicly supported the tale and another denied he ever had verified it.

Dr. Settharkarn Attakonpan said he and his technicians gave four laser treatments to the accused killer of JonBenet Ramsay in recent months to kill the roots of some of his facial hair. He said that Karr wanted the procedure because he was beginning hormone treatments to become a woman.
However, Attakonpan, a medical doctor and dermatologist, said that when he saw Karr March 9, he saw no sign of the physical changes that hormone treatments would produce.

He did not see Karr again. His technicians handled the next three treatments, ending in July. Attakonpan also said he's seen men get their beard hairs removed for other reasons, such as simply being too lazy to shave.

Meanwhile, Dr. Thep Vechavisit, a plastic surgeon and well-known sex-change doctor at the Pratunam Polyclinic, denied that he told the Associated Press on Sunday that Karr was his patient. Vechavisit said he would never reveal the identity of a patient or any details of his medical history.

An upset Vechavisit then turned to the Internet and pulled up a story from the New York Daily News that said "records indicate" Karr had work done at Vechavisit’s clinic. The newspaper can't possibly know, he said.

Vechavisit first insisted he had not revealed any such records and that he had not looked up Karr in his records. Then he detailed how Thai police might have found such a record in Karr’s belongings.

Karr paid 15,000 baht, the equivalent of $417 to have facial hair removed by laser in Attakonpan's spotless operating room in four slow procedures. But he was allegedly considering having a significant amputation and reconstructive sex-change surgery done for $1,625 in just three hours, by Vechavisit in a seedy storefront where paint peels off the walls in sheets, and prosthetic breasts and magazines are piled high on every surface of the faded chintz and wicker furniture of his jammed and dirty consulting room.

The allegations of a sex change surgery began with the New York Daily News reporting that it obtained phone records from Karr’s guesthouse, which show he made nine calls to facilities with cosmetic surgeons. That raised the possibility that Karr was seeking to change his appearance rather than his sex.

One Daily News story called Karr "the creep who confessed to killing JonBenet Ramsey" and said he had "another bizarre secret up his sleeve."Another called him a "solitary fiend" and "a perv with many faces."

Vechavisit said it is conceivable that Karr was one of the many people who call in response to his regular ad in the English-language Bangkok Post. But "most of the people who call us never show up," he said.

He also does all kinds of plastic surgery, so a phone call would be no indication that Karr had called about a sex change, he said.

But then he pulled out a wallet card that he gives to patients after they come in for a consultation. It contains a tiny notation of the person’s diagnosis, and a list of appointments as they are made. If Karr had been a patient, he theorizes, Thai police might have found such a card on him and leaked it to the press.

But if Karr had come into his office looking as masculine as he appeared in recent days, Vechavisit said he would have refused to do the surgery. That’s because most of his patients "are on hormone therapy for 10 years before they come here" for the surgery, he said. By the time they are seeking his help, the hormones have already softened the skin, reduced its gooseskin texture, shrunk muscles and reduced arm hair, he said.

"Most transvestites dress and work as a woman from when they are very young," he said. "And once you have lived like this for five or ten years, then you can have surgery. If you come in like this" — pointing to a man in the room — "you can’t do it."

In fact, it’s very rare for him to even see a man who dresses like a man seeking sex-change surgery, he said.

But across the packed streets of downtown Bangkok, Attakonpan is equally certain that Karr told him he wanted his facial hair roots burned out with a laser in preparation for a sex change. That notation is even scribbled in Attakonpan’s handwriting in Karr’s chart.

"He wanted to prepare himself for such a change," said Attakonpan, who runs the Siam Swan cosmetic clinic. "I think he already had a doctor in this field," he said, but then added that he was not sure that Karr had actually seen the physician as of March.

The dermatologist said Karr was quiet and serious but very exacting about how and where he wanted the work done on his facial hair — slowly, gently, and stopping when it hurt too much. Karr called him obsessive-compulsive about it, then backtracked and toned down the description to ‘perfectionist."

Karr had his hair follicles burned off only in the area of the sideburns, down his cheeks and under his chin, Attakonpan said. He didn’t know why Karr left alone other areas of his face, including mustache and chin.