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Man's Underwear Cynthia Tebbetts's fingers fidgeted on the steering wheel during the four-

hour drive from New Hampshire to Montreal.As his blue Chevy wound its way through New

England's mountainous north last January, all he could think about was his imminent surgery

in an unfamiliar, French-speaking province.He couldn't get there soon enough.Tebbetts sensed

the trip home to Goffstown, N.H., would be wonderfully different, because after a four-

decade wait, he would no longer be a man.The 43-year-old, diagnosed with gender identity

disorder, is one of thousands who have travelled to a small private hospital in Montreal's

north end for gender reassignment surgery.Doctors at the Centre Metropolitain de Chirurgie

Plastique say it is the only facility in Canada equipped to handle complicated sex-change

surgeries and provide valuable convalescence accommodations.Tebbetts, who went by the name

of John Jay until changing it to Cynthia a few years ago, considered hospitals in Colorado,

Florida and even Thailand. But the Montreal institution's reputation, and the resume of

surgeon Pierre Brassard, lured her to Quebec for the $17,000 operation."When you go for a

surgery like this you don't look for the person that has the brightest, four-colour ad in

the yellow pages," Tebbetts said in an interview with The Canadian Press outside the

hospital's red-bricked convalescence home."This is a surgery that can only be done once. You

want it done right."The hospital serves patients from across North America, but Brassard

says a growing number have come from the far reaches of the globe.He says the facility is

unique because most others operate on an outpatient basis only."That means they (patients)

are put on the sidewalk two hours after,"' said Brassard, who has/ performed some 1,500 sex

-change operations in his 13 years at the clinic. "Here, they can stay."As a result, the

number of operations at the 35-year-old hospital, the brainchild of Brassard's partner, Yvon

Menard, has doubled over the last five years.Because gender identity disorders - or gender

dysphoria - are quite rare, the surgeons in his trade make up an exclusive group, Brassard

said.About one in 40,000 to 50,000 people have a gender identity disorder, he added.Brassard

said it is rewarding to help people overcome the pain and confusion caused by gender

dysphoria."They have to go through the ordeal, the psychotherapy, (telling) their family and

friends, and then they come for surgery," he said of his patients. "They live in peace after

that - the great, great majority."For some, it's a life-saving procedure, and they tell me

that, often."Tebbetts says she wouldn't have lasted much longer in a man's body."If I had to

go back to being John, I can guarantee you I'd be dead in 30 days," said Tebbetts, who has

battled depression and alcoholism for much of her life."I'm now able to move forward as

Cynthia, as how I should have been 43 years ago. My mind is now in touch with my body."I'm

good to go and ready to take on the world."It took John Jay Tebbetts decades to come to

terms with a feminine side that bubbled deep within.She says the battle with these powerful

feelings started in Grade 2."I found myself very jealous of the girls and the bodies that

they had," Tebbetts said.The sensations intensified.In high school, she gave in to the daily

urge to wear women's underwear.Tebbetts tried to snuff out the desires by picking up a few

masculine hobbies."I worked very hard at protecting my male macho-ness," she said.Tebbetts

developed a passion for modified cars, a penchant for punk rock, and proudly earned the

occasional penalty for bashing an opponent on the hockey rink.She eventually landed a job

with a professional open-wheel race car team, and worked there for 27 years.But Tebbetts

never shook the feelings. She could not open up to her therapist. Her life spiralled out of

control."I was getting very depressed and very suicidal," she said."If I wasn't at work I

was usually intoxicated."Then one day in 2003, as she broke down in the parking lot of a New

Hampshire rehab centre, Tebbetts decided to confront everything she had been running

from.She went back to her therapist and two doctors diagnosed her with gender identity

disorder. She was prescribed testosterone blockers and estrogen.Slowly, Tebbetts's breasts

grew and her skin softened over the next couple of years. Her life had never been better.

She was beginning to feel like herself."What my body needed was that estrogen," she

said."Estrogen totally kicked the tail out of anything that the anti-depressants were

doing."She looked into male-to-female gender reassignment surgery and found the Clinique

Metropolitain, a three-storey hospital near the shores of Riviere-des-Prairies.Inside,

Brassard and Menard have been refining techniques for male-to-female and the more complex -

and uncommon - female-to-male operations."He got attention," Brassard said of Menard after

he first opened the hospital in 1973."Our exposure is much greater now, we've seen so many

(people)."Many patients come from Alberta and British Columbia, where the provincial

governments pay for the procedure at the Montreal clinic, he said.Less than 10 per cent of

the hospital's clients live in Quebec, where the procedure is not covered under medicare."I

think it's a question of time that it will (be covered)," Brassard said.It's been more than

three months since Tebbetts's operation. She is still sore, but says it gets easier every

day."What was essentially an 'outie' is now an 'innie,"' she said before wincing as she

stood up from the wooden patio chair.But the diehard Beatles fan, who renamed herself after

John Lennon's first wife, wouldn't have it any other way."I've now put a closure on a bad

chapter of my life and am ready to move on," said Tebbetts, who kept an online journal of

her operation and recovery.She also fields questions from people around the world."Now, I'm

finding myself reaching out to people and doing whatever I can to help people in this

situation," she said."I'm using my pain as an example to help other people, so they don't

have to go through what I went through."