The fascinating story behind the development of sex reassignment surgery in Morocco

Authors: Karim Moutchou, M.D., Fez Faculty of Medicine and Pharmacy

       Zineb Mekouar, Medical Student, Fez Faculty of Medicine and Pharmacy


    Although most medical discoveries and inventions are the fruit of years or decades of focused research, some occur in unexpected circumstances.


    For example, Alexander Fleming discovered penicillin when he found that mold he had mixed with bacteria, which he forgot in petri dishes before going on vacation, inhibited the growth of the bacteria. Similarly, radiologist Charles Dotter performed the first heart angioplasty when his catheter, which was destined for the heart chambers and valves, accidentally slipped into one of the coronary arteries. He discovered then that the patient survived, and that he could use this technique to visualize the artery.



    In this article, we explore the relatively unknown and unexpected story of the invention of modern male-to-female (MTF) sex reassignment surgery (SRS), one of the most intriguing and complicated plastic surgery procedures in the world. Nowadays, it is mostly performed in East Asia and in Western countries; however, modern SRS techniques emerged in Morocco, a country where they are no longer recognized or allowed.


    Credit for this discovery goes to George Burou, a French doctor who spent most of his life performing the surgery in the country’s economic capital, Casablanca.


Biography of George Burou


    George Burou, M.D., was an enigmatic French gynecologist who pioneered SRS for transgender women. He was born on September 6, 1910, in Tarbes in the Hautes Pyrénées, France. He spent his childhood in Algiers, where his father worked as a French language teacher.


    Burou studied medicine at the Algiers University of Medicine and served as a surgeon in the military in several countries before ending his service and returning to his childhood town. There, in 1939, he opened a gynecology clinic. He later moved to Casablanca in Morocco, where he and his wife built their private clinic, which they named Clinique du Parc (Park Clinic). Although he never intended to specialize in SRS, Burou independently developed the anterior pedicle penile skin flap inversion vaginoplasty at his clinic between 1956 and 1958.


    After that, he performed over 800 vaginoplasties for transgender patients from all over the world.