Serbia isn't exactly a sexually liberated country—just 20 years ago newspapers were publicly declaring transsexuality a blasphemous act, and last year's gay pride parade was canceled after protesters threw gasoline bombs and chanted, "Death to homosexuals." But somehow, it's become the go-to place for sex-change operations in Eastern Europe, the New York Times reports. Four clinics there specialize in the procedure, and almost 100 people underwent it last year.
To put that in perspective, the US has only five surgeons who regularly perform sex changes. "It is surprising that a conservative, patriarchal country is becoming a center for sex-change operations, but social attitudes are slowly shifting," says one transgender activist. A Serbian surgeon became an early practitioner of the procedure in 1989, attracting foreign patients and doctors intrigued by the challenge. Now, foreigners come for Serbia's know-how, and cheap prices—the operation costs about $10,000 there, compared to $50,000 in the US.