@Yanako
That doctor's look of horror is a reasonable response to many genital replacement surgeries. They're pretty gruesome. The artificial vaginas are essentially open wounds lined with skin, and the patients have to routinely do something called "dilation" (which is exactly what it sounds like) to keep the body from closing it, for the rest of their life. It can reportedly be quite painful, based on accounts from those who had it done in Western hospitals. I can only imagine what the results are like for the Thai black market.