AN AMERICAN schoolteacher who says he killed six-year-old beauty queen JonBenet Ramsey visited a Bangkok clinic specialising in sex changes, it emerged yesterday, as he was flown from Thailand to face a murder charge in the United States.
A doctor at the Pratunam Polyclinic said John Karr, 41, had a consultation and sources revealed it was in connection with having a sex change.
The clinic, which co-sponsors a popular transsexual beauty contest, advertises a large menu of plastic surgery procedures in the English-language Bangkok Post. Breast implants cost 600, liposuction 330 and sex-change surgery is about 860 - a bargain compared with US prices.
Sources at the clinic said Karr had consulted the doctor about sex-change surgery.
Karr took off from Bangkok's airport yesterday on a flight bound for Los Angeles. He will face charges of first-degree murder, kidnapping and child sexual assault in connection with the 1996 killing of JonBenet.
At the Pratunam clinic, Dr Thep Vechavisit admitted Karr was "one of my patients", but refused to comment further.
Dr Thep said he performed about one sex-change operation a week with each procedure taking about two to three hours and patients typically able to return to their hotels a day after.
He said most patients had been living as women - dressing and taking hormones - for years before appearing at the clinic.
Karr was arrested last week in Thailand and told authorities he was with JonBenet when she died but that her death was an accident. While travelling the world working as an English teacher, Karr exchanged e-mails with US journalism professor Michael Tracey over four years.
Excerpts in the US newspaper, the Rocky Mountain News, touched on gender issues.
Karr said his father was a "strong influence but rarely around".
Responding to Mr Tracey's question about whether his "fascination with little girls - which clearly has a strong erotic component - is a way of going back", Karr said: "Maybe I am not going back, but have simply stayed consistent. My peer group has not changed since I was a little boy, and girls were the people I was with always.
"Referring to them as a peer group is somewhat incorrect, but might also be the very definition of what they continue to be in my life."
Bangkok is well-known for its large, open transgender population, and is a haven for many foreigners in search of acceptance and gender reassignment surgery.
Karr, who was not charged with any crime in Thailand, was expelled from the country because he was regarded as an undesirable person.
On the flight to the US, Karr sat in a business class window seat next to Mark Stray, an investigator with the Boulder district attorney's office. A US embassy official and a security officer were also part of the escort party.
Before take-off, Karr - who was not handcuffed - took a glass of champagne from a cabin attendant and clinked classes with Mr Stray, who drank orange juice.
Although Karr took responsibility for the girl's death, his statements have been sketchy. With little public evidence linking him to the crime, some experts have speculated that he is either lying or delusional.
"Many high-publicity crimes have these people coming out of the woodwork," said Elizabeth Loftus, director of the Centre for Psychology and Law at the University of California-Irvine.
More than 200 people confessed to the 1932 kidnapping and murder of Charles Lindbergh's infant son.
The 1947 "Black Dahlia" murder - the infamous killing of aspiring actress Elizabeth Short - also attracted numerous spurious confessions.
Lawyers for the Ramsey family have said that a number of people have already confessed to the killing of JonBenet, but none of them did so with enough credibility to attract the attention of the police.
When Karr spoke to reporters on Thursday, he said he was alone with JonBenet when she died in the basement of her home on Boxing Day in 1996, but that her death was an accident.
"I am so very sorry for what happened to JonBenet," Karr said. "It's very important for me that everyone knows I love her very much, that her death was unintentional."