By Mark Ellis
Dr. Paul McHugh, the former psychiatrist-in-chief at Johns Hopkins Hospital, says transgender is a mental disorder rather than a civil rights issue, and decried attempts for surgical solutions – especially those paid for by taxpayers.
Transgender individuals believe their gender identity differs from their biological, God-given sex.
Recently, those advancing the transgender cause seem to be scoring victories. On May 30, a government review board ruled that Medicare can pay for “reassignment” or sex-change surgeries. And Defense Secretary Chuck Hagel said he is “open” to lifting a ban on transgender individuals serving in the military.
“Policy makers and the media are doing no favors either to the public or the transgendered by treating their confusions as a right in need of defending rather than as a mental disorder that deserves understanding, treatment and prevention,” writes Dr. McHugh in the Wall Street Journal.
McHugh was the Henry Phipps Professor of Psychiatry and the director of the Department of Psychiatry and Behavioral Science at the Johns Hopkins University. His own research focused on the neuroscientific foundations of motivated behaviors, psychiatric genetics, epidemiology, and neuropsychiatry.
He says transgender is a mental disorder for two reasons. First, the idea of sex misalignment is mistaken because it doesn’t correspond with physical reality. Second, transgender can lead to harmful psychological outcomes, including an alarming rate of suicide following surgeries.
The transgendered harbor false assumptions similar to other disorders familiar to psychiatrists, according to Dr. McHugh. He compares this to anorexia and bulimia nervosa, where the sufferer may believe he or she is overweight when they are actually dangerously thin.
Dr. McHugh cites a 2011 study at the Karolinska Institute in Sweden. The long-term study—up to 30 years—followed 324 people who had sex-reassignment surgery. The study revealed that beginning about 10 years after the surgery, the transgendered began to experience increasing mental difficulties.
“Most shockingly, their suicide mortality rose almost 20-fold above the comparable non-transgender population,” Dr. McHugh notes. “This disturbing result has as yet no explanation but probably reflects the growing sense of isolation reported by the aging transgendered after surgery. The high suicide rate certainly challenges the surgery prescription.”
Johns Hopkins University pioneered “sex-reassignment surgery” in the 1960s. But when they launched a study in the 1970s comparing the outcomes of transgendered people who had the surgery with those who did not, they were surprised.
The “subsequent psycho-social adjustments were no better than those who didn’t have the surgery,” Dr. McHugh notes. Hopkins stopped doing the surgeries in 1979, “since producing a ‘satisfied’ but still troubled patient seemed an inadequate reason for surgically amputating normal organs.”
“’Sex change’ is biologically impossible,” Dr. McHugh notes. “People who undergo sex-reassignment surgery do not change from men to women or vice versa. Rather, they become feminized men or masculinized women. Claiming that this is a civil-rights matter and encouraging surgical intervention is in reality to collaborate with and promote a mental disorder.”
Another study revealed that when children who reported transgender feelings were tracked without medical or surgical treatment at Vanderbilt University and London’s Portman Clinic, 70%-80% of them spontaneously lost those feelings as they grew into adulthood.
In the last few years, the transgender cause has moved from seeking tolerance to pursuing affirmation or “transgender equality,” with demands for government payment for medical and surgical treatments, and access to all sex-based public roles and privileges.
“Advocates for the transgendered have persuaded several states—including California, New Jersey and Massachusetts—to pass laws barring psychiatrists, even with parental permission, from striving to restore natural gender feelings to a transgender minor,” Dr. McHugh observes.
He believes that psychiatrists should challenge the concept that what is in the mind cannot be questioned. “Disorders of consciousness, after all, represent psychiatry’s domain; declaring them off-limits would eliminate the field.”
Dr. McHugh also disagrees with “diversity” counselors in public schools, who may encourage young people to distance themselves from their families and urge them toward surgery.
He is alarmed by a program at Boston’s Children’s Hospital to treat children with gender confusion by administering puberty-delaying hormones to render later sex-change surgeries less onerous—even though the drugs stunt the children’s growth and risk causing sterility.
“Given that close to 80% of such children would abandon their confusion and grow naturally into adult life if untreated, these medical interventions come close to child abuse.”
He suggests a better way to help such children is with devoted parenting.