Former Johns Hopkins Psychiatrist: Transgender Surgery Isn't the Solution

A former psychiatrist in chief at Johns Hopkins Hospital has written an explosive editorial at the Wall Street Journal saying, "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." Dr. Paul McHugh, the former chair of the Department of Psychiatry at Johns Hopkins, challenges the notion that sex-reassignment surgery is good for transgendered persons and provides statistics to back up his assertions.

You won't hear it from those championing transgender equality, but controlled and follow-up studies reveal fundamental problems with this movement. When children who reported transgender feelings were tracked without medical or surgical treatment at both Vanderbilt University and London's Portman Clinic, 70%-80% of them spontaneously lost those feelings. Some 25% did have persisting feelings; what differentiates those individuals remains to be discerned.

We at Johns Hopkins University—which in the 1960s was the first American medical center to venture into "sex-reassignment surgery"—launched a study in the 1970s comparing the outcomes of transgendered people who had the surgery with the outcomes of those who did not. Most of the surgically treated patients described themselves as "satisfied" by the results, but their subsequent psycho-social adjustments were no better than those who didn't have the surgery. And so at Hopkins we stopped doing sex-reassignment surgery, since producing a "satisfied" but still troubled patient seemed an inadequate reason for surgically amputating normal organs.

McHugh has some strong words for parents who decide to treat their young children for gender disorders:

Then there is the subgroup of very young, often prepubescent children who notice distinct sex roles in the culture and, exploring how they fit in, begin imitating the opposite sex. Misguided doctors at medical centers including Boston's Children's Hospital have begun trying to treat this behavior 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. A better way to help these children: with devoted parenting.

Dr. McHugh explains the fundamental nature of the problem:

At the heart of the problem is confusion over the nature of the transgendered. "Sex change" is biologically impossible. People who undergo sex-reassignment surgery do not change from men to women or vice versa. Rather, they become feminized men or masculinized women.

He notes that transgendered advocates are so powerful that they have persuaded several states, including California, New Jersey and Massachusetts to pass laws making it illegal for psychiatrists, even with parental permission, to attempt to restore natural gender feelings to a transgender minor, despite data that shows many of these children can and do lose their transgendered feelings. He called on his fellow psychiatrists to challenge the "solipsistic concept that what is in the mind cannot be questioned."