Anti-LGBT Doc Paul McHugh: I Will Not Be Silenced

Dr. McHugh fires back after 600 LGBT health experts claim he “does not represent prevailing expert consensus opinion about sexual orientation or gender identity related research or clinical care.”

Photo Illustration by The Daily Beast

In the seemingly endless debate over transgender people, one figure has become inescapable: Dr. Paul McHugh.

Whether the former Johns Hopkins psychiatry chair is being cited in anti-transgender articles for conservative media outlets—like Breitbart, The Federalist, The Daily Caller, The Blaze, and Fox News—or in the footnotes of amicus briefs, his name has given an imprimatur of science to those already inclined to attack LGBT people.

His Wall Street Journal op-ed “Transgender Surgery Isn’t the Solution,” in particular, has become a mainstay in anti-transgender circles.

In reality, the following major medical associations support transgender health care: the American Medical Association, the American Psychiatric Association, the American Psychological Association, the American Academy of Family Physicians, the American Public Health Association, the World Professional Association of Transgender Health, and many more.

So, after McHugh made headlines last October for co-authoring a non peer-reviewed paper for The New Atlantis questioning the current scientific consensus around sexual orientation and gender identity, Dr. Lauren Beach, the director of LGBTI Research at Vanderbilt, decided she had had enough.

On Thursday, she released a letter signed by nearly 600 experts on LGBT health stating that the New Atlantis report “does not represent prevailing expert consensus opinion about sexual orientation or gender identity related research or clinical care.”

Beach told The Daily Beast that she and her Vanderbilt colleague Dr. Jesse Ehrenfeld began collecting the signatures “a couple months back” and decided to release the letter after a wave of anti-LGBT bills in 2017 because “we think it’s critical that the best scientific evidence is used to inform public policy.”

Recently, McHugh’s New Atlantis paper has been cited in an amicus brief opposing transgender teenager Gavin Grimm, whose Supreme Court case was sent back to the Fourth Circuit earlier this month.

His name can be spotted elsewhere, too: In New Hampshire, where a transgender non-discrimination bill failed to pass a few weeks ago, one of the representatives opposing the legislation cited McHugh’s Wall Street Journal opinion piece in a Concord Monitor op-ed a few days before the vote.

Beach is hopeful that the letter—whose signatories include experts with positions at Johns Hopkins, Harvard Medical School, Northwestern, and other prestigious institutions—can persuade policymakers and the general public alike to interrogate the reliability of the New Atlantis paper which, as The Daily Beast previously reported, received widespread positive coverage in conservative media. (As is common in letters of this sort a note at the end indicates that the institutional affiliations of the signatories are listed for identification purposes only, not as institutional endorsements.)

“We are writing to the public at large as experts in this area of LGBTI health and we want to send a strong message that peer-review is essential for scientific integrity,” Beach told The Daily Beast. “We want to clearly state the New Atlantis article is not peer-reviewed and that—as experts—we disagree with the conclusions expressed in the report. They’re scientifically and medically unfounded.” Among other conclusions, the New Atlantis paper cast doubt on the idea that “in order to live happy and flourishing lives, we must somehow discover this innate fact about ourselves that we call sexuality or sexual orientation” and advocated taking “a skeptical view toward the claim that sex-reassignment procedures provide the hoped-for benefits.”

Many of the signatories to Beach’s letter, she told The Daily Beast, discovered that their research had been cited—and in their view, misinterpreted—in the New Atlantis paper and “felt it was critically important that their work be framed in line with the scientific conclusions that it supports.”

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McHugh himself reviewed the letter after The Daily Beast reached out to him for an interview.

“I see they don’t like me,” he said. “They’ve got an army of people that want to say so.”

In a wide-ranging phone interview, the Johns Hopkins professor disputed the importance of peer review for the New Atlantis report—“It’s an opinion piece for the general public,” he said—and maintained his opposition to transgender medicine as practiced in accordance with the recommendations of major medical associations.

“I don’t want to trouble transgender people,” he said, arguing that transgender people should live however they wish without undergoing medical treatment: "[This] is something that, if you wish to live in that way, [then] this is America—live in that way.”

McHugh is unperturbed by the fact that he disagrees with the American Medical Association—“You should ask them for their evidence,” he quipped when asked why they would support sex reassignment surgery if there weren’t solid scientific support for its benefits—and he effectively called on the letter writers to address the arguments in the New Atlantis article with more specificity.

“What they’re saying here is that my reading is wrong but they don’t point out where it’s wrong,” he said, adding later, “They should look and tell us where evidence-based medicine supports some of the treatments being used for transgender people against what we say is little scientific evidence.”

The letter is indeed short, clocking in at under 300 words. However, it contains a list of references at the end and refers the reader to the “many major medical associations [that] have issued guidelines and policy statements” on LGBT health care.

For example, the American Medical Association adopted a resolution in 2008 recognizing that “an established body of medical research demonstrates the effectiveness and medical necessity of mental health care, hormone therapy and sex reassignment surgery as forms of therapeutic treatment for many people diagnosed with [gender identity disorder, now called gender dysphoria].” The citation for that statement was a list full of peer-reviewed literature dating as far back as 1985.

(Medical associations themselves did not sign Beach’s letter—and it would be unusual for them to single out a physician in that way—but Dr. Carl Streed Jr, the chair of the AMA’s Advisory Committee on LGBTQ issues, did add his name to the lengthy list.)

McHugh still believes that transgender medicine is a “craze,” as he previously told The Daily Beast and as he reaffirmed in this latest interview. (“I think my views will prevail,” he said.) As for the New Atlantis article that was condemned in Beach’s letter, McHugh ultimately dismissed the entire affair as “old news,” referring back to a Baltimore Sun op-ed he co-wrote last October defending the article’s lack of peer review.

“It’s true it’s not in a peer-reviewed journal but it’s not intended to do that,” McHugh reiterated to The Daily Beast. “It’s intended to be published in a journal of opinion in which the public can view what we think about the contemporary scientific literature just like articles in the New Yorker or The Atlantic.”

Asked if he was worried that the letter might harm his reputation, McHugh batted away the idea as if it were ridiculous.

“I’m 85 years old,” he said. “I’m a university professor. I’m a member of the Institute of Medicine. I’m a person who has been through a lot of crazes before. I’m not going to my grave not having spoken my mind, OK? I don’t think I’m doing anybody any harm; I think I’m doing people some good and the conversation should go on.”

The letter, he concluded, won’t stop him: “I believe what’s trying to be done here is simply silence me and I’m not ready to be silenced. I’m going to let nature take [care of] that.”