Former Johns Hopkins psychiatry chair Dr. Paul McHugh has a long history of staking out anti-LGBT positions. But The Washington Examiner and other conservative media outlets would have you believe that McHugh’s statements on LGBT issues are significant because he is a “prominent psychiatrist.”
At least, that’s how the Examiner referred to him after he and Arizona State statistician Dr. Lawrence Mayer published a lengthy paper casting doubt on the scientific consensus around sexual orientation and gender identity. That paper appears in a recent issue of a journal called The New Atlantis and it has already generated the predictable far-right lovefest.“Almost Everything the Media Tell You About Sexual Orientation and Gender Identity Is Wrong,” the Daily Signal gleefully declared. The Daily Signal is owned by The Heritage Foundation, a conservative think tank.
The Christian Post weighed in on the paper, too, repeating the researchers’ claim that there is “No Scientific Evidence That People Are Born Gay or Transgender.”
There is plenty of evidence to show that this isn’t McHugh’s first anti-LGBT rodeo.
In 2006, he was quoted as saying that sexual abuse in the Catholic Church was the result of “homosexual predation on American Catholic youth,” as GLAAD noted. Four years later, he filed an amicus brief supporting California’s same-sex marriage ban, arguing that “sexual orientation is, in part, a choice.” In 2014, McHugh wrote a widely-cited anti-transgender op-ed for the Wall Street Journal that contradicts position statements from several major medical organizations including the American Medical Association and the American Psychiatric Association. Most recently, in the spring of 2016, he helped write a position paper for the American College of Pediatricians (ACPeds), a small Gainesville, Florida-based organization that the Southern Poverty Law Center has called “an anti-LGBT hate group.” That position paper called health care for trans youth a form of “child abuse.”
“It may be an intrinsic problem of American psychiatry to fall into a craze or cult-like misdirection once a decade,” McHugh previously told The Daily Beast about his involvement with that ACPeds paper. “Transgenderism seems to be this decade’s version.”
So it’s no surprise to see McHugh’s name crop up yet again in connection with another round of headlines questioning LGBT identities.
In their new paper, McHugh and Mayer express skepticism over the concept of “sexual orientation,” writing that “we may have some reasons to doubt the common assumption 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 invariably express it through particular patterns of sexual behavior or a particular life trajectory.”
With regards to transgender people, they advocate taking “a skeptical view toward the claim that sex-reassignment procedures provide the hoped-for benefits.” They especially question the provision of health care for transgender children, writing that they are “disturbed and alarmed by the severity and irreversibility of some interventions being publicly discussed and employed for children.”
On all of these counts, McHugh and Mayer are at odds with the positions of major physicians’ associations.
The 117,575-member American Psychological Association (APA), for instance, has long acknowledged sexual orientation, defining it as “an enduring pattern of emotional, romantic and/or sexual attractions to men, women or both sexes.”
As the APA also notes, research demonstrates that “feeling positively about one’s sexual orientation and integrating it into one’s life fosters greater well-being and mental health.” That sounds a lot like a “happy and flourishing” life.
Several major medical associations also support health care for transgender people, including sex reassignment surgery.
The 200,000-member American Medical Association is on board: “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].”
So is the World Professional Association of Transgender Health (WPATH): “Sex reassignment, properly indicated and performed as provided by the Standards of Care, has proven to be beneficial and effective in the treatment of individuals with transsexualism, gender identity disorder, and/or gender dysphoria.”
And although McHugh and Mayer are “alarmed” by the prospect of affirming health care for transgender youth, the 64,000-member American Academy of Pediatrics (AAP) issued a 2013 position statement supporting health care for LGBTQ youth. In an accompanying technical report, the AAP outlined the Endocrine Society’s 2009 recommendations for puberty-suppressing drugs and eventual hormone therapy for transgender youth, calling them the product of “the best available evidence with clinical experience from experts in the field of assisting transgender patients with transition.”
In an August letter, too, AAP president Dr. Benard Dreyer summarized current research showing that social transition can improve transgender children’s’ mental health, writing, “There appears to be no harm—and possible benefit—from such parent-supported early social transitions.”
In addition, the use of puberty-blocking drugs among transgender adolescents is not nearly as alarming as McHugh and Mayer suggest.
Dr. Annelou de Vries, a Dutch psychiatrist who has studied transgender youth, told HealthDay in 2014: “Since puberty suppression is a fully reversible medical intervention, it provides adolescents and their families with time to explore their gender dysphoric feelings, and [to] make a more definite decision regarding the first steps of actual gender reassignment treatment at a later age.”
Another study from deVries, published in the Journal of Sexual Medicine, found that “[b]ehavioral and emotional problems and depressive symptoms decreased, while general functioning improved significantly during puberty suppression” among transgender adolescents old enough to receive a prescription.
In a phone interview with The Daily Beast, McHugh denied that his statements on LGBT issues were in any way politically motivated, characterizing them as “an exercise in the act of discussion with the public over important matters of human relationships."
“I don’t believe that this is politically-motivated,” he said. “I believe that this is motivated out of an understanding of what science does and does not say."
When asked about his positions being at odds with major medical organizations, McHugh said, “My answer to that is this is not the first time I’ve been contradicting traditions and, in these areas, I am saying that they do not have evidence-based medicine on which to back their prescriptions.”