Psychiatrist says transgender medicalization is a ‘folly’ that will ‘collapse’ like eugenics movement

Getty Images/nito100
Getty Images/nito100

A renowned psychiatrist who was instrumental in shutting down the sex change clinic at Johns Hopkins University in 1979 argues that the contemporary “folly” of transgender medicalization will soon “collapse” similar to how the eugenics movement crumbled. 

In a recent interview that covered many areas of psychiatric medicine with Public Discourse, Johns Hopkins University School of Medicine Distinguished Service Professor Dr. Paul McHugh explained that the bodily process of puberty is one of the most mysterious stages of human development.

Gender dysphoric youth who are given drugs in pediatric gender clinics across the country to suppress their normal puberty are incapable of consenting to such interventions, as are their parents, he said. 

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Unlike other animals, “[w]ith human beings, some of the most interesting individuating characteristics of themselves occur only after puberty, probably with a combination of the intellectual powers and the energy that sexual development brings,” McHugh recounted.

“I don’t think any child — and any parent, for that matter — can make an informed consent to permit the blocking of puberty and the transmission of another sex. That’s the first thing: you don’t have an idea what you’re doing. So how can you have an informed consent about it? Because nobody knows.”

McHugh co-authored a controversial 2017 report arguing that the treatment of gender-confused children with puberty blockers and cross-sex hormones has not been adequately researched by the science and medical communities. He and his colleagues argued that treating kids with puberty blockers should be seen as "radical" and "experimental." The report received much opposition from the LGBT community. Other doctors and researchers have argued that the report misrepresents the state of scientific research. 

McHugh has maintained that although he is not against transgender people, he believes that they should receive psychiatric help rather than hormone therapy and reassignment surgeries.  

He explained in the interview that almost all children, 85% to 95%, who believe they are the opposite sex will grow out of it if allowed to go through the normal puberty process. 

Yet, if a hormone blocker is introduced at age 9 or 10, only 5% to 10% of such children will refuse to go further down a medicalized pathway that may entail cross-sex hormones or body-altering surgery. He said the reason for this dramatic difference in percentages is because the pubertal processes shape the brain, and the normal signaling does not occur if thwarted by a blocker. 

Transgender advocates frequently assert that puberty blockers are completely reversible, an idea McHugh says is “still very debatable.”

Moreover, he continued, puberty is an incredibly complex process that is being reduced by some to appear as though it is simple.  

The vulnerability of scientists is that they “can be dealing with the most complex issue and try to oversimplify it and make it seem like a simple issue" despite complex brain issues, hormones and neuroendocrine relationships, he said.

The psychiatrist added that he is amazed at how much money, medical institutions and political machinery the transgender movement has amassed to support its goals. But, he believes it will not succeed in the end.

“I’m absolutely convinced that this is folly and it’s going to collapse, just as the eugenics folly collapsed,” he asserted.

McHugh was the director of the psychiatry and behavioral sciences department at Johns Hopkins University and was the psychiatrist-in-chief at Johns Hopkins Hospital from 1975 to 2001.

His comments come amid greater scrutiny of specific practices now occurring in some European nations. 

Late last year, the High Court of Justice in the United Kingdom ruled in a judicial review brought in part by a young woman named Keira Bell that children under the age of 16 are unlikely to be mature enough to consent to chemical puberty blockade given the significant risks and repercussions to their health.

Bell, now 24, underwent the experimental practice as a teenager at the London-based Tavistock gender clinic. She went on to take cross-sex hormones and have her breasts surgically removed. Bell argued that she was not capable of understanding the consequences of what she was doing as a troubled youth battling depression and other social struggles.

A subsequent court ruling held that parents could give consent for their under-16 children for the hormone blockers. 

Earlier this year in Sweden, the prominent Karolinska University Hospital said that as of April 1, puberty blockers would no longer be given to youth younger than 16 and reference the Bell ruling in the U.K. 

“These treatments are potentially fraught with extensive and irreversible adverse consequences such as cardiovascular disease, osteoporosis, infertility, increased cancer risk, and thrombosis," the statement read. "This makes it challenging to assess the risk/benefit for the individual patient, and even more challenging for the minors and their guardians to be in a position of an informed stance regarding these treatments."

In June of last year, health authorities in neighboring Finland revised their professional guidelines by prioritizing psychological help and support over experimental medicine, especially for young people whose gender dysphoria came about after puberty, which is at present the most common form of gender confusion.

Although McHugh helped shut down the sex change clinic at Hopkins in 1979, the influential medical school relaunched the clinic in 2017.

Last month, an episode of "60 Minutes" aired the concerns of detransitioners, those who once identified as transgender but now regret their decisions to transition. They testified about how they felt rushed into a decision to undergo medicalized gender transition procedures. 

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