A Fascinating Piece By A Johns Hopkins Professor

I mentioned a few days ago my revulsion at a partial sex change who is now pregnant--a pregnant "man" by his/her/its definition. A reader pointed me to this long and important article by Professor Paul McHugh, the head of psychiatry for Johns Hopkins University medical school--rather an expert, by the terms of such things. It is too long to summarize fairly, but he explains why he made the decision that Johns Hopkins would no longer do sex change operations, and why increasingly, other university medical schools are following suit:

The subjects before the surgery struck me as even more strange, as they struggled to convince anyone who might influence the decision for their surgery. First, they spent an unusual amount of time thinking and talking about sex and their sexual experiences; their sexual hungers and adventures seemed to preoccupy them. Second, discussion of babies or children provoked little interest from them; indeed, they seemed indifferent to children. But third, and most remarkable, many of these men-who-claimed-to-be-women reported that they found women sexually attractive and that they saw themselves as “lesbians.” When I noted to their champions that their psychological leanings seemed more like those of men than of women, I would get various replies, mostly to the effect that in making such judgments I was drawing on sexual stereotypes.

...

Two issues presented themselves as targets for study. First, I wanted to test the claim that men who had undergone sex-change surgery found resolution for their many general psychological problems. Second (and this was more ambitious), I wanted to see whether male infants with ambiguous genitalia who were being surgically transformed into females and raised as girls did, as the theory (again from Hopkins) claimed, settle easily into the sexual identity that was chosen for them. These claims had generated the opinion in psychiatric circles that one’s “sex” and one’s “gender” were distinct matters, sex being genetically and hormonally determined from conception, while gender was culturally shaped by the actions of family and others during childhood.

The first issue was easier and required only that I encourage the ongoing research of a member of the faculty who was an accomplished student of human sexual behavior. The psychiatrist and psychoanalyst Jon Meyer was already developing a means of following up with adults who received sex-change operations at Hopkins in order to see how much the surgery had helped them. He found that most of the patients he tracked down some years after their surgery were contented with what they had done and that only a few regretted it. But in every other respect, they were little changed in their psychological condition. They had much the same problems with relationships, work, and emotions as before. The hope that they would emerge now from their emotional difficulties to flourish psychologically had not been fulfilled.

We saw the results as demonstrating that just as these men enjoyed cross-dressing as women before the operation so they enjoyed cross-living after it. But they were no better in their psychological integration or any easier to live with. With these facts in hand I concluded that Hopkins was fundamentally cooperating with a mental illness. We psychiatrists, I thought, would do better to concentrate on trying to fix their minds and not their genitalia.

Professor McHugh has a detailed discussion of the characteristics of men who want to be women--and regular readers of my blog will not be surprised by what they found:

Most of the cases fell into one of two quite different groups. One group consisted of conflicted and guilt-ridden homosexual men who saw a sex-change as a way to resolve their conflicts over homosexuality by allowing them to behave sexually as females with men. The other group, mostly older men, consisted of heterosexual (and some bisexual) males who found intense sexual arousal in cross-dressing as females.

Now, some of you are going to say, "If it makes them happy, what's wrong with them doing this?"

1. Medical resources spent on this wrongheaded procedure are not available for legitimate medical problems. Even if the confused ones pay for this procedure entirely themselves, it is still using plastic surgeons who could be doing legitimate reconstructive surgery, hospital beds, and operating rooms.

2. In some cases, the taxpayers are paying for sex-change operations. San Francisco, which is self-insured, does so--up to $50,000 per employee, according to this February 18, 2001 New York Times report. Berkeley apparently did likewise last year, according to this account copied from the May 8, 2007 Contra Costa Times. This October 10, 2007 KTVB channel 7 report tells us that the federal courts have been wrangling over whether two Idaho prisoners have a right to a treatment for "gender identity disorder."

Really bad ideas don't seem to stay private; they soon became a constitutional right.