Psychiatrist Paul McHugh speaks about decades-long career, opposition to sex-reassignment surgeries

McHugh told “EWTN News In Depth” that “we don’t know enough” about the psychiatric impact of gender reassignment surgeries.

Psychologist Dr. Paul McHugh spoke with “EWTN News In Depth” about his decades-long career, detailing how sexual reassignment surgeries are not the answer for transgender individuals.

McHugh is a 94-year-old American psychiatrist and educator. He is a distinguished service professor of psychiatry at the Johns Hopkins University School of Medicine, where he was previously the Henry Phipps professor and psychiatrist-in-chief from 1975 to 2001.

McHugh has conducted years of research on sexual reassignment surgeries, which are medical procedures that alter a person’s physical sex characteristics such as the chest, genitals, or facial features. McHugh found they do not resolve underlying psychological issues. While some may believe McHugh’s view on the surgeries comes from his faith as a Catholic, he said it is also based in research.

“I am Catholic, and I can’t tell in what way my faith influences any of the things I do. I’m sure it’s important in everything I do. So I can’t deny that it may play a role,” he said. “But … I try to use the information that everybody else uses in determining the fixity or the ‘born that way’ idea.”

McHugh’s career

McHugh is known for many actions in his career, including a move to shut down Johns Hopkins Gender Identity Clinic in 1979 that was performing sex reassignment operations.

When McHugh started to work at Johns Hopkins, the treatment had been going on for about 10 years at the clinic. There were some faculty members following up on the cases to decide if the patients were getting better or worse.

While “most of the patients at the time felt that they had done the right thing when they subjected themselves to the surgery,” all of the issues that they were told would be corrected “didn’t improve,” he said.

“Their difficulties in interpersonal relationships, their difficulties in their jobs. They had difficulty with their families, which was the whole reason for doing it. They were not better,” he said.

“So it didn’t seem to me that this experiment was working out,” McHugh said, noting that it was in fact “an experiment,” because “it wasn’t that they knew perfectly well that these patients would benefit from it.”

“And when they weren’t benefiting … I thought: ‘Well, why do it? Let’s find another way of helping them.’” The clinic was then shut down because of “the evidence,” McHugh said. “I didn’t think at the time that we had enough experience to be able to justify such a radical procedure.”

After years of further research, in 2016, McHugh released a special report in The New Atlantis, “Sexuality and Gender: Findings from the Biological and Psychological and Social Sciences.” Among other findings, the report detailed that there’s no scientific evidence to support that sexual orientation is biologically fixed.

At the time, McHugh’s colleagues at Johns Hopkins took out an op-ed in the Baltimore Sun with pushback on his views. “I suppose I shouldn’t have been surprised because the truth of the matter is many people want to know the answer to a question, but they don’t want to have an answer that they don’t like,” McHugh said.

“And if you start asking, just asking the question, it causes them anxiety because they want a particular answer. So I wasn’t particularly surprised that it didn’t go down easily. But I just think we ought to continue asking the question because it’s a very important question,” he said.

Transgender movement today

McHugh has been “astonished” by the momentum from 1979 to today of the transgender movement, the social and political effort advocating for the rights and inclusion of people whose say their gender identity differs from their biological sex.

By closing the clinic, “it didn’t seem to me that we were doing anything terribly radical,” McHugh said. “But gradually, the idea became that somehow or another we were denying these people their honest sex. And I kept saying, ‘Look, we have two things here. We have the facts of the body, and we got the ideas of the patient.’”

Instead of the program building upon “facts,” it was “generating more concern about the ideas and giving the ideas primary focus,” McHugh said. “And I thought that was one of the kinds of things where psychiatry has gone wrong in the past and could go wrong again — imagining things rather than knowing things.”

“We don’t know enough” about the psychiatric impact, especially on children who undergo these operations, “because we’re not spending enough time studying them,” McHugh said.

“The whole idea of doing this to children to … presumably get them to think more about what they’re experiencing has been a track towards … persuading them and has not been a good idea,” he said.

“I’ve, after all, seen a lot of young people … especially young girls, being persuaded that there are some aspects of themselves, in their body, that needs correction,” he said. “It’s really the foundation of anorexia nervosa and things of that sort.”

Children need to be “encouraged to just grow up and let their body take it,” McHugh said. “It turns out that 85% to 90% of them drop off of this. So if you don’t treat them with so-called gender affirming treatments, hormones, or surgery, they gradually give it up.”

Puberty is “a very vulnerable time … all kinds of things are changing in your body and in your mind,” McHugh said. “Once you get through puberty, a new kind of person comes to think about what life is going to be like, what they would commit themselves to.”

“Human beings are different from animals,” he said. “Animals, when they go through puberty, just become what they were from the start. Human beings have a rebirth after puberty as they think in terms of who they are, and what they would like to do. And those ideas would be best appreciated, and filled out, if you were what God made you, as it were.”

“But if you are changed, then you have to spend your life committed to this change, and defending it, rather than moving forward,” he said.

‘Many more lawsuits’ to come

McHugh has stated publicly over the years that he thought it would be lawsuits that ultimately cease the surgeries for minors.

In February, a New York jury awarded $2 million to a woman who underwent a double mastectomy at age 16 in what is believed to be the first U.S. malpractice case of its kind to reach a trial verdict.

Following the first malpractice suit, “it should be” the end of transgender surgeries for minors, McHugh said. “But there are going to be many more lawsuits coming down the pike now, as I predicted it would come.”

The “$2 million is a small thing,” McHugh said. “It’s going to be a lot higher as more and more people come to realize, and they’re going to be mostly women in their mid-20s.”

Next steps

At 94, McHugh said “I’m not retiring yet.” He added: “I’m going to see if I can go a bit further. God got me this far. Maybe he’ll carry me on another while. I’ve got wonderful grandchildren I want to see more of and see how they flourish.”

While he has no plans to retire yet, when that day comes he spoke to what he hopes his legacy is. He said: “I want people to think … that I was part of my times and that I didn’t shy away from the things that occupied the attention of my fellow Americans.”

“I think it’s really important to see that the role you have calls for certain kinds of courage. And if you don’t have that, you shouldn’t have that role. And I had some adventures. And it turns out I was right about a lot of things — that’s the fun part.”