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from Clinical/Therapeutic Issues
Johns Hopkins Psychiatrist Urges
End To Sexual Reassignment Surgery
December 2, 2004 - Dr. Paul McHugh, University Distinguished Service
Professor of Psychiatry at Johns Hopkins University, urges that psychiatrists
put an end to sexual reassignment surgery (SRS) for individuals with gender
identity confusion.
McHugh's remarks were published in the November, 2004, issue of First Things.
Writing in "Surgical Sex," the professor notes that Johns Hopkins University was
a pioneer in SRS beginning in the early 1970s. The prevailing theory at the time
was that while sex was genetically determined at birth, the concept of gender
was culturally shaped and malleable and that being female or male were
interchangeable.
Dr. McHugh became psychiatrist-in-chief at the university in 1975 and decided
that it would be useful to have follow-up studies on individuals who had
undergone SRS at the facility. He wanted to test the claim that men who had
undergone SRS had found a resolution for their general psychological problems
and wanted to see if male infants with ambiguous genitalia who were raised as
girls could easily settle into the female identity chosen for them by the
surgeons.
To accomplish these two goals, he encouraged a fellow psychiatrist, Jon Meyer,
to follow up on those having sex change operations. He found that most of the
patients were content and only a few regretted it, but their psychological
condition was little changed.
A study of similar subjects at Clark Institute in Toronto had found that many of
these men described themselves as lesbians to psychiatrists because they were
sexually attracted to women. "... I concluded that to provide a surgical
alteration to the body of these unfortunate people was to collaborate with a
mental disorder rather than to treat it," said McHugh.
Another psychiatrist, William G. Reiner, conducted follow-up studies on boys who
were raised as girls. Reiner found that these re-engineered males were almost
universally uncomfortable with the female role assigned them and many wished to
revert to male status once they discovered the truth about themselves. Reiner's
findings were published in the January 22, 2004 issue of the New England Journal
of Medicine.
Dr. McHugh says that his research led Johns Hopkins to stop offering SRS for its
patients, "... much, I'm glad to say, to the relief of several of our plastic
surgeons who had previously been commandeered to carry out the procedures." He
observes: "Having looked at the Reiner and Meyer studies, we in the Johns
Hopkins Psychiatry Department eventually concluded that human sexual identity is
mostly built into our constitution by the genes we inherit and the embryogenesis
we undergo."
McHugh says "I have witnessed a great deal of damage from sex-reassignment. The
children transformed from their male constitution into female roles suffered
prolonged distress and misery as they sensed their natural attitudes. ... We have
wasted scientific and technical resources and damaged our professional
credibility by collaborating with madness rather than trying to study, cure, and
ultimately prevent it."
He urges that psychiatrists discourage individuals from seeking sexual
reassignment surgery.
Updated: 8 February 2008
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