from Gender Identity Disorders
In 1992, Dr. McHugh also published "Psychiatric Misdirections," in The American Scholar's Autumn issue.
The noted psychiatrist warned in his essay that psychiatry had succumbed to numerous cultural fads in the 1960s that were misdirections of thought and practice. He observed:
I have witnessed the power of cultural fashion to lead psychiatric thought and practice off in false, even disastrous, directions. I have become familiar with how these fashions and their consequences caused psychiatry to lose its moorings. Roughly every ten years, from the mid-1960s on, psychiatric practice has condoned some bizarre misdirection, proving how all too often the discipline has been the captive of the culture.
Dr. McHugh says that one of the most conspicuous misdirections was the dismissal of patients with severe and chronic mental disorders from mental hospitals. Such actions were defended as bringing "freedom" to these individuals. An anti-psychiatry school of thought depicted mental institutions as medically useless and self-serving institutions.
Sex Reassignment Surgery
Another misdirection, notes McHugh, was the use of sex reassignment surgery to allegedly help those individuals who felt they were trapped in the wrong body. According to McHugh, "I happen to know about this [sex reassignment surgery] because Johns Hopkins was one of the places in the United States where this practice was given its start. It was part of my intention, when I arrived in Baltimore in 1975, to help end it."
According to McHugh, when dealing with a patient who wants a sex change operation, "It is not obvious how this patient's feeling that he is a woman trapped in a man's body differs from the feeling of a patient with anorexia nervosa that she is obese despite her emaciated, cachectic state. We don't do liposuction on anorexics. Why amputate the genitals of these poor men? Surely, the fault is in the mind not the member."
McHugh says psychiatrists have an obligation to prevent such sadness, "... indeed horror. We have to learn how to manage this condition as a mental disorder when we fail to prevent it." Psychiatrists, warns McHugh, should not give in to the idea that they should approve of sex change operations instead of treating the mind. "As physicians, psychiatrists, when they give in to this, [they] abandon the role of protecting patients from their symptoms and become little more than technicians working on behalf of a cultural force."