Ética y Derecho
Posted insex & society Interrogating the transgender agenda
A psychiatrist questions the scientific and medical basis for current treatments of gender dyphoria.
by Paul McHugh Jun 1, 2020 / 19 mins / 42
Dr Paul McHugh is one of America’s leading psychiatrists. The article below is his testimony to the US Supreme Court in the case of R.G. & G.R. Harris Funeral Homes Inc. v. Equal Employment Opportunity Commission.
An employee of the funeral home, Aimee Stephens, decided to transition from a man to a woman in 2013. Her employer sacked her. Stephens sued. The case rose steadily through the courts. Although Stephens died of kidney disease last month at the age of 59, her estate is carrying on the lawsuit.
This is a very significant case. At stake is whether bans on sex discrimination in the United States also include discrimination on the basis of sexual orientation and gender identity. Dr McHugh’s expertise is helpful in questioning a so-called scientific imperative for gender affirmation. (Footnotes and references have been removed and the text has been slightly abridged.)
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Sex refers to the two halves of humanity, male and female. It is well defined based on the binary roles that males and females play in reproduction. “In biology, an organism is male or female if it is structured to perform one of the respective roles in reproduction. This definition does not require any arbitrary measurable or quantifiable physical characteristics or behaviors, it requires understanding the reproductive system and the reproduction process.”
The structural difference for the purpose of reproduction is the only “widely accepted” way of classifying the two sexes. “This conceptual basis for sex roles is binary and stable, and allows us to distinguish males from females on the grounds of their reproductive systems, even when these individuals exhibit behaviors that are not typical of males or females.”
Sex is not and cannot be “assigned at birth,” despite the assertions of the American Medical Association (AMA), the American Psychiatric Association (APA), and Respondents. The language of “assigned at birth” is purposefully misleading and would be identical to an assertion that blood type is assigned at birth. Yes, a doctor can check your blood type and list it. But blood type, like sex, is objectively recognizable, not assigned. In fact, the sex of a child can be ascertained well before birth.
“Gender identity” has no bearing on a male’s or a female’s sex. Stephens [legal team] maintains that, although in every biological and physiological way a man, Stephens is really a woman. Stephens felt a deep affinity towards things that are culturally and stereotypically associated with girls. But Stephens was not, and is not, a girl no matter how many of the stereotypes about girls Stephens adopts and no matter how deeply Stephens believes that affinity for those stereotypes about females transforms Stephens into a female.
A boy mind in a girl body?The “popular notion regarding gender identity” that says a person has a “boy mind in a girl body” or vice versa is merely an idiom used by a person seeking to describe some type of distress to others. Just as we have seen before during the height of the discredited multiple personality disorder era, such testimonials are not truth, even if one asserts it as a truth claim. Such a “view implies that gender identity is a persistent and innate feature of human psychology.” But based on “the neurobiological and genetic research on the origins of gender identity, there is little evidence that the phenomenon of transgender identity has a biological basis.” There are problems with the methodological limitations of any imaging study that assesses “girl brain” and “boy brain” theories:
[I]t is now widely recognized among psychiatrists and neuroscientists who engage in brain imaging research that there are inherent and ineradicable methodological limitations of any neuroimaging study that simply associates a particular trait, such as a certain behavior, with a particular brain morphology. (And when the trait in question is not a concrete behavior but something as elusive and vague as “gender identity,” these methodological problems are even more serious).
[Therefore] there are no studies that demonstrate that any of the biological differences being examined have predictive power, and so all interpretations, usually in popular outlets, claiming or suggesting that a statistically significant difference between the brains of people who are transgender and those who are not is the cause of being transgendered or not — that is to say, that the biological differences determine the differences in gender identity — are unwarranted. In short, the current studies on associations between brain structure and transgender identity are small, methodologically limited, inconclusive, and sometimes contradictory.
In short, science does not support the notion that gender identity is an innate, immutable physical property of human beings. One’s sense of self and one’s desire to present to others as a member of the opposite sex have no bearing whatsoever upon the objective biological reality that one is male or female.
Even if evidence existed that brain studies showed differences, which they do not, it would not tell us whether the brain differences are the cause of transgender identity or a result of identifying and acting upon their own stereotypes about the opposite sex, through what is known as “neuroplasticity.”
Regardless of the extent transgender identities and aspects of the brain could correlate in some way, none of this speaks to the question of biological sex. Even if there was a biological basis for people to think they’re the opposite sex, that does not make them so.
No matter how difficult the condition of gender dysphoria may be, nothing about it affects the objective reality that those suffering from it remain the male or female persons that they were in the womb, at birth, and thereafter – any more than an anorexic’s belief that she is overweight changes the fact that she is, in reality, slender.
Gender identity is not immutable, but is based on persons’ beliefs associating themselves with whatever stereotypes they have about people of the opposite sex. It is a subjective perception not limited to the two sexes, but expands to categories other than male or female. Contrarily, sex is not a belief. It is an objective and scientifically demonstrable reality.
Stephens, as well as the APA and AMA, asserts that “everyone has a gender identity, which is ‘one’s internal, deeply held sense of gender.’” The APA’s and the AMA’s proffered descriptions of gender identity operate, in all essentials, analogous to a religious belief system. But neither the sincerity of a religious belief nor the sincerity of a person’s beliefs about gender identity determine reality. Even the Sixth Circuit noted that gender identity has an “internal genesis that lacks a fixed external referent,” and much like religion, should be “authenticat[ed]” through professions of identity rather than “medical diagnoses.” But because it is more like a belief system, it does a great disservice to everyone, those suffering with gender dysphoria and others who are affected, to treat gender identity like sex. A person is either a man or a woman, regardless of what anyone — including that person — happens to believe.
Sex is not a social constructSome of the errors described above may have led to the Sixth Circuit’s mistaken conclusion that employers that have sex-specific policies based on their employees’ sex instead of their gender identity “necessarily” rely on “stereotypical notions of how sexual organs and gender identity ought to align.” However, the exact opposite is true. Gender identity is a social construct that stands in contradistinction to sex. The biological reality of sex is not a stereotype or social construct.
The irony of course is that labeling sex itself as an illicit stereotype turns everything on its head and actually elevates stereotypes as a reason to treat members of the same sex differently. An employer that has sex-specific policies would be treating all employees equally based on their sex. But, an employer who instead, had “gender identity-specific” policies, would by definition be treating employees of the same sex differently, and basing the different treatment on socially constructed sex stereotypes.
Sex matters in various contexts. Getting the definition wrong affects those areas. If the definition of “sex” is rewritten to mean “gender identity,” doing so both deconstructs the meaning of “sex” and undermines the ability to account for those situations where the distinctions between the two halves of humanity matter.
In addition to bodily privacy in locker rooms, restrooms, and changing facilities (where sex distinctions are crucial based on the bodily differences between the sexes, which accounts for separate facilities in the first place) or the ability to maintain competitive athletic environments for females (again due to bodily differences), we must maintain both the language and the legal construct to recognize sex in other settings such as where strip searches must occur. An inability to do so will put those being searched — including children — in situations where a person of the opposite sex (who identifies with their sex) conducts the search.
Similarly, if we are to disconnect sex from our anatomical differences, other unreasonable demands will be made of persons, such as beauticians in the business of waxing being asked to wax the genitals of a man who identifies as a woman. Even our understanding of sexual orientation is based on sex, not gender identity. Because distinctions based on sex matter in myriad contexts (many of which may only be discovered as the consequences of this experiment unfold), this Court should be slow to muddle the definitions of sex and gender identity.
Treating gender dysphoriaWhile this case involves the question of whether the term “sex” in federal law means gender identity or includes gender identity, the AMA asks the Court to consider the policy implications, namely the notion that protections under Title VII are necessary to advance the treatment goals of those with gender dysphoria. It claims that science shows that transgender individuals benefit from being affirmed in their beliefs about their sex, from social transition, from hormonal interventions, and from surgeries.
However, these professional associations rely on mere testimonials rather than evidence-based medicine. They treat the supposed benefits of gender affirmation as fact, rather than a clinical judgment call. And we ought not make policy decisions in the name of science when the kind of evidence necessary to support these “treatments” simply does not exist. Instead, those who are affirmed in their gender beliefs progress from social transition to surgical interventions at their peril. Indeed, if the evidence shows us anything, it indicates that those who progress all the way through surgery fare poorly.
Gender affirmation and social transitionThe AMA suggests that the many difficulties that are sadly experienced by those who identify with the opposite sex are caused by social stigma. What is necessary, they claim, is that those with gender dysphoria be affirmed in their beliefs. From there, the protocol calls for three phases: (1) social transition, (2) hormone therapy, and (3) surgical interventions.
However, subjecting gender dysphoric persons to this protocol is risky because there is little evidence that social transition is the panacea that the AMA makes it out to be. Often it is a self (or therapist) fulfilling prophecy. Worse, gender affirmation does not end with social transition, but leads to medical and surgical interventions. Even the World Professional Association for Transgender Health (WPATH) itself admits that “no controlled clinical trials of any feminizing/masculinizing hormone regimen have been conducted to evaluate safety or efficacy in producing physical transition.”
Moreover, some patients wish to detransition, and “the potential that patients undergoing medical and surgical sex reassignment may want to return to a gender identity consistent with their biological sex suggests that reassignment carries considerable psychological and physical risk.” This also “suggests that patients’ pre-treatment beliefs about an ideal post-treatment life may sometimes go unrealized.”
This protocol begins with the notion that gender affirmation is necessary in order to avoid social stigma. And while we should all agree that all persons should be treated with respect, blame should not be laid at the feet of friends, relatives, or co-workers who believe that social transition may not be in a person’s best interest. In fact, even in environments that are fully supportive of transition, “a large number of people who have the surgery . . . remain traumatized — often to the point of committing suicide.”
The most thorough follow-up of sex reassigned people — extending over thirty years and conducted in Sweden, where the culture is strongly supportive . . . documents their lifelong mental unrest. Ten to 15 years after surgical reassignment, the suicide rate of those who had undergone sex- reassignment surgery rose to 20 times that of comparable peers. Clearly poor outcomes cannot be blamed on lack of acceptance.
Contrary to what the AMA proposes, there is insufficient evidence that any phase of treatment is helpful. Instead, some studies suggest that not following the protocol may have more positive results. It is unacceptable to have lower standards of care for a group already at a far greater risk for psychological problems and suicide. Doctor Susan Bewley told the BBC in a Newsnight special that “We must not miss the opportunity to do good research now, helping . . . concerned clinicians actually deal with the uncertainty of what they’re doing.”18
Failing to address root issuesPrevious editions of the American Psychiatric Association’s Diagnostic & Statistical Manual of Mental Disorders, as recent as 2013, listed “gender identity disorder” rather than “gender dysphoria.” And until recently, clinical distress was not a part of the diagnosis criteria, indicating professional concern for anyone who manifests an incongruence between biological sex and gender identity — not just those who experience distress.
People who identify as transgender “suffer a disorder of ‘assumption’ like those in other disorders familiar to psychiatrists.” “The ‘disordered assumption’ of those who identify as the opposite sex . . . is similar to the faulty assumption of those who suffer from anorexia nervosa, who believe themselves to be overweight when in fact they are dangerously thin.”
Dr Anne Lawrence, who is transgender, has argued that body integrity disorder, which involves a person who identifies as disabled and feels trapped by a fully functional body, draws parallels to gender dysphoria. Dr. Josephson describes this type of phenomenon as a “delusion . . . [to] a fixed, false belief which is held despite clear evidence to the contrary.”
To illustrate in another way, someone with anorexia may feel overweight and know that they are not. As a result, they struggle with their feelings until they come to believe that they are fat. Similarly, someone with gender dysphoria begins by feeling like they are the opposite sex but know they are not. They then struggle with those feelings until they come to believe they are the opposite sex and try to act accordingly.
Yet, just as you would not treat an anorexic person’s delusion by helping that person to lose weight, it is unwise to treat a gender dysphoric person’s delusion by encouraging them to indulge in that falsehood. When false beliefs about reality are not addressed by helping people come to accept reality, their false beliefs “are not merely emotionally distressing . . . but also life-threatening.” Treatment should “assess and guide them in ways that permit them to work out their conflicts and correct their assumptions.”
Instead, some in the scientific community want gender dysphoric individuals to “find only gender counselors who encourage them in their sexual misassumptions.” Indeed, there are no other health issues where doctors modify healthy bodies to align with a mind’s misperception or where they would call a healthy body a “birth defect” rather than working with the mind to accept bodily reality.
A more appropriate treatment would be to show gender dysphoric individuals that feelings are not the same as reality. “Psychiatrists obviously must challenge the solipsistic concept that what is in the mind cannot be questioned.”
“Disorders of consciousness, after all, represent psychiatry’s domain; declaring them off- limits would eliminate the field.” Indeed, when treatment is focused on helping patients align their subjective gender identity with their objective biological sex by use of normal counseling methods such as talk therapy, gender dysphoria has proven to be significantly reduced.
Given the harms of the next two phases of the WPATH protocol, social transition should not be encouraged. Not only does it not address the root issues causing clinical distress, it also makes it more likely for patients to forge ahead into hormone therapy and physical alteration of their body.
The harm of hormone therapyHormone therapy has not been proven to improve the overall quality of life or reduce psychological symptoms or other negative outcomes. At best, the scientific data is inconclusive. At worst, it is harmful.
Hayes Inc., a company which focuses on “unbiased” “evidence-based assessments of health technologies and clinical programs to determine their impact on patient safety,” gave the quality of evidence for hormone treatment its lowest possible rating. The Hayes Directory explains that some groups advocate for hormonal treatments as “medically necessary treatments.” However, these treatments do “not readily fit traditional concepts of medical necessity since research to date has not established anatomical or physiological anomalies associated with [gender dysphoria].”
After reviewing 21 studies, the Hayes Directory concluded that the studies “were inconsistent with respect to a relationship between hormone therapy and general psychological health, substance abuse, suicide attempts, and sexual function and satisfaction.” For quality of life, “[d]ifferences between treated and untreated study participants were very small or of unknown magnitude,” suggesting little evidence of effectiveness.
Alarmingly, and contrary to the AMA’s and the APA’s narrative, the Hayes Directory reports that the studies show the prevalence of suicide attempts was not affected by hormone therapy.
Additionally, hormone therapy increased risk of cardiovascular disease, cerebrovascular and thromboembolic events, osteoporosis, and cancer. No proof of improved mortality, suicide rates, or death from illicit drug use was observed.
Similarly, in 2010, Mohammad Hassan Murad of the Mayo Clinic studied the body of research involving the outcomes of hormonal therapies used in advance of sex reassignment procedures. He found there to be “very low quality evidence” that hormonal interventions “likely improve gender dysphoria, psychological functioning and comorbidities, sexual function and overall quality of life.”
Without well-designed studies that provide conclusive results that treatments designed to block natural maturation of the body are helpful, public policy should not be used to mandate the kind of gender affirmation that result in such treatments.
The harm of sex reassignment surgeryScientific support for sex reassignment surgery is equally lacking. After one of the first studies addressing the efficacy of surgical transition occurred in 1979, Johns Hopkins Medical Center discontinued surgical intervention. A study performed by Jon K. Meyer and Donna J. Reter found that when individuals who underwent sex reassignment surgery reported improvement, it did not rise to the level of statistical significance, but those who opted not to undergo sex reassignment surgery showed statistically significant improvement. Those authors concluded that “sex reassignment surgery confers no objective advantage . . . .”
Other studies have shown negative consequences. In a study performed by Cecilia Dhejne with the Karolinska Institute and Gothenburg University in Sweden, it was found that “transsexual individuals had an approximately three times higher risk for psychiatric hospitalization than the control groups, even after adjusting for prior psychiatric treatment.” “[M]ost alarmingly, sex reassigned individuals were 4.9 times more likely to attempt suicide and 19.1 times more likely to die by suicide compared to controls.”
In 2009, a longitudinal study performed by Annette Kuhn in Switzerland found that over a 15-year period the quality of life for 55 sex-reassigned individuals was “considerably lower” than females who had pelvic surgery for other reasons. Moreover, “none of the studies included the bias-limiting measures of randomization . . . and only three of the studies included control groups.” While the Mayo Clinic report indicated that 80% of sex reassigned patients reported improvement in gender dysphoria, 78% improvement in psychological symptoms, and 80% improvement in quality of life, none of the studies included the bias-limiting measure of randomization or control groups. Thus, the claim that improvement occurred after surgical transition is merely comprised of testimonials.
Another Hayes Directory report, this time addressing surgical interventions, concluded that there is not good scientific evidence to support surgical modifications. It concluded that the “evidence was too sparse to allow any conclusion regarding the comparative benefits of different [sex reassignment surgery] procedures.”The “very low” quality of evidence was “due to limitations of individual studies, including small sample sizes, studies lacking evaluating any one outcome, retrospective data, lack of randomization, failure to “blind outcome,” lack of a control or comparator group, and other problems. Unbiased assessment of the claims leads to the following conclusion:
The scientific evidence summarized suggests we take a skeptical view toward the claim that sex reassignment procedures provide the hoped-for benefits or resolve the underlying issues that contribute to elevated mental health risks among the transgender population. While we work to stop maltreatment and misunderstanding, we should also work to study and understand whatever factors may contribute to the high rates of suicide and other psychological and behavioral health problems among the transgender population, and to think more clearly about the treatment options that are available.
There is no good evidence that this dramatic surgery produces the benefits espoused by the AMA. There is, however, evidence that surgical modification poses health risks.20 Moreover, one unalterable consequence is that anyone who goes through with “sex change” surgery will be sterilized. Without firm scientific evidence, the medical and psychiatric community should not follow the WPATH protocol to progress from social transition, to medical interventions, and ultimately to surgery, which therefore calls into question the AMA’s claim that government policy should require persons to affirm others’ beliefs that they are the opposite sex.
Other proceduresAnother Hayes Directory report reviewed all the relevant literature on ancillary procedures and services for the treatment of gender dysphoria, such as voice training, facial modifications, reduction of the Adam’s apple, and other cosmetic surgeries to feminize or masculinize features. These too do “not readily fit traditional concepts of medical necessity since research to date has not established anatomical or physiological anomalies associated with [gender dysphoria].”
As with its conclusion on hormone therapies as well as surgical modifications, the Hayes Directory gave the scientific support for these treatments its lowest possible rating. The studies not only had limitations such as small sample sizes, separating procedures by category, and a lack of control or comparator group, they also measured “technical success and patient satisfaction” while ignoring “overall measure of well-being.” In fact, the Hayes Directory found that the “overall individual well- being is unknown.”
In conclusion, relevant to the Court’s present concern, the AMA’s suggestion that gender identity should be read into sex protections in furtherance of treatments goals for those suffering from gender dysphoria is misplaced. Given that the stated goal of transitioning people with gender dysphoria to their identified gender is to improve their overall well- being, altering a person’s body, sometimes permanently, should not be done without solid scientific evidence of its benefits. Since the known studies only measure self-reported satisfaction with the aesthetic result, and not improved quality of life, mental state, or overall well-being, these procedures should not be recommended treatment.
How about children?… If this Court, for policy reasons, were to redefine sex to mean gender identity, that definition will impact children in educational settings. Indeed, such an interpretation has been used to force some schools to open privacy facilities to the opposite sex. Such an approach not only subjects students to sexual harassment through the systematic loss of bodily privacy, but such treatment is actually contraindicated for those children who suffer from gender dysphoria.
Gender dysphoric children subjectively feel they are the opposite sex based on what they think it is like to be the opposite sex. Other than in this area, children who have persistent beliefs that do not conform with reality are not encouraged to persist in those beliefs. In the same way, counselors should assess and guide those with gender dysphoria in ways that permit them to work out their conflicts and correct their false assumptions.
Until recently when ideological imperatives took the place of scientific evidence, this is precisely what was done for gender dysphoric children. Dr. Kenneth Zucker, a leading authority on gender dysphoria, successfully helped children through psychosocial treatments like talk therapy, organized play dates, and family counseling. A follow-up study revealed that only 3 of 25 female children continued to struggle with gender dysphoria.
In contrast to the belief that we and our children are best served by observing and cooperating with our observable biological reality, the AMA and the APA say that children who suffer from gender dysphoria can relieve that dysphoria through social transition, puberty blockers, cross-sex hormones, and eventually surgically altering sex-based anatomy to look like that of the opposite sex. This progression, however, is unhelpful since children who identify with the opposite sex but who are allowed to go through puberty without puberty blockers and cross-sex hormones cease identifying with the opposite sex 70% to 98% of the time for males and 50% to 88% of the time for females.
Conversely, when children are encouraged to progress through social transition to puberty blockers, they tend to persist with their dysphoria. Yet no longitudinal, controlled studies support gender-affirming treatments for gender dysphoria. The problem is that while some persons who go through all these stages may report satisfaction with an eventual surgery, they may still suffer the same morbidities and experience startlingly high rates of suicide and attempted suicide.
Not only does the progression from affirmation to surgery result in increased psychological problems, but the evidence is insufficient to suggest that each step along the way is safe and efficacious. While affirming a child’s gender identity may appear a compassionate way to help a child during a painful and confusing experience, it is not.
There is an obvious self-fulfilling nature to encouraging young [gender dysphoric] children to impersonate the opposite sex and then institute pubertal suppression. . . . All of his same-sex peers develop into young men, his opposite sex friends develop into young women, but he remains a pre-pubertal boy. He will be left psycho-socially isolated and alone.
Repetition affects the structure and function of the brain through what is called neuroplasticity. Thus, children who are encouraged to live as the opposite sex may be increasingly unable to live as their own sex. As a result, some children who would otherwise overcome their gender dysphoria may be unable to do so.
Puberty blockers pose other health risks. For example, they impair bone growth, decrease bone accretion, interfere with brain development, and impair fertility.
Rather than encouraging the progression through these stages, children would be better served at the very first stage by not encouraging their belief that they are the opposite sex. If they are allowed to progress through puberty, the issues of gender dysphoria naturally resolves the vast majority of the time. Therefore, a more cautious approach, supplemented by individual or family psychotherapy would be most compassionate. In short, the notion that science requires gender affirmation, and thus for policy reasons gender identity should be read into the word “sex” is misplaced.
Activism, not medicineWe should treat everyone with dignity and respect, but there is significant disagreement in the particulars of what is helpful to those identifying as transgender and what should be asked of others in the process. Though some research has been conducted regarding treatment of those who identify as transgender, when “research touches on controversial themes, it is particularly important to be clear about precisely what science has and has not shown.”
As discussed above, the existing studies on treatment of and outcomes for transgender persons are poor support for gender affirmation or the progression to medication or surgery, yet the large medical associations like the AMA and APA ardently endorse these practices. Unfortunately, ideology rather than science is driving the support. And since dissent is systematically eliminated and those who disagree are loudly condemned, the kind of research necessary to inform the public debate is not occurring.
“Consensus” in the scientific community is more contrived than scientific. “Mainstream clinicians and scientists who consider gender discordance to be a mental disorder have been deliberately excluded in the makeup of the steering committees of academic and medical professional societies which are promulgating guidelines that were previously unheard of.” Id. For instance, when the Endocrine Society created its guidelines, “the panel selected included only those who supported the emerging practices and attempts by many of the endocrinologists present to raise concerns were muted.”
The American Psychiatric Association, in the most recent edition of DSM, removed gender identity disorder and replaced it with gender dysphoria.
“Changes in diagnostic nomenclature in this area were not initiated through the result of scientific information but rather the result of cultural changes fueling political interest groups within professional organizations.” Naturally, considering identity with the opposite sex to be a mental disorder is incompatible with social affirmation. Therefore, the nomenclature was changed so that only the anxiety caused by the incongruity between sex and identification is considered to be a disorder.
Yet, since we would neither affirm a person who believed themselves disabled when they have a fully functional body nor suggest surgeries to disable such persons to conform their bodies to their beliefs, we should carefully consider the approach we take concerning persons’ subjective beliefs about their sex.
Indeed, if something conflicts with our understanding of biological facts, is inconsistently applied, and defies common sense, we should demand more evidence to suggest that these factors are all pointing the wrong direction. The support for gender affirmation, medications, and surgery come from testimonials, but that is not evidence. It would be akin to asking consumers if they are satisfied with their vehicles, and publishing those testimonies, claiming it to be evidence of quality or reliability. It is not as if we do not know how to get good data, such as with control studies, but we refuse to conduct good science or follow the science — and that has everything to do with activism and ideology — not good medicine.
As confirmation of the power of activism over science, those who follow the science are often shut down. Consider Lisa Littman, Assistant Professor of the Practice of Behavioral and Social Sciences at Brown University, who coined the phrase “rapid onset gender dysphoria.” She made the observation based on various parental reports that those who identify as transgender during or after puberty appear to have underlying and preexisting psychiatric conditions, and she called for more research. After members of the transgender community criticized the research, Brown quickly distanced itself. And ultimately, she lost a consulting job due to the research.
Jeffrey S. Flier, M.D., former dean of Harvard Medical School, wrote, “I have never once seen a comparable reaction from a journal within days of publishing a paper that the journal already had subjected to peer review, accepted and published. One can only assume that the response was in large measure due to the intense lobbying the journal received. . . .”
Similarly, Dr. Kenneth Zucker, a leading expert on gender dysphoria in children, who headed the Child Youth and Family Gender Identity Clinic in Toronto, was removed from his clinic on baseless charges and the clinic shut down. Zucker helped to write the “standards of care” guidelines for the WPATH and led the group that developed criteria for gender dysphoria used in DSM-5. But as others increasingly pushed gender affirmation and social transition, Zucker’s clinic continued to be cautious, suggesting that it was better to “help children feel comfortable in their own bodies,” since it recognized the malleable nature of gender identity in children and the likelihood that it will resolve. Activists saw this as a rejection of children’s gender identities.
As a result, the parent organization running the gender identity clinic interviewed activists and clinicians critical of the clinic and fired Zucker and shut down the clinic based on false claims. Yet for the many families who benefited from Zucker’s work and others who would benefit, “a sustained campaign of political pressure” took away their options to find help feeling comfortable with their own bodies.
This, of course, was not the first time science took the back seat in the practice of medicine. Trendy diagnoses and treatments have lead us astray in the past. The practices of eliciting alternative personalities from patients as well as lobotomy had many testimonials about their benefits to patients, but testimonials do not form the substance of evidence- based medicine. Thus we should be especially cautious when activism or ideology has the upper hand over science.
Ultimately, poor science exacerbated the suffering of those treated by lobotomy or diagnosed with multiple-personality disorders in the past, and appears to be doing the same with those suffering from gender dysphoria today.
As a matter of science, sex and gender identity are so distinct that gender identity cannot properly be read into or replace sex. And with regard to the underlying policy question, there is no reliable evidence that gender affirmation — understood as asking or requiring persons to affirm others’ beliefs that they are the opposite sex — is efficacious.
The original text of Dr McHugh’s essay may be consulted HERE.
Paul McHugh
Dr. Paul McHugh, M.D. is the University Distinguished Service Professor of Psychiatry at the Johns Hopkins University School of Medicine. From 1975 until 2001, Dr. McHugh was the Henry Phipps Professor... More by Paul McHugh
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Barend Vlaardingerbroek • 10 months ago
What comes through strongly in the discussion below is that people can be remarkably critical when science does not concur with their personal view (derived from non-empirical axioms) but are willing to suspend that critical thinking faculty when it does. Both sides are equally guilty of that.
Ultimately, it's not about science at all but about value judgments.Thank you Dr. McHugh for all of your good work. It is nice to see you clearly show how science is opposed to the trans ideology.
Andy Dixon-Smith • 10 months ago
I find it remarkable that so many people are advocating medical and surgical intervention as the 'cure' for a mental illness. It is akin the telling a schizophrenic that 'I can hear the voices too'...
leona marshall • 10 months ago
It's a bit off to terminate someone's employment solely because they came out as transgender. No matter your views on transgender people, it doesn't mean they cannot do any task of their job.
David Cary Hart • 10 months ago
I would barely know where to begin considering the many misstatements in this religion-inspired diatribe. McHugh is a master at selective observation.
Nevertheless:
Does [McHugh's] report actually offer alternatives? Because I don’t know of anybody who’s discovered a way to actually talk a transgender person out of their gender dysphoria.
Dr. Jack Drescher
Member, APA’s DSM-5 Workgroup on
Sexual and Gender Identity DisordersAs for Lisa Littman, she was clearly out of her depth and she used — not just a convenience sample — a sample of anonymous parents culled from transgender denial websites who completed online questionnaires.
The correction issued by PLOS-One speaks for itself. People will continue to manufacture victims an an attempt to demonstrate that people are transgender for political reasons.
People become transgender to mitigate the effects of gender incongruity and there is a mountain of peer-reviewed research demonstrating that gender-affirmed individuals, with family support, have levels of anxiety and depression at or near those experienced by their cisgender peers.
Finally, gender dysphoria is a medical condition. It is not an ideology. Saying otherwise is intellectually dishonest.
aussiej > David Cary Hart • 10 months ago
"Finally, gender dysphoria is a medical condition. It is not an ideology. Saying otherwise is intellectually dishonest" Just keep saying that to yourself, that's how ideology works... Why you would not want to try less invasive methods first, particularly on children? Why would anyone want to subject their child to untested, body altering puberty blockers, when maybe the thoughts are just a stage that CAN be talked through. The idea that a child knows best is rubbish.
Joan_A > David Cary Hart • 10 months ago
Dr McHugh clearly identifies the reproductive organs that differs a male from a female. This is biologically correct. At what embryological age does the development of these distinctive features begin to develop? How does it begin? How many sex specific hormone receptor sites that sit on either the xx chromosomes or the xy chromosomes have been discovered by scientists in the past decade. Gender dysphoria is a mental illness that has developed into an ideology by those who know so little about embryological facts. No amount of cross sex hormone therapy or surgical intervention can make a man become a woman or a woman become a man.
This comment was deleted.
Joan_A > Guest • 10 months ago
Like every good Marxist, you attack the person rather than the work he has done.
McHugh is either lying or doesn't understand what he's reading. You see where he refers to a study at the Karolinska Institute? The title of that study is: "Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden" (Google it and you can read the whole thing). It was a study headed by a scientist called Cecilia Dhejne.
Now Google "Fact check: study shows transition makes trans people suicidal" and that will take you to an interview with the scientist herself in which she explains why people like McHugh have completely misunderstood what the study says.
Essentially, the study compares transitioned trans people to people who aren't trans - it doesn't compare transitioned trans people to trans people who haven't transitioned. Scroll down the study itself and you will see this very clear caveat:
" It is therefore important to note that the current study is only
informative with respect to transsexuals persons health after sex
reassignment; no inferences can be drawn as to the effectiveness of sex
reassignment as a treatment for transsexualism. In other words, the
results should not be interpreted such as sex reassignment per se increases
morbidity and mortality."So McHugh either hasn't read the study he's quoting, or he has read it and doesn't understand it, or he does understand it but he's lying about it because it doesn't support his position. You can choose which ever you prefer, but every option paints him as a poor scientist.
If you want to read what the actual science says, Cornell University have analysed all the studies into trans outcomes written in English since 1991. That's a total of 55 studies. Their conclusion? Here:
"This search found a robust international consensus in the peer-reviewed
literature that gender transition, including medical treatments such as
hormone therapy and surgeries, improves the overall well-being of
transgender individuals. The literature also indicates that greater
availability of medical and social support for gender transition
contributes to better quality of life for those who identify as
transgender."If you want to read the studies yourself - they are all available, just Google "What does the scholarly research say about the effect of gender transition on transgender well-being"
faith kuzma > Wakame • 10 months ago
Wakame here is the brief take from the article above:"Other studies have shown negative consequences. In a study performed by Cecilia Dhejne with the Karolinska Institute and Gothenburg University in Sweden, it was found that “transsexual individuals had an approximately three times higher risk for psychiatric hospitalization than the control groups, even after adjusting for prior psychiatric treatment.” “[M]ost alarmingly, sex reassigned individuals were 4.9 times more likely to attempt suicide and 19.1 times more likely to die by suicide compared to controls.” In other words, health outcomes are not really improved.by surgery because there is 5 times a likelihood of suicide attempts when compared to controls. Not good for those treated--which is the category of interest (not prevention).
Al Brennan > faith kuzma • 10 months ago • edited
But our tendentious friend above is only looking for the evidence which supports his already predetermined conclusion. Academics worth more than 2 bob usually look at the evidence and then form their conclusion.
Elizabeth Nolan > Wakame • 10 months ago
55 studies in 29 years
Joan_A > Elizabeth Nolan • 10 months ago
Not a single one of these studies have been clinically proven. What has been identified by the manufacturers is that cross sex hormones that are applied to a transgender person for their lifetime are clinically dangerous.
faith kuzma > Elizabeth Nolan • 10 months ago
Wakame also mentions the Cornell study--the one often cited is anonymous, misleading, and deceptive study called: "What does the scholarly research say about the effect of gender transition on transgender well-being?"
https://whatweknow.inequali...
This study starts with a far too generalized a research question for the scope of review it presents, one that would entail a much more extensive overview of available research than the pro-WPATH studies cited. As a result, readers can and do conclude research exists to support the presumed beneficial health outcomes of transitioning.
The Cornell study, which never underwent peer review, purports to do a systematic review of research in order to demonstrate good outcomes for those choosing to transition from their natal sex. Embarrassingly, the study does not pass muster when evaluated according to AMSTAR 2 guidelines or the PRISMA checklist it references. Moreover, this systematic review lacks legitimate critique of the studies cited, merely assembling abstracts and presenting rosy findings. It's really egregious that such a lame study remains posted in the Cornell website.
Claire Teasedale • 10 months ago
This is a skewed perspective by a psychologist who has been widely discredited. John Hopkins, as an institution, is no longer associated with McHugh, and I think it’s for good reason. McHugh’s commentary on trans people over the years has been motivated, I believe, more by his religious convictions to propagandize against trans people. In other words, his position here serves his religiously motivated politics, rather than his duty as a man of science or as a mental health professional.
His explanation here ignores gender identify, and focuses on chromosomal sex as the only aspect of a person’s biology. He asserts that this is all that matters in the formation of a person’s male or female identity. This is simply not true, and ignores the evidence from neuroscience concerning gender. McHugh dismisses such science as inconclusive or “limited,” but his invalidation of trans people ignores the more complex scientific picture of gender that scientists have come to understand in the more than 100 years of scientific study that has been conducted since sex chromosomes were first discovered in 1905. McHugh, however, speaks as though nothing of significance has been learned since 1905. McHugh is oversimplifying human knowledge of human identity in order to support his own socially constructed, religiously
biased need for conformity to a strict binary.True: most people do have a chromosomal sex, assigned gender, and gender identity in the brain that align, putting them clearly on one side of the binary or the other (clearly male or clearly female). But as intersex people clearly demonstrate, this isn’t always the case, and for McHugh to falsely oversimplify biological sex and gender in order to invalidate the rights of trans people— it’s grossly irresponsible to his duty as a mental health professional. It reveals nothing about scientific truth about human identity, and everything about McHugh’s own personal need to oversimplify human identity in service of his religious and political views.
Al Brennan > Claire Teasedale • 10 months ago • edited
"This is a skewed perspective by a psychologist who has been widely discredited"<----- This amounts to no more than investigations into the corruption of the Police Force have been widely discredited ... by the Police Force. Occams Razor is always a good fall back, if someone perceives they are uncomfortable with their biological axiom then I'd go with the problem being anchored in the mind before I'd start mutilating the body. I understand this may, ostensibly, seem to be oversimplifying an obviously complex condition, but that's Occam's Razor; looking for more complicated solutions where the correct one is hidden by its utter obviousness. Ulterior motives and downright obvious agendas are clearly involved.
Claire Teasedale > Al Brennan • 10 months ago • edited
It’s definitely harder to get a brain transplant than it is to get gender reassignment surgery (seriously). Also, conversion therapy and trying to “change the mind” of the trans person— this had been proven to be almost 100% ineffective as well. So, no. You are shaving the wrong direction with your razor, Occum :)
Meyer Mussry > Claire Teasedale • 10 months ago
Over 70% of people who present for gender dysphoria have a previously diagnosed mental illness and/or autism. When a seemingly quick fix like changing your gender is proposed to them as the way out of their difficulties, many grab at it. Clinicians, ever eager to make a buck, say that the subjects are the experts on their condition! Really? Should we now help species dysphoric people become cats or dogs because they are experts on their condition?
If you treat an illness with radical therapies that do not address the fundamental issues, then guess what? After the therapies, when the body has been ravaged by the drugs and destroyed by surgery, the problems still remain, and are compounded. People are stuck in a place they realise is wrong, but they can't go back. That's why there is so much unhappiness and suicide.
Among kids, watchful waiting and family therapy has proved effective in about 85% of cases. Affirmative dogma locks them into reinforcing the aberration without addressing the real cause of the initial confusion, whether it be curiosity or interference. This dogma funnels them into puberty blockiing, hormones and surgery, and guess what? In 85% of cases it is wrong. So really, Claire, getting the brain sorted is much easier than you make out, and it does not require a transplant.
Occum is shaving the correct direction. You are the one with the confusion.
Claire Teasedale > Meyer Mussry • 10 months ago
Gender transition is not a quick fix. Therapists and physicians are not rushing young people into clinics to perform rapid sex changes on them (this is yet another myth).
Instead, WPATH standards insist that a person go through a long period of therapy, have a second opinion from another therapist and their primary care physician even before they usually start hormones. They have to live one year full time in their identified gender before they can have any surgery. And no one under 18 is supposed to have gender affirming surgeries.
And sadly, there are more mental health issues affecting LGBTQ people, but much of this is likely explained by rejection and mistreatment within families or by society as a whole.
And there are plenty of trans people who are still trans even though they have no other mental health conditions. About fifty percent of transgender people have other mental health conditions, like depression. But 50% do not have other mental health conditions. It’s certainly not the cause of their gender identity being different than the one assigned at birth, as you seem to want to imply.
Guglielmo Marinaro > Claire Teasedale • 10 months ago
And no one under 18 is supposed to have gender affirming [sic] surgeries.
But it is clear that some are.
https://jamanetwork.com/jou...
It should be illegal also to prescribe puberty blockers or cross-sex hormones to anyone under 18.
Al Brennan > Claire Teasedale • 10 months ago • edited
Yeah right.. OK.. let's throw out all psychiatry because it deals with the mind, CBT, the works, all out the window.
Your silly opening sentence about brain transplants is enough to disqualify you from being taken seriously. Your "almost 100% ineffective" assertion is in the same category as Mr Hart's palliative delusion about no one ever being sued for performing these mutilations. I notice his predictable silence since the posting of evidence to contrary.
The lesson is, that he and you ought to inform yourselves objectively with facts before letting loose your trigger fingers.
Claire Teasedale > Al Brennan • 10 months ago
I am informed with facts. In the most comprehensive study of transgender women, over 80% report being happy with medical and physical gender transition.
As for your assertion that I’m throwing psychiatry out, I am not. In fact, psychiatry and psychology are not successful in “changing” gay people to straight people, or trans people to cisgender people. Quite the opposite: when such efforts are made, the gay or trans person is much more likely to commit suicide or have greater mental health issues as a result of such efforts. Conversion therapy, or anything like it, has generally been responsible for causing higher suicide rates in the people subjected to it. But I guess your desire for them to be “normal” is more important than their lives to you?
Not a good mentality. Shame on you!
Al Brennan > Claire Teasedale • 10 months ago • edited
Utter rubbish....when time permits I will address your mendacity. For now it is sufficient to say that anything deviating from the evolutionary imperative to advance the species is absolutely not in accord with nature and the result is an Evolutonary deadend.
Joan_A > Claire Teasedale • 10 months ago
No amount of willpower will change a biological male into a biological female or vice versa. The differential process begins during the embryological phase, full stop.
Claire Teasedale > Joan_A • 10 months ago • edited
A trans woman was always a biological female, if we consider her brain as a part of her biology. I actually think the organ between the ears matters even more, in formation of identity, than the organ between the legs. Most of the time, the two are in alignment. However, with trans people, they usually aren’t in alignment at birth, as the brain has been shaped as more female or more male in the womb, on a different trajectory than their chromosomes or other aspects of their sexual anatomy. It’s honestly not that difficult to imagine how early brain development, in the fetus of trans people, isn’t parallel to other aspects of the embryo’s development. In fact, researchers know that this happens from studying development in the womb. It’s only people motivated by religion or rigid social constructs who have to deny that trans people are who they say they are.
Moebius > Claire Teasedale • 10 months ago • edited
"Most of the time, the two are in alignment. However, with trans people, they usually aren’t in alignment at birth..."
Most of the time, not always. Usually, not always. So you're admitting that. Can you thus tell us how we might determine who is "really" trans from those who are not? Or are we just to assume all kids who sometime during the formative years claim to be trans are really so? Have any researchers actually identified these brain differences in individuals while they are still alive? Also, do the studies say that all with these brain differences are trans, or that all without them are not?
Claire Teasedale > Moebius • 10 months ago
I’d also add that all people really come into themselves and “find themselves” as they mature into adults. I think there is a lot of needless handwringing over the fear that young trans people are being pushed by their parent or parents to adopt a “trendy identity” or a that they are being shaped by some kind of liberal brainwashing. However, the parents of trans youth, whom I know, are merely responding to their child’s persistent identification with the gender opposite of what was assigned. The parents I’ve witnessed are supportive and loving of their kids, but haven’t pushed this on them at all. If anything, they’ve often done a lot of things to initially help their child be okay with their assigned gender. But even better, I’ve only seen their parents give their child room to explore— no push to keep identifying as trans. I’ve witnessed at least one young trans person who identified as trans and then went back to identifying with the gender assigned at birth.
As long as that openness to explore is combined with the love and acceptance of a parent, the children who aren’t actually trans are unlikely to have any consequences by having the opportunity to figure out who they really are.
Also, if they truly are trans, they won’t have to wait until they are in their 40s or later to finally start being themselves. I also know a few trans women who were raised in conservative homes, expected to adhere to standards of masculinity all of their life (many of whom served in the military or in law enforcement), and who did their best to reject their trans identity. Nothing changed the fact that they were trans though, and they simply ended up transitioning later in life.
And while greater openness for trans identity has made trans people more visible and more often a topic of conversation, the number of trans people remains a very small minority (about .6% of the US population, or a little over one million people). While that number has risen in the last decade, a likely cause is that more people are simply able to feel like they can openly identify as who they are, rather than remain in hiding. Anymore, young trans people also find more flexibility when it comes to their specific identification— they can identify as non-binary, for example, and further feel free of any pressure to conform to any external demands on their identity (trans or otherwise).
So all the fear of young people being “made” trans or somehow being caught up in some movement— this is likely a fear resulting from the broader ignorance, polarization, and hysterics that have colored our partisan political views in this country. And it’s certainly owing to an evangelical Christian culture that feels threatened by science, by advances in technology, and by the shift in gender roles that has occurred due to the availability of birth control, etc.. Men, who have usually been privileged by a patriarchal society, with religious dogma supporting their position as “leaders in the home” may feel especially threatened by others being free to simply be themselves. Rather than being obligated as cis females to be subordinate to men, women can now work outside the home, vote, own property, and even be the head of a family that doesn’t include a husband. Trans women perhaps seem to threaten the traditional role of men even further, by suggesting that those assigned male at birth don’t have to remain in the subjugating authoritative role. So I think a lot of the fear of trans identity is truly coming from cis, heterosexual men who feel that their privileged role in a patriarchal society is threatened. Really, most of that privilege is already gone, and the most healthy and confident men have likely come to terms with a healthier equality between genders. Such men, in all likelihood, don’t feel threatened by LGBTQ people. And in the end, confidence is so much more masculine and attractive than the insecurities that cause a man to desperately appeal to his religion or societal gender traditions to preserve a male identity which he wrongly feels is threatened just by allowing others to be themselves.
Claire Teasedale > Moebius • 10 months ago
A recent study, using MRI scans of trans girls younger than 18 and prior to hormone therapy, showed that these girls showed similarities in brain structure to cisgender girls. Another study of genetic markers showed similarities between trans brains and the gender of cis brains of the gender with which the trans person identifies.
Ultimately, though, the test of whether someone is trans is whether their feelings of gender dysphoria are significant enough and persistent enough that the person feels they need to transition to resolve the dysphoria and feel whole. Again, WPATH standards have a pretty rigorous timeline and therapy requirements before the person can start hormone therapy or have any surgeries.
In the end, I think society should give people the freedom to be who they are, with no pressure to conform one way or the other. A transgender person is ultimately someone who transitions to living full time in the gender opposite of the one assigned at birth. But that transition can include different steps for different people. Some people, because of health reasons may not be able to have gender reassignment surgery, but may go on hormones, etc..
Joan_A > Claire Teasedale • 10 months ago
Lady, the sex of a person is binary, a fact that begins at conception when either xx or xy chromosomes are formed. From thereon, the development of sexual organs are totally reliant on neurohormones produced by the Hypothalamus (LH and FSH) which in turn stimulates the anterior pituitary hormones and they in turn stimulate production of oestrogen and progesterone in the ovary in females or testosterone from the Leydig cells of the Testes. These pathways are fully established from 5 weeks embryo stage, when the first throb occurs. Sex specific receptor sites are found either in the xx chromosomes of females and xy chromosomes of males. If as you state "the fetus of trans people isn't parallel to other aspect's of the embryo's development"; Why have they fully developed sexual organs at birth? The neurohormone levels from the hypothalamus significantly drops from birth and only begins to raise very gently from 10 to 14 years of age. Therefore, children's feelings during this period of their life are asexual.
Among the reasons why children develop sexual feelings during this period of their lives is mainly due to grooming either directly or indirectly through unsuitable library books, comprehensive sex education aided and abetted by access to pornography, or they have been physically or sexually abused.
Maybe you should consider what changes to their healthy hormone levels can also be affected while they are developing within their mother's womb should she be continuing during their vital developmental stages on the pill, not aware she is pregnant.
Synthetic hormones are 1-2 million times stronger than the hormones normally produced by the body. What do you consider is happening to healthy organs including, bone tissue, liver tissue, the heart and brain when cross-sex hormones are applied to a person whose receptor cells within these organs are not designed for these cross sex hormones? Where do you suppose these cross-sex hormones travel too when they are expelled from the body through bodily fluids? Are you aware of the studies of waterways done in Great Britain, where women pockets of women treated by HRC live who in turn contribute to deformed fish and even impacts on the sex organs of larger sea creatures? Are you aware that the receptor sites for oestrogen of post menopausal women actually significantly diminish with age?Claire Teasedale > Joan_A • 10 months ago
You seem to imply that a transgender identification is caused by sexual abuse or exposure to pornography. It’s a myth that trans or gay people end up being that way because of such experiences. There is data that shows that a higher percentage of LGBTQ people, compared to heterosexual people, do report having been sexually abused when they were young. That said, being different, being gay or having a trans gender identity, can make children seem different and perhaps more vulnerable. This can sadly, therefore, make them more likely to be targets of sexual predators.
And again, your need for a rigid binary isn’t affirmed in cases where people are born clearly not fitting into this rigid binary. Intersex people are born as often as 1 in 2000 births, and such people do not physiologically fit into your round or square holes from the very beginning of their lives. You can judge them as deficient or damaged goods if you need to stigmatize them, but such stigma really does them no good and it doesn’t make them disappear. They still exist, and they do better if they have love and acceptance for who they are, not demands from people about what they should be or could have been if they were just “born normal.”
As for your talk of hormones, that part of your discussion really points out that there are environmental factors outside a person’s control that shape their sexual and gender development. These environmental factors, if they do in fact have some impact of some people developing into gay or trans identifying adults, offer even more reasons to not blame the LGBTQ person for an “alternative lifestyle choice”or for somehow “living in sin,” or “against God’s design.” Again, shaming, rejection, or therapy can’t change LGBTQ people into cis gender, heterosexual people. Instead, it just causes them great harm.
Finally, even identities of cis gender and heterosexual people exist in various places along a spectrum of gender identity and gender expression. There is no “ideal” perfectly female woman. There is no “ideal“ perfectly male man. Rather, there are various degrees of masculinity and femininity for all people, with some men perhaps exemplifying the most obviously masculine characteristics and behaviors, and some women exemplifying the most obviously feminine characteristics and behaviors. But for even those people, they likely have had to work on some parts of their gender expression to make them seem so obviously masculine or feminine (such as when a male body builder takes performance enhancing drugs to increase his size, or perhaps just lifts heavy weights). But even these people probably have aspects of themselves that don’t fit into your rigid binary.
In the end, this world will be a better place, especially for LGBTQ people, when folks like you start working on your acceptance of these minorities, rather than building up your arguments to stigmatize and judge them. Your judgement, your rejection, your discrimination, your harassment, or even your violence toward them, won’t change them into cis gender, heterosexual people. You will just hurt them. And you will keep being wrong and overly simplistic in your assessment of the diversity within the human population. Instead, accept people for who they are and let them love themselves and the adult partners who consent to love them. That won’t hurt you at all. It will actually make you a better, fairer, more loving person!
Moebius > Claire Teasedale • 10 months ago • edited
"There is data that shows that a higher percentage of LGBTQ people,
compared to heterosexual people, do report having been sexually abused
when they were young. That said, being different, being gay or having a
trans gender identity, can make children seem different and perhaps
more vulnerable. This can sadly, therefore, make them more likely to be
targets of sexual predators."So, you're assertion is that we just know this, that when there is a history of sexual abuse, we can just assert up front that all of the children were abused because they were gay or trans, and that the abuse had absolutely nothing to do with their self-identification as such. Therefore, there is no need for therapy or counseling to actually determine if this is so.
Because it is more important that there be more and more kids identifying as gay or trans, than that any of them be determined to be identifying as such due to unresolved issues relating to the abuse.
In making this statement, you have just blown all credibility. You don't care about the kids. If you did, you would have no problem with them undergoing counseling to determine the very thing you simply assert. You're just following the script.
Guglielmo Marinaro > Claire Teasedale • 10 months ago
I’d just like to point out that there is no such entity as an LGBTQ person. That initialism is simply factitious and illogical. One might just as well talk about a SBTAR (straight, bisexual, transgender, asexual and reincarnated) person.
Claire Teasedale > Guglielmo Marinaro • 10 months ago
Sure, being reincarnated is just like having a different sexual orientation or gender identity. Absurd!
Joan_A > Claire Teasedale • 10 months ago • edited
"Your judgement, your rejection, your discrimination, your harassment, or even your violence toward them, won’t change them into cis gender, heterosexual people. You will just hurt them. And you will keep being wrong and overly simplistic in your assessment of the diversity within the human population."
Hi Claire, I merely supplied biological knowledge, to make the above assumptions based on the extensive biological knowledge I do have, is a clear indication that you are the one with discrimination problems not I. But I forgive you, as with your ideological blockage, you know no better.
As for your argument you set forth that hormones produced within the body within the hypothalamus, the anterior and posterior pituitary, the ovary or testes that I discussed are environmental factors clearly demonstrates a lack of understanding of biochemistry. I was referring to the internal feedback system that naturally occurs within both females and males that begins at 5 weeks at embryo stage.
What I was referring to as environmental contamination is the amount of Synthetic Hormones, one to two million times more powerful and at a constant rate, that you and your colleagues are responsible for releasing into the environment rather than the nth levels of hormones normally intermittently produced from 5 weeks in embryo.
By prescribing these powerful drugs at a constant level to people who lack the receptive sites to retain them. The obvious impact on fish should have you thinking a little deeper, about what you are doing, not denying the obvious.
Too many psychiatrists who have been treating patients with gender dysphoria have identified that the majority of their patients had a past history of mental illness or were subject to abuse as a child, to ignore these facts. Denial of this history and failure to address the underlying issues is a sure sign of negligence. So very easy to refer a patient to a colleague with the same mindset as your own. The current treatment regime for transgenders in Melbourne, confirms this.
No amount of biochemical or surgical treatment that alters secondary characteristics alone, will change the sex of a person.
You mentioned intersex persons as equalling 1:2000, where as the vast information I have read, reveals their numbers comprise 0.00005% of the population and is related to a blockage within the biochemical pathways in-utero. By acknowledging and accepting these small numbers of people are different, and are sterile, does not mean the whole population should automatically be defined accordingly. Are you actually intimating that all people who identify as transgender actually are intersex? To my knowledge the number of people identifying as transgender based solely on the way they feel, far outweigh those tiny proportion of the population who do face this challenge.
For this reason, I strongly object to the stories invented by like minded people such as you, and presented by Drag Queens in libraries under the label of 'education' when they are actually grooming these children to doubt their own sexual identity.
I also strongly object to children being subjected within schools to Comprehensive Sex Education that fails to acknowledge children are not sexual and should not be subject to this information until they are old enough to comprehend what they are being taught. As a mother of six, I firmly believe it is the parent's responsibility to teach their children about sex and sexuality, when they know their individual child is ready, not that of teachers who have been subjected to false ideology themselves.
I also strongly object to transgender males sharing female toilets, showers or participating in female sports. As I am fully aware of their different biological development. They should be provided with separate conveniences of their own and maybe with the amount of grooming going on their numbers will be sufficient to support separate sporting facilities.
You may refer to this as bigotry, I refer to it as being a responsible adult.
Michel Lhombreaud • 10 months ago
At last a clear and concise report on gender ideology and
its risks to health. The American Psychiatric Association has gone insane (so
has the American Medical Association). I do hope each prominent individual
involved in pushing these policies that harm human beings - especially children
- in the long run get their butts sued off! I liked the "Brainwash"
documentary made by Norvegian comedian and sociologist Harald Eia which reveals
the phoney character of these gender studies academics. It is still on YouTube
though they have now imposed an "adult only" limitation, which is
quite ludicrous. https://youtu.be/3OfoZR8aZt4 Ten years ago YouTube did
not censure it this way, it just goes to show how they got sucked into all this
insanity!eddytwo > Michel Lhombreaud • 10 months ago
I agree.
What is really going on!
https://www.nationalreview....David Cary Hart > Michel Lhombreaud • 10 months ago
The first gender confirmation surgery was performed on Dr. Allen Hart (no relation) more than 100 years ago. Transgender people have been treated with gender-affirming models for many decades and I have yet to see anyone suing doctors for medical malpractice.
No one is “pushing” anything. The gender-affirming care model is the clinical practice standard of the American Academy or Pediatrics; the result of research.
There does not exist some grand sinister conspiracy to mistreat patients in distress.
Guglielmo Marinaro > David Cary Hart • 10 months ago
“Sex change surgery” (like “conversion therapy” for gay people) has been periodically re-named. I’ve noticed that the latest label is “gender confirmation surgery”. For the next re-branding I suggest the more accurate “delusion affirmation mutilation”.
Al Brennan > David Cary Hart • 10 months ago
https://www.theage.com.au/n...
Joan_A > Al Brennan • 10 months ago
Excellent reference Al, thank you.
Dr Paul McHugh, a big thank you for sharing your scientific depth and understanding. Thank you MercatorNet for your persistence in consistently illuminating this scientific objectiveness that Dr Paul McHugh has expressed.
Andrew MAYO • 10 months ago
A very convincing exposition - thank you for sharing this
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