Failed Operations

Medical Malpractice in an Age of Gender Denial Disorder

“I just got a call from the New York Times," said Dr. Russell Nelson, president of Johns Hopkins Hospital, to Dr. Milton Edgerton, a Hopkins plastic surgeon. "Tell me, Milt, are we doing transsexual operations here?" It was fall, 1966.

"We are," said Edgerton, "but I don't think we're ready to give any public announcements."

But it was too late. A local gossip columnist had already written about a stunning girl making the rounds of Manhattan clubs. She said she used to be a man but that she'd had a sex-change operation at Johns Hopkins less than a year ago.

And so it came about that a news conference was scheduled for November 21, 1966. Edgerton and several colleagues announced the establishment of the Johns Hopkins Gender Identity Clinic (GIC). They defined transsexuals for attending press as "physically normal people who are psychologically the opposite sex." They explained that since "psychotherapy has not so far solved the problem," the clinic was investigating the benefits of surgery. "If the mind cannot be changed to fit the body," said plastic surgeon Dr. John Hoopes, inaugural chairman of the GIC, "then perhaps we should consider changing the body to fit the mind." At this point, the Hopkins physicians had operated on ten patients.

Another of the cofounders of the GIC was New Zealand-born Dr. John Money. A disciple of Alfred Kinsey, Money had served on the board of the Kinsey Institute and, like Kinsey, engaged in all manner of deviant sex, including pedophilia. Money introduced the novel concepts of gender roles and gender identity, theorizing that a person's sex wasn't monolithically male or female, but was determined by seven variables. When the variables got mismatched, he said, a person's gender identity could be end up being different from his physiology. Money also theorized that that gender identity got imprinted in the brain early on, and that once imprinting took place, it was unalterable.

He offered no evidence to support his ideas, but that didn't seem to matter. Within a year, the GIC received some 700 letters from people saying they believed they were trapped in the wrong body. Could the GIC help them? The clinic also received a steady stream of patients asking if GIC surgeons could correct botched sex-change surgeries they'd previously had done in other countries.

From the start, there was conflict among the medical staff over the criteria by which patients would qualify as surgery candidates. Some preferred counseling as a first-line treatment, but Money was an indefatigable driver for sex-change (later called gender reassignment) surgery. Daring to go where no reputable physicians had gone before, the GIC was off, blazing a brave new medical trail.

A Failed Experiment

But reality tends to have an indefatigable boomerang effect of its own. In 1969, psychiatrist Dr. Jon Meyer assumed directorship of the GIC. He was enthusiastic at first, reported Baltimore STYLE magazine, but after talking with patients over time, some at length, "he observed that they 'would start out talking about their wish for sex reassignment but would very rapidly get into anything people would talk about in therapy'—loss, abandonment, grief." A well-meaning physician, Meyer set out to study post-op patients more systematically.

In 1979, with several years' accumulated data, Meyer concluded that "these patients have severe psychological problems that don't go away following surgery." Hence, "to say that this type of surgery cures psychiatric disturbance is incorrect. We now have objective evidence that there is no real difference in the transsexual's adjustment to life in terms of jobs, educational attainment, marital adjustment and social stability."

Dr. Paul McHugh, who oversaw the GIC as Director of Psychiatry, concurred: "With these facts in hand I concluded that Hopkins was fundamentally cooperating with a mental illness. We psychiatrists . . . would do better to concentrate on trying to fix their minds and not their genitalia." Johns Hopkins stopped doing the surgery that year, and many other university-affiliated clinics that had sprung up across the country followed suit.

If enough of the professionals involved had been strictly pursuing medicine as the art and science of healing that medicine should be, the whole debacle would have been written off as a failed experiment. "We tried changing the body to fit the mind" they might have announced, "but found that changing the body did not solve patients' problems." Transsexual surgery would have gone the way of leeching and lobotomy, as it should have.

From "Cooperating With" to Celebrating a Mental Illness

But that didn't happen. Transgenderism is more the rage today than ever before. Caitlyn Jenner became a household name this year among a generation of young people who'd never even heard of Bruce. Following that craze, Barnard College announced it would begin accepting trans women. (Barnard had actually been one of the holdouts. Now most women's colleges effectively accept all gender fusions except for straightforward, lifelong males.) Then came Bravo TV's announcement that it would cast a transgender woman in season 8 of Real Housewives of Atlanta. And lest the children be left out, Gen Zed, a new animated comedy set to launch in late 2015, will feature transgender Shona as a lead character who is "proud of who she is."

And if you display a different response to Caitlyn, Barnard, or Shona . . . well, now aren't you the transphobic bigot who ought to be shut up in the closet?

Whether or not you are a bigot, though, you would be a reasoned responder with a cogent point. Studies conducted since 1979 have only underscored the mental health problems that Meyer and McHugh recognized in the 1970s. In 2004, the UK Guardian reported on more than 100 international medical studies of post-operative transsexuals reviewed at the University of Birmingham. Not only did the reviewers find "no conclusive evidence that sex change operations improve the lives of transsexuals," they found that many of the patients remained "severely distressed and even suicidal after the operation." In 2014 the American Foundation for Suicide Prevention reported that 41 percent of transgender adults have tried to take their own lives. A suicide hotline set up in 2014 by transgenders for transgenders, Trans Lifeline, received more than 20,000 calls in its first nine months of operation.

Tragically, the cultural powers that be seem to have contracted an illness. In any other realm, we would call it denial.

Full Steam Ahead

And rather than acknowledge gender reassignment as a failed experiment, as good science and medicine would require, the medical profession blazes on, human lives be damned.

Amid the Caitlyn craze, Rod Dreher at The American Conservative posted a piece titled "A Christian Doctor in Our Brave New Trans World." It contained a troubling letter he'd received from a semi-closeted (as a Christian) med student who explained her concerns about a required class on human sexuality, much of which dealt with the treatment of transgender patients, including children. The suicide rate, she wrote,

was stated as one of the primary reasons that gender reassignment surgery was such a wonderful thing for these patients. Also, hormonal therapy for children with gender dysphoria was taught to us as a promising treatment option that saved these children from a life of harassment, depression, anxiety, and suicide.

In class, students were taught that gender identity is usually determined by the age of three, and that as physicians, they should refer children exhibiting nontraditional gender behavior to a child psychiatrist who works with LGBTs for psychological testing and gender reassignment if appropriate.

It wasn't that she had any objection to treating transgender patients. It was that she was deeply concerned that the prevailing standards of care were not likely to serve their best interests, especially in the case of children. As should be clear by now, transgenderism should at least come with some kind of psychiatric warning label. There was none. Worse, in her classroom training, no one discussed the potential side effects of early hormone therapy or questioned whether such drastic, life and body altering decisions should be summarily ratified medically, merely on the basis of childhood confusion. "(I personally wouldn't want anything I did at 16 to be permanent)," she noted parenthetically. Really, now. Who would?

"Medicine is a hard place for Christians these days," she observed. One can almost hear her sigh.

It seems to me that the battle is already lost. In the generation I am part of (I'm in my late 20s), I'm very much [in] the minority, especially in my field. The indoctrination they've put university-educated people through, and the discrimination against Christians and other social conservatives, both make my world feel very toxic at times. All discussion ends at "You bigot!"

Informed Resistance

Walt Heyer, who underwent male-to-female surgery more than thirty years ago and then subsequently returned to living as a male, has walked and talked extensively with transgenders and seen the devastating unintended consequences of attempting to change gender. He's written four books on the subject and hosts the website SexChangeRegret.com as an outreach to people with sex-change regret. "[T]he true purpose," he writes in Paper Genders, "was (and is) to advance an agenda."

He traces it directly back to Kinsey, which is certainly apropos, but there's a deeper, broader way to look at this as well. In What We Can't Not Know, a treatise on natural law, Dr. J. Budziszewski unpacks the concept of goetia—"the ancient practice whose goal was to acquire power by 'breaking' nature, unpatterning its patterns, uncreating creation." He applies the concept to several immoralist movements of our day. "The homosexual movement ultimately seeks not the protection of homosexuals from cruelty, but the annihilation of natural boundaries. The euthanasia movement ultimately seeks not an end to pain, but endless death. . . . The eugenics project seeks not a cure of disease, but the overthrow of the Creator by the creature."

Similarly, the transgender movement ultimately seeks not healing for the gender-confused, but the utter undoing of natural, gendered humanity. To sow gender confusion and then laud the prospects of altering physiology as a fix for what ails the patient is worse than cooperating with a mental illness, although it is indeed that. It is doubling down on a destructive, evil design on a human being made male or female in God's image.

Do not look at all this and simply say, That's just crazy! Call it what it is—an affront to God and a medical crime against vulnerable human beings. People of conscience should resist full force—by hammering home the data to the impartial bystander, by ministering natural truth to the gender-confused, and by ministering recovery and gospel restoration to the medically betrayed. •