World’s experts condemn the McHugh hoax

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World’s experts condemn the McHugh hoax

By Cristan Williams
@cristanwilliams

 

The Wall Street Journal (WSJ) recently ran an op-ed by the right-wing anti-transgender psychiatrist, Paul McHugh. McHugh purposefully misrepresented the research he cited in his article, misleading WSJ readers and the wider population into believing the lie he was selling. When the World Professional Association for Transgender Health (WPATH) learned of the McHugh hoax, they responded. While WPATH Board Member, Dr. Dan Karasic, responded to McHugh and the WSJ published the response, they refused to publish the part where WPATH notes that McHugh misrepresented the research he cites.

Since the WSJ seems to be content to help McHugh perpetrate his anti-trans hoax, I present the actual response WPATH sent to the WSJ which includes the section that notes that McHugh misrepresented the research he cites in his WSJ article:

Dr. Paul McHugh (“Transgender surgery isn’t the solution”) writes about the study at Johns Hopkins in the 1970’s showing poor outcomes from transgender surgeries, leading to McHugh shutting down Johns Hopkins’ transgender program in 1979, and the US Department of Health and Human Services declaring transgender surgery experimental, and therefore not covered. Two weeks ago, HHS reversed its 1981 decision, and removed transgender health exclusions from Medicare. McHugh seems unaware of the work in transgender health in these last 30 years that led to this reversal by HHS.

McHugh does cite one study from 2011, by Cecilia Dhejne, MD and colleagues at Karolinska Institute in Stockholm. However, he misunderstands Dr. Dhejne’s work. In the paper, Dr. Dhejne states that the study was not designed to draw conclusions on the efficacy of transgender surgeries, yet McHugh does exactly that. A closer reading of the paper shows that the increased mortality is in those who had surgery before 1989, and that mortality in trans people after 1989 is not statistically different from the general population. A recently published paper by Dr. Dhejne and colleagues shows that the regret rate for those having surgery from 2001-2010 is only 0.3%. Dr. Dhejne’s work shows that outcomes for transgender surgery have improved tremendously in the past 30 years, which supports the HHS decision to remove trans exclusions.

McHugh also mischaracterizes the treatment of gender nonconforming children. As McHugh states, most gender nonconforming children do not identify as transgender in adulthood. However, those who receive puberty blocking drugs do not do so until puberty, when trans identity is likely to persist. These drugs allow adolescents and their parents to work with doctors to achieve the best outcome. This approach was demonstrated to be successful in research in the Netherlands before being adopted widely in the U.S.

The American Psychiatric Association and the World Professional Association for Transgender Health no longer view transgender identity as inherently pathological. Dr. McHugh’s views are stuck in the past.

Dan Karasic, MD
Health Sciences Clinical Professor of Psychiatry, UCSF
Member, American Psychiatric Association Workgroup on Gender Dysphoria
Member, Board of Directors, World Professional Association for Transgender Health

Compare the above with the redacted letter the WSJ published:

Dr. McHugh writes about the study at Johns Hopkins in the 1970s showing poor out­comes from transgender surgeries, leading to Dr. McHugh shutting down Johns Hop­kins’s transgender program in 1979, and the Department of Health and Human Services declaring transgender surgery experimental, and therefore not covered. Two weeks ago HHS reversed its 1981 decision and removed transgen­der health exclusions from Medicare. Dr. McHugh ignores the work in transgen­der health in these last 30 years that led to this reversal by HHS.

Dr. McHugh also mischar­acterizes the treatment of gender-nonconforming chil­dren. As he states, most gen­der-nonconforming children do not identify as transgender in adulthood. However, those who receive puberty-blocking drugs do not do so until puberty, when trans identity is likely to persist. These drugs allow adolescents and their parents to work with doctors to achieve the best outcome. This approach was demonstrated to be successful in research in the Netherlands before being adopted widely in the U.S.

The American Psychiatric Association and the World Professional Association for Transgender Health no longer view transgender identity as inherently pathological. Dr. McHugh’s views are stuck in the past.

Dan Karasic, M.D.
Professor of Psychiatry University of California San Francisco

In a notice sent to WPATH membership, alerting them of the McHugh/WSJ hoax, the WPATH newsroom wrote:

Many more responses and blogs relating to this article have been published; however, we thought we would provide you with a link to the response prepared by Mari Brighe: “Clinging to a dangerous past: Dr Paul McHugh’s selective reading of transgender medical literature.”

Mari gets to the facts in her response, stating: “It is important to remember that the opinions of Dr McHugh fly in the face of currently accepted medical practice and the positions of many major medical associations. The American Medical Association, the American Psychological Association, the American College of Obstetrics and Gynecology, the American Psychiatric Society, the American Public Health Association, and the World Professional Association for Transgender Health have all adopted positions supporting the medical necessity of transition-related care, including hormonal and surgical interventions, as well as expressing support for insurance coverage of these interventions. Despite his authoritative sounding title at a respected medical institution, Dr McHugh’s opinions do not represent the views of the mainstream medical establishment, rather they are the erroneous, bigoted beliefs of a scientist who appears far too invested in his own antiquated, disproven theories and his anti-LGBT political position than the current state of medical affairs”.

See the full text of Mari’s response at http://www.transadvocate.com/clinging-to-a-dangerous-past-dr-paul-mchughs-selective-reading-of-transgender-medical-literature_n_13842.htm

WPATH is an international multidisciplinary professional Association that promotes evidence based care, education, research, advocacy, public policy and respect in transgender health. The organization represents the world’s leading experts in transgender psychological and medical health care.


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Cristan Williams
Cristan Williams
Cristan Williams is a trans historian and pioneer in addressing the practical needs of the transgender community. She started the first trans homeless shelter in the South and co-founded the first federally funded trans-only homeless program, pioneered affordable healthcare for trans people in the Houston area, won the right for trans people to change their gender on Texas ID prior to surgery, started numerous trans social service programs and founded the Transgender Center as well as the Transgender Archives. Cristan is the editor at the social justice sites TransAdvocate.com and TheTERFs.com, is a long-term member and previous chair of the City of Houston HIV Prevention Planning Group.

9 Comments

  1. Nuala Shields says:

    Thank you for an excellent article Cristan. These hired guns of the right will say anything they’re told to for cash.

  2. Zoey Tur says:

    Thank you for your informative work. Just completed SRS and FFS four days ago and I know the truth…Paul McHugh is a Catholic apologist posing as a physician. A dangerous man.

  3. beneficii says:

    It ultimately doesn’t matter. The way the mention of the paper was redacted shows that, just like climate change denialism and creationism, the conservative dupe machine is in full swing.

    Give this dupe machine a few years to run and you’ll find that Medicare won’t be covering sex reassignment surgery anymore, neither will any state’s Medicaid or a plan on any state’s exchange (or those of D.C.), because the GOP will have gotten the Democrats to sell out on our health care. And everyone will feel happily bipartisan about it.

  4. Dee Omally says:

    I just had an insight…as I re-read Mister “Whew’s” Op-ed.

    1. Have we the trans community in America, really and truly reached our “tipping point”? Yes we have, and yes we are extremely fortunate to be players in the year 2014….when we finally are allowed to take our place behind the microphone. Trans history in America, despite the presence of trans persons even before, begins in 1951 with Christine Jorgensen and her orchiectomy. It took 63 years to arrive but we are fortunate to be alive decades after Christine’s “one small step for man, and one large step for transkind”, daring to step out and live her truth. It is an honor to be a trans veteran as she was….military service has perfected the art of removing fear from self and plays a large part in how I dare to challenge trans bigots.

    2. After years of pushing the trans closet inward and as we finally break free, are our six-decades long adversaries going into panic mode? You betcha they are. How so? Well, go back to 1970 and look around. I was ten….and so were many of you around that age (if your parents hadn’t yet placed an order for you on E-bay 😉 ). Fast forward 44 years to today. Anything different? Practically everything is different. When an “opponent” has to resort to information that is almost half a century old and long since expired……such as Dr. “Whew”, that opponent is trying to fight with a club in the modern age. If that doesn’t demonstrate panic-mode I don’t know what does. Reaching so far back to fight today means our opponents are out of ammunition, and are picking up rocks. Such is best called “unplanned obsolescence.”

    3. We ‘ve all experienced this scenario: SHUT THE HELL UP YOU WORTHLESS JERK!!! YOU ARE SO RUDE!!!—someone exhibiting very rude behavior while accusing someone else of being guilty of the same thing. Dr. “Whew” is no different, as he, while calling us “the confused” reaches way back in the filing cabinet, dusts off obsolete 1970 studies and applies them 44 years into the future. If this isn’t a confused man, then I don’t know who is. What field of study hasn’t expanded or changed after 40 years of empirical study? Part of my duties, wearing other hats, has included transporting “the confused” to medical facilities for a 72 hour observation, commonly called “5150 holds, after initial field testing revealed that required such. Based on Dr. “Whew’s” statement, I “the confused” was leading “the confused.” I think not. No, wearing socks of different colors is a mismatch, not confusion. Having a different body than gender identity is a mismatch also.

    As we traverse the great chasm that has kept the trans community in the train caboose for far too long, our opponents who espouse liberty and freedom for all while planning for our demise will keep pushing the closet door even harder. Such acts of desperation are to be expected. As trans rights become recognized as human rights, momentum is a force unto itself. I am a trans group of one, and one alone. I don’t attend nor believe in “support” groups….but all of us must keep pushing on that door so that our opponents can finally fall on their ass, and taste life as we have for far too long….with buttocks on the ground as we extend a hand up.

  5. Anonymous says:

    […] work in transgender health in these last 30 years that led to this reversal by HHS. – See more at: World?s experts condemn the McHugh hoax | The TransAdvocate The American Psychiatric Association and the World Professional Association for Transgender Health […]

  6. […] Despite the comparatively high volume of studies that show positive outcomes with medical support of transition, some American doctors remain skeptical and may refuse treatment. Dr. Paul McHugh, former psychiatrist in chief at Johns Hopkins Hospital, is a notable opponent of SRS. In an op-ed originally published in 2014 and republished last month by the Wall Street Journal, McHugh claims that “There are subgroups of the transgendered [sic], and for none does “reassignment” seem apt.” The only study McHugh cites is the one of the Swedish cohort previously mentioned. His misinterpretation of that data and lack of evidence for other claims have been criticized by other psychiatrists and the trans community. […]

  7. […] very well done but if you don’t know what’s wrong with citing McHugh, there are lots of good resources out there. McHugh is the go-to guy for religious critics of trans people but, as I […]

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