The Scary Science at Johns Hopkins University
The name Johns Hopkins University connotes an institute of higher learning in medicine to most people. For those paying attention, it represents one of the most unapologetically transphobic institutions in America. JHU professors have headlined conferences on reparative therapy, cozied up with many Southern Poverty Law Center-certified hate groups, and taken money from the government to argue in court that transgender people don’t need medical care.
Administration has allowed staff members at JHU to ignore standards of care, reject evidence based medicine, and skip over guidelines of their professional organizations as long as the transgender community is at the receiving end of such malpractice.
Just prior to an October gathering of the World Congress of Families (which is an SPLC-certified hate group), a radio station in Utah held a pre-conference event called STAND4TRUTH 2015, sponsored by the Family Research Council (another hate group), American Family Association (another hate group), and MassResistance (yet another hate group). Their speakers included some of the most radical anti-LGBT leaders from these groups such as Peter Sprigg, Peter LaBarbera, Michael Brown, Dave Welch, Matt Staver, and Brian Camenker.
And then there was Dr. Paul McHugh of JHU, prominently displaying his JHU credentials in support of reparative therapy and anti-LGBT animus.
When I contacted JHU regarding Dr. McHugh’s participation in this conference, the university informed me he had “declined the invitation” and that “Johns Hopkins Medicine lives by its mission and its vision and embraces diversity and inclusion.”
However, when I spoke with the STAND4TRUTH 2015 organizers, they informed me that McHugh was in town for the event but missed his panel because he set his alarm to the wrong time. They also claimed he came to the conference after his panel. STAND4TRUTH organizers deny that McHugh declined their invitation. Wherever the actual truth lies, however, the conference’s brochure suggests he had said yes at some point.
Dr. McHugh has a lot in common with these right-wing, religiously -motivated hate groups. He is a self-described orthodox Catholic whose radical views are well documented. In his role as part of the United States Conference of Catholic Bishops' review board, he pushed the idea that the Catholic sex-abuse scandal was not about pedophilia but about "homosexual predation on American Catholic youth." He filed an amicus brief arguing in favor of Proposition 8 on the basis that homosexuality is a "choice." Additionally, McHugh was in favor of forcing a pregnant 10-year-old girl to carry to term even though she had been raped by an adult relative.
His words and actions toward the transgender community are the most radical and egregious, however. He has compared medical care for transgender people to “the practice of frontal lobotomy.” McHugh’s disdain for his own patients is evident, calling them “caricatures of women” and pushing the demeaning narrative that all transgender women are either self-hating gay men or perverted heterosexuals. Worse, the damage McHugh has done to transgender health care is incalculable. McHugh shut down one of the few gender clinics in the U.S. in 1979, and his lobbying in 1981 was instrumental in getting a national coverage decision forbidding the government from covering gender-affirming care. It wasn’t reversed until 2014. As a result of his outspoken desire to see transgender people shoved back into the closet, Dr. McHugh has become the go-to “expert” for right-wing organizations.
While Johns Hopkins claims “respect for patients’ backgrounds and beliefs” is vital in its Diversity and Inclusion Mission Statement, the actions of staff members and administration should make it clear that these are just words where transgender patients are concerned. When other JHU staff members have made controversial and public anti-LGB statements, the organization has been quick to put space between themselves and the positions of their staff. Dr. Ben Carson (also of JHU, also of bizarre and offensive beliefs about lesbians and gays) went a step too far by comparing same-sex marriage to bestiality and the North American Man/Boy Love Association. Johns Hopkins University publicly distanced itself from him as a result.
"Controversial social issues are debated in the media on a regular basis, and yet it is rare that leaders of an academic medical center will join that type of public debate," said Dr. Paul Rothman, CEO of Johns Hopkins Medicine, in a statement in April. "However, we recognize that tension now exists in our community because hurtful, offensive language was used by our colleague, Dr. Ben Carson, when conveying a personal opinion. Dr. Carson’s comments are inconsistent with the culture of our institution."
Rothman's statement highlighted JHU's nondiscrimination policy as being inclusive of sexual orientation and gender identity, noting that Carson's statements mean "the fundamental principle of freedom of expression has been placed in conflict with our core values of diversity, inclusion and respect."
And then there's McHugh, who has also very publicly gone against the World Professional Association of Transgender Health Standards of Care for transgender people and the positions of his own professional organization, the American Psychiatric Association, in his 2014 Wall Street Journal article. McHugh suggests in the article that he speaks for Johns Hopkins when he states, “And so at Hopkins we stopped doing sex-reassignment surgery, since producing a 'satisfied' but still troubled patient seemed an inadequate reason for surgically amputating normal organs. … It now appears that our long-ago decision was a wise one.”
This biased and dangerous misrepresentation of evidence on transgender people was called out by prominent members of the American Psychiatric Association in a rebuttal letter to the Journal, as was his flagrant misuse of a 2011 study on outcomes for post-operative transgender people by Dr. Celia Dhejne. His deliberate misinterpretation of the 2011 study led Dr. Dhejne to publicly denounce McHugh’s actions as “unethical.”
McHugh has a history of engaging in behavior that endangers people he disagrees with for religious reasons. Kansas Attorney General Paul Morrison issued a cease and desist legal order in 2007 against McHugh for appearing in an inflammatory video that railed against Dr. George Tiller and which was arranged by anti-abortion activists. It ended up on Bill O’Reilly's show, and right-wing outrage spread in response to the Fox News segment. Then Dr. Tiller was assassinated in 2009.
If it were just McHugh, though, it wouldn’t be a pattern. However, other members of JHU's staff have become the “go-to” people whenever a defendant needs to justify denying transgender people health care. JHU’s Dr. Cynthia Osborne has been a witness in at least three cases in which transgender people were seeking health care. She says prisoners should never receive gender-confirmation surgery. As a result of her testimony, all three inmates lost their cases, and two of them resorted to self-castration out of desperation.
The university’s Dr. Chester Schmidt has also been a star for defendants who wish to ignore standards of care. Schmidt testified that he has never recommended transgender surgery out of the 300 transgender patients he's had. During his testimony, Schmidt stated (against WPATH standards of care) that the correct course of treatment for gender dysphoria is, in his opinion, “psychotherapy and medication.” Schmidt has availed himself of right-wing news outlets to make a case that transgender people should not be given affirming care.
For both Osborne and Schmidt, their positions at Johns Hopkins lent credence to their opinions in court, despite violating both the WPATH Standards of Care and the positions of their own professional organizations. A First Circuit Court of Appeals decision cites their positions at JHU as authoritative in their decision against providing health care to transgender inmates. Schmidt was also brought in by government as a defense witness in an employment discrimination case, where he testified that transgender people should not be legally protected under Title VII of the U.S. Civil Rights Act of 1964, since he viewed being transgender as a matter of sexual deviance rather than one of gender.
Anti-transgender bias at JHU has a long and sordid history. The study McHugh ran in the late 1970s was deeply flawed and biased, having been designed to get a particular answer. As a result, the psychiatric community no longer considers this study persuasive or credible. Fellow psychiatry staff member Dr. Thomas Wise has also espoused similarly outdated, offensive views on transgender people, including a belief that transgender people need reparative therapy, and not affirming medical care. In 1979, Dr. Wise wrote:
“The genesis of this perversion appears to be identification with a phallic maternal figure. … Identification of important losses in this patient's recent life allowed proper diagnosis and appropriate ongoing therapy to prevent the patient from irreversible surgery for a condition that was a symptom not an ingrained belief of gender dysphoria.”
McHugh, Schmidt, and Wise have made it clear that their opinions on medical care for transgender people have not wavered in the last 35 years, despite the rest of the medical and psychiatric community moving on.
These biases and adherence to discredited hypotheses has had a direct effect on the quality of patient care. Transgender patients have described humiliating, abusive, and demeaning treatment by JHU staff for years. Jennifer McCandless, a transgender woman, described to me in an email how she was treated by Dr. Schmidt and JHU staff:
“I was sent to JHU by a sympathetic doctor who just didn't know what dosages of hormones to give me. JHU charged me $900 out of pocket for the appointment. During intake, they asked lots of sexually leading questions on their background questionnaire. They kept trying to want to find some kind of underwear fetish in my past. Chester Schmidt came in and chewed me out for being nothing more than a closet transvestite, then ranted about how my therapist must have filled my mind with these crazy ideas. I was grilled for an hour. I was constantly challenged about my identity by a bunch of white-coat underlings ... just grueling. Schmidt also called my therapist and chewed her out; she said he (Schmidt) was really arrogant and obnoxious during the call.”
She never went back, and sought medical and therapeutic help elsewhere.
Some might note that the Johns Hopkins Bloomberg School of Public Health recently published a study supporting insurance coverage of transgender specific health care. However, this study is 10 years behind the research done by advocacy organizations, and half a decade behind the American Medical Association, American Psychological Association, and the American Psychiatric Association. This is the public health policy equivalent of the physics department confirming Newtonian theory. The School of Public Health doesn’t treat transgender patients either. In the end, this study does not change the equation at all, since mainstream medicine already agrees with it, and JHU’s staff is still actively and deliberately doing more harm than good to the transgender community.
The abysmal treatment of transgender people and failure to follow evidence-based medicine have been noticed by younger staff members at JHU. They are also upset at how McHugh, Wise, and other members of the psychiatric staff are protected by the administration. One younger doctor at JHU spoke with me on the condition of anonymity. He stated flatly that the institutions mistreatment of transgender people directly affected his decision to leave.
A number of disturbing facts emerge from all of this. Staff members at JHU appear free to participate in hate groups, ignore standards of care, disregard the positions of their professional organizations, deliberately misuse and misrepresent research, advocate for and practice medicine that isn’t evidence-based, and let their biases affect the quality of care that patients receive.
This raises the question, Is the staff always allowed to do this, or only where transgender people are concerned? If the former, it speaks very poorly of the organization as a whole. If the latter, it means the organization is actively supporting discrimination against, and mistreatment of, a community that is already extremely vulnerable.
Either way, there is a lot of explaining to do.