Transgender: The Heart of the Issue


A woman shall not wear a man’s garment, nor shall a man put on a woman’s cloak, for whoever does these things is an abomination to the Lord your God. (Deuteronomy 22:5)

Dr. Paul McHugh

It’s always useful to hear both sides of the story — a dimension lacking in the current transgender debate. So, here’s the view of Dr. Paul McHugh, former Chief Psychiatrist at Johns Hopkins University Medical Center. His thoughts on transgendered individuals are worth reading in the wake of the Bruce/Caitlyn Jenner revelation. His recent Wall Street Journal article is behind a subscription wall, but here is the gist of it.

First, Dr. McHugh asserts, “the idea of sex misalignment is simply mistaken — it does not correspond with physical reality. Second, it can lead to grim psychological outcomes.”

Johns Hopkins University was the first American medical center to venture into “sex-reassignment surgery”. Then, a study in the 1970s comparing the outcomes of transgendered people with and without the surgery revealed that although most surgically treated patients described themselves as “satisfied” by the results, their subsequent psycho-social adjustments were no better than those who didn’t have the surgery. As a result, Johns Hopkins discontinued offering the procedure.

Risk of various outcomes among sex-reassigned subjects in Sweden (N = 324) vs. population controls.

Perhaps the most disturbing evidence comes from a 2011 study at the Karolinska Institute in Sweden. This long-term study (up to 30 years) followed 324 people who had sex-reassignment surgery.

Beginning about 10 years after having the surgery, the transgendered began to experience increasing mental difficulties. Most shockingly, their suicide mortality rose almost 20-fold above the comparable nontransgender population (compare columns 3 and 4)

This result has yet to be explained, but the high suicide rate certainly challenges the surgical option.

At the heart of the problem, according to Dr. McHugh, is confusion over the nature of the transgendered. People who undergo sex-reassignment surgery do not change from men to women or vice versa. Rather, they become feminized men or masculinized women. Claiming that this is civil-rights matter and encouraging surgical intervention is in reality to collaborate with and promote a mental disorder!

If individuals seeking sex reassignment surgery are suffering from a treatable mental disorder — a form of body dysmorphic disorder – they might be able to recover without invasive surgery. Shouldn’t society encourage the less intrusive psychological therapy rather than the more intrusive (and irreversible) surgery?

And, if the surgery does not improve — but amplifies — underlying psychological disorders such as depression, doesn’t surgery constitute an unethical harm?

Finally, when children with transgender feelings were followed without medical or surgical treatment at the Vanderbilt University and London’s Portman Clinic, 70% to 80% of them spontaneously lost those feelings. Some 25% did have persisting feelings; and what differentiates those individuals remains to be discerned.

Search me, O God, and know my heart! Try me and know my thoughts! And see if there be any grievous way in me, and lead me in the way everlasting! (Psalm 139:23-24)

For Christians living in a secular world it is of no matter whether the basis of gender distortion is genetic, hormonal, physiological, or psychological. The Bible views it as rebellion against God’s plan. The good news is that lives can be changed through faith in Christ.

And such were some of you. But you were washed, you were sanctified, you were justified in the name of the Lord Jesus Christ and by the Spirit of our God. (1 Corinthians 6:11)