Johns Hopkins Resumes Trans Care

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Johns Hopkins was an early pioneer in American trans care until anti-LGBT activist Paul McHugh began working at the hospital. In 1979, McHugh was able to end trans care at Johns Hopkins and later wrote that it was his goal to force the closure of the hospital’s gender program saying, “It was part of my intention, when I arrived in Baltimore in 1975, to help end it.” McHugh went on to describe his professional assessment of how and why transgender medical care was made available at Johns Hopkins:

The zeal for this sex-change surgery–perhaps, with the exception of frontal lobotomy, the most radical therapy ever encouraged by twentieth century psychiatrists–did not derive from critical reasoning or thoughtful assessments. These were so faulty that no one holds them up anymore as standards for launching any therapeutic exercise, let alone one so irretrievable as a sex-change operation. The energy came from the fashions of the seventies that invaded the clinic–if you can do it and he wants it, why not do it? It was all tied up with the spirit of doing your thing, following your bliss, an aesthetic that sees diversity as everything and can accept any idea, including that of permanent sex change, as interesting and that views resistance to such ideas as uptight if not oppressive. Moral matters should have some salience here.

Compare McHugh’s fact assertions about the genesis of the Johns Hopkins’ program with the way the program’s creator, Dr. John E. Hoopes, described the program in 1966:

After exhaustively reviewing the available literature and discussing the problem with people knowledgeable in the area. I arrived at the unavoidable conclusion that these people need and deserve help… Over the years, psychiatrists have tried repeatedly to treat these people without surgery, and the conclusion is inescapable that psychotherapy has not so far solved the problem.

Anti-trans activists have, for decades, cited McHugh’s closure of Johns Hopkins’ gender program as “proof” that whatever anti-trans trope they were pushing (usually to a credulous reporter) was evidence-based or reasonable. Today, the Catholic News Agency earnestly told their readers, “Johns Hopkins University, once a pioneer in sex reassignment surgery, has since ended the practice, finding that it was actually damaging to those who undergo it.” Recently, news cited a (non-peer reviewed) “study” that had Johns Hopkins’ name attached to it as yet more proof that it’s unethical to provide trans medical care. Unfortunately for McHugh and other anti-trans activists, Johns Hopkins has announced that it is strongly committed to providing trans care, including trans surgery, and that it’s committing to being an LGBT-affirming provider of care.

What follows are two letters that are being distributed among the Johns Hopkins faculty members:

Dear Colleagues:

Johns Hopkins Medicine’s commitment to the LGBT community is strong and unambiguous.

In July, we wrote to you in support of the LGBT community and Baltimore Pride celebration. In that message, we highlighted the policies, practices and programs at Johns Hopkins Medicine that reflect our deep commitment to providing a welcoming and supportive environment—and the best possible care—for all LGBT individuals who work for or seek help from Johns Hopkins Medicine.

In recent months, some have questioned our position, both inside and outside the institution, not because of any change in our practice or policy, but because of the varied individual opinions expressed publicly by members of the Johns Hopkins Medicine community. We have taken these concerns seriously. We want to reiterate our institutional support for LGBT individuals and update you on the work we are doing to further that commitment.

We also restate that as an academic medical research institution, academic freedom is among our fundamental principles—essential to the self-correcting nature of scientific inquiry, and a privilege that we safeguard. When individuals associated with Johns Hopkins exercise the right of expression, they do not speak on behalf of the institution. As set forth in the Johns Hopkins University Statement of Principles on Academic Freedom, academic freedom “is designed to afford members of the community the broadest possible scope for unencumbered expression, investigation, analysis, and discourse.”

Johns Hopkins Medicine highly values and is fully committed to supporting LGBT individuals. We have developed practices and policies consistent with this commitment, including:

• All Johns Hopkins Medicine and Johns Hopkins University nondiscrimination policies now include gender identity, gender expression and sexual orientation.

• We promote culturally competent care for every person we are privileged to treat, including training our staff members, faculty members and students in issues related to LGBT health, and improving our capacity to deliver an extraordinary experience for every patient.

• We have expanded our health care benefits to cover transgender health services, including surgical procedures, with no lifetime maximum benefit.

• Johns Hopkins Children’s Center physicians helped lead an American Academy of Pediatrics committee that authored the 2013 policy statement that supports access to clinically and culturally competent health care for all LGBT and questioning youth.

• In field and clinical research, Johns Hopkins University faculty members have advanced understanding of LGBT health and well-being, contributing to the important work of counteracting the negative effects of bias, discrimination and stigma that can hinder LGBT communities from seeking and receiving the best health care.

• In the past year, two Johns Hopkins Medicine task forces on LGBT health care have been charged with developing new paths for our institutions to further approaches to evidence-based, patient-centered care for LGBT individuals.

• We have committed to and will soon begin providing gender-affirming surgery as another important element of our overall care program, reflecting careful consideration over the past year of best practices and the appropriate provision of care for transgender individuals.   

The Johns Hopkins Medicine commitment to the LGBT community is sincere, strong and unwavering. We are intent on creating an environment and approaches to health care that are in keeping with our commitment and are in the best interest of our entire community—patients, faculty members, students and employees.

Sincerely,

Paul B. Rothman, M.D.
Dean of the Medical Faculty
CEO, Johns Hopkins Medicine

Ronald R. Peterson
President, Johns Hopkins Health System
EVP, Johns Hopkins Medicine

In support:

Michael J. Klag, M.D., M.P.H.
Dean
Johns Hopkins Bloomberg School of Public Health

Patricia M. Davidson, Ph.D., M.Ed., R.N.
Dean and Professor
Johns Hopkins School of Nursing

Dear Johns Hopkins University Community:

We are writing to share with the broader community the statement below from Johns Hopkins Medicine and Health System supported by our Bloomberg School of Public Health and School of Nursing. On behalf of the entire university, we echo this statement. We declare our university’s unequivocal and profound commitment to the LGBTQ community, those who are part of our academic family and those we seek to serve. We also reiterate our commitment to the principles of academic freedom as fundamental to our mission.

Johns Hopkins will remain steadfast in enacting our commitment to LGBTQ equality in our mission to educate, discover, and serve.
 
Sincerely,

Ronald J. Daniels
President

Sunil Kumar
Provost and Senior Vice President for Academic Affairs

H/T slowlyboiledfrog