Now comes a bit of a switch.  After relying upon internal evidence in the New Atlantis report, Sexuality and Gender, it’s time to give attention to the undercurrents of the report.  Like many partisan writings, an undercurrent of disingenuousness begins to reveal itself.

In the first part of this series we looked at some examples in Sexuality and Gender of how Drs. Mayer and McHugh treated evidences offered in scientific research in favor of transition.  A pattern emerged in which Dr. Mayer presented the shortcomings of each study as “not scientifically established” as if to propose that these studies were scientifically refuted when in fact they were not refuted.1

In the second part of this series we looked at the core study that purportedly gave cause for Dr. McHugh to shut down the Johns Hopkins transition program, Sex Reassignment: Follow-up  by Jon K. Meyer and Donna J. Reter.  The Meyer-Reter study used against transition turned out to be at least as flawed as studies cited favoring transition.2

Clearly, we’re seeing the workings of philosophy in its living quality:  a never ending conversation going back and forth, digging deeper with each critique.  When it comes to science, criticism should lead to more thorough and more sophisticated scientific examination in the spirit of Socrates as gadfly pushing minds toward greatness.

One of the tenets of scientific thought, and what makes science more than simple philosophy is the emphasis of knowing on the basis of deductive or inductive proof, often by empiric means, but following closely to the philosophical framework of logic established as reliable in a epistemological system akin to the Foundationalism of Rene Descartes.  In other words, a real scientist does not speak of that which he does not know through these means, at least as far as what he may consider indubitable and that range of non-doubt can vary widely.

So far, the charge made by Drs. Mayer and McHugh that science hasn’t properly established a whole lot in terms of what we can say is known is correct.  But plenty of reputable studies do suggest to varying degrees of probability that transition may be viable.  In many cases real controls may not even be possible.  Most of these studies have not been mentioned in the New Atlantis report at all.3

Of course, psychology is more art than science per sé.  It isn’t classed with natural sciences.  It may use scientific methods to produce observed data but it remains a humanity, an art drawing from multiple disciplines.  Psychiatry applies more medical science in terms of the physiology behind psychiatric disorders.  But even so, it cannot be regarded as a pure science either.  It’s also an art drawing from the fields of medicine and psychology.

What has not been established at this point is whether the study prompting the closure of Dr. Harry Benjamin’s program at Johns Hopkins was based upon real objectivity or was pre-meditated, and leaving the general population unable to access and democratically scrutinize the Meyer-Reter study upon which the actions of Dr. McHugh purportedly relies.

Nothing within the New Atlantis report allows anyone to call the actions of Dr. McHugh one way or another.  Instead we must look outside the New Atlantis report.  In 1992 Dr. McHugh had given his own account concerning this:

“From the faddish idea of institutions as essentially oppressive emerged a nuance that became more dominant as the 1970s progressed. This was that social custom was itself oppressive. In fact, according to this view, all standards by which behaviours [sic] are judged are simply matters of opinion–and emotional opinions at that, likely to be enforced but never justified. In the 1970s, this antinomian idea fuelled several psychiatric misdirections.

“A challenge to standards can affect at least the discourse in a psychiatric clinic, if not the practice. These challenges are expressed in such slogans as “Do your own thing,” “Whose life is it anyway?” “Be sure to get your own,” or Joseph Campbell’s “Follow your bliss.” All of these slogans are familiar to psychiatrists trying to redirect confused, depressed, and often self-belittling patients. Such is their pervasiveness in the culture that they may even divert psychiatrists into misplaced emphases in their understanding of patients.

This interrelationship of cultural antinomianism and a psychiatric misplaced emphasis is seen at its grimmest in the practice known as sex-reassignment surgery. I happen to know about this because Johns Hopkins was one of the places in the United States where this practice was given its start. It was part of my intention, when I arrived in Baltimore in 1975, to help end it.4

Dr. McHugh’s own statement is clear.  He intended to eliminate Dr. Benjamin’s program from the beginning.  The Meyer-Reter study, despite its admitted faults, did not cause this to happen and directly contradicts this statement from Dr. Meyer in the New Atlantis report:

This study led the psychiatry department at Johns Hopkins Medical Center (JHMC) to discontinue surgical interventions for sex changes for adults.” 5

But it didn’t according to Dr. McHugh.  This was clearly premeditated, presuming upon those transitioning that their intention to transition must be purely psychological, even indoctrinated.  Psychiatry alone must provide the answer to combat an “antinomian” idea that the subjective feelings associated with gender dysphoria have no real validity and are the entire issue behind transsexualism… a straw man fallacy presumed upon an entire demographic and dismisses the view of others concerning the gender of transsexuals, such views often being consistent with the aims of transition.

That alone belies the underlying pretense regarding the approach to the polemic of Sexuality and Gender.  This foundation of premeditation must lead us to consider more closely certain other claims.  But it opens up other questions pertaining to Dr. McHugh in his activities for the Congregation for the Doctrine of the Faith at the Vatican.  He had been selected to participate in a “Lay Person’s Sexual Abuse Board.”6 In the following year, 2003, the Congregation for the Doctrine of the Faith led by Cardinal Joseph Ratzinger (the future Pope Benedict XVI) directed the superiors of religious orders worldwide that transsexuals be barred as priests, nuns, friars, nuns, and brothers in religious orders or expelled if found afterwards to be transsexual.  A document reported by the liberal Catholic news agency Adista and confirmed by a Vatican official states in these directives:

“In the case that there is a serious and irreversible pathology of transsexuality, (the candidate) cannot be validly admitted into the institute or the society, while in cases of doubt, it is forbidden to allow admission since the candidate is missing a clear and full eligibility.”7

From where did the terms “serious and irreversible pathology” originate concerning transsexuals?  Did this originate within an already existing mindset of the Vatican or did this originate with Dr. McHugh?  Does Dr. McHugh believe transsexualism is an irreversible pathology?  If irreversible then 2 things become necessary:

  1. Transition must be forbidden not only in private practice but as a matter of public policy.
  2. Transsexualism must be classified as mental illness, demanding permanent psychiatric treatment not excluding psychiatric incarceration and psychological experimentation imposed upon those patients once their capacity to object to such treatment has been legally and socially impeached by labeling them as “mentally ill.”

The American Psychological Association stopped classifying gender dysphoria within the framework of mental illness in 2012.8 But if, counter to the APA’s reclassification, we must bring back outdated psychiatric practices upon transsexuals, stigmatizing them as “irreparably” mentally ill, then a number of things come into play:

  1. Trust established between transsexuals and psychiatric professionals for assessment will have been destroyed.
  2. A system of reparative therapy or conversion therapy once more becomes normalized.
  3. Abuses of reparative therapy under the color of authority become accepted
  4. Within the scope of abuse electro-convulsive therapy (ECT) and electroshocks as a means of conditioning against homoerotic images become accepted without question in the case of transsexuals.
  5. Within the scope of abuse contracts become imposed that include a penalty of frontal lobotomy if a patient “backslides” into any part of LGBT practice or society.

Reparative therapy properly consists of 4 principles according to the proponent Joseph Nicolosi, Ph.D:

“(1) the therapist’s disclosing of his own views; (2) encouragement of the client’s open inquiry; (3) resolving past trauma; and (4) education regarding associated features of homosexuality.”9

It’s aimed at “correcting false assumptions.”  These assumptions, attributed entirely within the thought framework of the patient, have nothing to do with social perceptions of the patient.

But widespread abuses have been noted, mostly within the context of impressments of LGBT peoples by Evangelicals as a form of intervention.  One of the greatest proponents of reparative therapy, Dr. Kenneth Zucker recently lost his clinic in Toronto due to the outcry against such abuses.10

The potential of abuse certainly exists within medical institutions including Johns Hopkins.  That institution does practice ECT and this is posted on the Johns Hopkins website.11 While nothing exists on that site concerning psychosurgery of any kind, the facilities obviously exist if any practitioner calls for it.  Of all, frontal lobotomy is perhaps the most feared, making it effective in written contracts certain patients of private self-styled Evangelical conversion therapists to prevent recidivism through fear.  Severance of connections to the frontal lobe may impair those potentials for higher thinking and spirituality, and in extreme cases, rendering patients as little more than automatons__ verily a form of institutionalized murder.12

Dr. Mayer tries to present a heartfelt care for LGBT people, especially transgender adults and youth.  But the reader must exercise caution in judging these stated intentions, for while professing one course of helping transsexuals, the report itself attempts to undermine them.  Careful reading betrays a deeper undercurrent in which ideas concerning what benefit may be turns out to be quite different from what they initially appear to be.  Worse yet, that deeper undercurrent reveals something genuinely insidious, a thing consistent with the Dominionism of the Vatican with a current more akin to the Inquisition than genuine therapy.

We find this dedication offered to the reader:

“I dedicate my work on this report, first, to the LGBT community, which bears a disproportionate rate of mental health problems compared the population as a whole. We must find ways to relieve their suffering.”12

Most readers may be inclined to take these words at face value.  But exactly what does Dr. Mayer mean by saying, “We must find ways to relieve their suffering?”  Does Dr. Mayer really want transpeople to function in society consistent with their gender identity?  Or would he do what many medical practitioners do: to toy with patients in a system that leaves them in an endless cycle of dependency upon the psychiatrist and to lead them into a pattern of denial concerning their continued suffering?  Read on:

“As citizens, scholars, and clinicians concerned with the problems facing LGBT people, we should not be dogmatically committed to any particular views about the nature of sexuality or gender identity; rather, we should be guided first and foremost by the needs of struggling patients, and we should seek with open minds for ways to help them lead meaningful, dignified lives.”13

Let’s consider for a moment the details of this statement addressed to citizens (reasonably presumed by context to consist of voting citizens of the United States), scholars (those who examine the details of science, language, and philosophy as recognized in scholastic communities and sustained through funding), and clinicians (medical and psychiatric professionals) concerned with problems LGBT people face. Each of these points raise important questions concerning the intentions of the New Atlantis report:

  1. All need to release any dogma concerning particular views regarding the nature of sexuality or gender identity.  Yet the New Atlantis report contributes to the dogma that LGBT issues fall exclusively under the venue of psychiatry, attempting to discredit all other studies examining other factors.  By doing so Dr. Mayer really invites us to drop our ideas and listen exclusively to the views presented in the New Atlantis report which tries to claim examination without dogma.
  1. We should be guided first and foremost by the needs of struggling patients. Who gets to define what those needs are?  Does the patient have any real say in this?  Or does the psychiatrist define what needs may or may not be?
  1. Seek with open minds for ways to help them lead meaningful, dignified lives. Does the current practice at Johns Hopkins Hospital really do this?  Open-mindedness does not simply cite the shortcomings of one side to discredit it while glossing over the shortcomings of others. More importantly, what exactly does Dr. Mayer and Dr. McHugh regard as “meaningful” or “dignified”?  In who’s context must such judgments be made?  Does the patient’s sense of meaning and dignity have any validity or must they be impeached in deference to the psychiatrist’s version of “dignity” and “meaning”?

We should also consider these words specifically directed against sex-reassignment procedures:

“The scientific evidence summarized suggests we take a skeptical view toward the claim that sex-reassignment procedures provide the hoped for benefits or resolve the underlying issues that contribute to elevated mental health risks among the transgender population. While we work to stop maltreatment and misunderstanding, we should also work to study and understand whatever factors may contribute to the high rates of suicide and other psychological and behavioral health problems among the transgender population, and to think more clearly about the treatment options that are available.”14

An examination of this portion in the context of the practice of Drs. Mayer and McHugh becomes more illuminating than the one preceding:

  1. Skepticism concerning the claim that sex-reassignment procedures provide hoped for benefits or resolution. “Skepticism” such as Drs. Mayer and McHugh have maintained has been demonstrated in the New Atlantis report to be a euphemism by unequal acceptance of studies pro and con.  Real skepticism is open-minded, not seeking to justify any pre-meditated course of action one way or another.
  1. We work to stop maltreatment and misunderstanding. By context we begin with Drs. Mayer and McHugh and extend the same circle to all readers, or at least such is attempted by leading the reader.  But what is this “maltreatment” and “misunderstanding” to which Dr. Mayer refers?  The passage says nothing about human rights.  Neither Dr. Mayer nor Dr. McHugh have offered anything at all to assist transsexuals to overcome social barriers in employment, safety, housing, or any other aspect of human rights.  Instead, Dr. Mayer and Dr. McHugh regard sex-reassignment to be “maltreatment” and other views of sex and gender as “misunderstanding”.  In this statement Dr. Mayer begs the reader to follow his course of thought and Dr. Mayer to what he would regard as proper treatment and proper understanding as he has laid out for the reader, thereby delegating all other practices to quackery without actually saying so directly.
  1. Work to study and understand whatever factors may contribute to high rates of suicide. We as activists agree, but object to the abuse of studies that actually do explore those factors which had been effectively rejected in the New Atlantis 
  1. Think more clearly about available treatment options. Actually, the current treatment options offered at Johns Hopkins are quite limited.  Only psychiatric treatments are now available to those struggling with gender dysphoria.  This is what Dr. Mayer is asking everyone to think more clearly about, and the exclusive treatment to which Drs. Mayer and McHugh want every transsexual to submit.

Dr. McHugh makes clear his position on treatment of transsexuals, defining his stance as consistent with reparative therapy:

“In fact, gender dysphoria—the official psychiatric term for feeling oneself to be of the opposite sex—belongs in the family of similarly disordered assumptions about the body, such as anorexia nervosa and body dysmorphic disorder. Its treatment should not be directed at the body as with surgery and hormones any more than one treats obesity-fearing anorexic patients with liposuction. The treatment should strive to correct the false, problematic nature of the assumption and to resolve the psychosocial conflicts provoking it. With youngsters, this is best done in family therapy.”16

Dr. Mayer’s repeated call in the New Atlantis report for better science is a genuinely correct directive and fully agreeable to trans activists everywhere.  But if the conclusions asserted in the New Atlantis report were actually carried out in public policy, then that science would never happen.  The reason isn’t hard to see.  If public policy prohibits transition and existing transsexuals face incarceration, that science eliminates old and new patients over the course of decades, especially large numbers of transsexuals who live according to their gender identity.  Those sought-after control groups simply could not exist.  This fact alone betrays the underlying disingenuousness of the authors.  The conditions which the current reforms in psychological and medical practice regarding gender dysphoria are attempting to do would never have any chance for proper assessments of long term outcomes.

This constraint in public policy desired by Dr. McHugh actually would deny other schools of thought the freedom to seek out a better world for transsexuals, and subsequently efforts by transsexuals to make a better life possible in what has been a traditionally oppressive society with respect to sex and gender.  That isn’t in the spirit of science at all.  Instead it provides one more convenient excuse for those inclined toward cruelty in their dealings with transpeople.

It’s that influence upon public policy, an affect that undercurrent of disingenuousness that makes it so dangerous.  The publisher states, “Applying the Judeo-Christian moral tradition to critical issues of public policy,” is that publisher as that mission, and the participation of Drs. Mayer and McHugh as contributors makes them part of that mission.17  It’s the same traditionalist premeditated mindset that spurred Dr. McHugh to take part in that “Lay Person’s Sexual Review Board” at the Vatican.  Religion too often interferes with the natural course of scientific inquiry, and Roman Catholic institutions have a long history of interference as any student of science learns.  The New Atlantis report will hardly be the end of these philosophical discussions.  Others will no doubt step up to the task… if they are allowed to do so.  Others will no doubt do so anyway whether authorities permit them to do so or not.



Note to readers:  since the first part of this series was posted, the original link to the pdf version of Sexuality and Gender has been severed.  The report can still be obtained from The New Atlantis at , however the page numbers will be absent from this version.


  1.  Stuart, Lynnea Urania.  Gender Identity and the Special Report (September 9, 2016) Web: Transpire:  Retrieved September 18, 2016.
  2. Stuart, Lynnea Urania. The Tipping of the Scales (September 16, 2016) Web: Transpire:  Retrieved September 18, 2016.
  3. (n.a.) References 5.a: Causes – Hormone exposure – Human studies (n.d.) Web: Cakeworld: Retrieved September 20, 2016.
  4. McHugh, Paul.  Psychiatric Misadventures (Autumn 1992), American Scholar, Chapter III available at Web: Retrieved September 9, 2016.
  5. Mayer, Lawrence S. M.B., M.S., Ph.D., and McHugh, Paul, MD Sexuality and Gender: Findings from the Biological, Psychological, and Social Sciences (Fall 2016) Web: New Atlantis 50. www.TheNewAtlantis.com20160819_TNA50SexualityandGender.pdf, p. 110. Retrieved August 26, 2016.
  6. Goldstein, Laurie. Bishops Select Lay Board On Sexual Abuse Review (July25, 2002) Web: New York Times. Retrieved August 10, 2016.
  7. Winfield, Nicole. Vatican Denounces Transsexuals (January 31, 2003) Associated Press, Web:  Free Republic. Retrieved August 9, 2016.
  8. Lee, Traci G. Being transgender no longer a ‘mental disorder’: APA (December 4, 2012) Web: MSNBC  Retrieved September 21, 2016.
  9. Nicolisi, Joseph, PhD. What Is Reparative Therapy? Examining the Controversy. (n.d.) Web:  Joseph Nicolisi:  Retrieved September 20, 2016.
  10. Singal, Jesse. How the Fight Over Transgender Kids Got a Leading Sex Researcher Fired (February 27, 2016) Web: Science of Us Retrieved September 20, 2016.
  11. (n.a.) Electroconvulsive Therapy (ECT) Service. (n.d.) Web: Johns Hopkins:   Retrieved September 20, 2016.
  12. The fact of contractualized frontal lobotomies has been attested to by individuals known to the author who had endured conversion therapy. For some details on its association, see: (n.a.) Conversion Therapy (January 16, 2014) Web:  SexInfo: Retrieved September 21, 2016.
  13. Mayer and McHugh, Sexuality and Gender, p. 6
  14. Ibid.
  15. Ibid, pp. 112, 113.
  16. McHugh, Paul, MD. Transgenderism: A Pathogenic Meme (June 10, 2015) Web: The Witherspoon Institute: Public Discourse:  Retrieved September 21, 2016.
  17. (n.a.) About (n.d.) Web: Ethics and Public Policy Center. Retrieved September 7, 2016.