The Riddle of Gender - Deborah Rudacille [74]
Clinic at Johns Hopkins was soon followed by the opening of similar research projects at other university hospitals, including Stanford and the University of Minnesota. Despite the generally positive media response to the hospital’s decision to begin performing sex-reassignment surgery, many doctors and researchers continued to object to the practice—much to the sorrow of Harry Benjamin and the disdain of John Money. “The Johns Hopkins transsexual program was a source of immense satisfaction to Harry Benjamin, for it vindicated and authenticated his otherwise lonely advocacy of a group of patients generally despised and ridiculed by the medical establishment,” Money said at Benjamin’s memorial service in 1987. “Conversely the public repudiation of this program by medical moralists who were not members of the gender-identity team was to him a source of immense sorrow. I knew about that sorrow from my periodic phone calls and occasional visits with Harry Benjamin.”
Paul McHugh, who has himself been attacked by Money for “medical moralism,” maintains that resistance to the practice never really died down at Johns Hopkins. Soon after he became chair of the department of psychiatry there in 1975, he told me in 2003, he became aware of the discontent of the surgeons who performed the surgeries, he says. “The surgeons were saying to me, ‘Imagine what it’s like to get up in the morning and come in and hack away at perfectly normal organs because you psychiatrists don’t know what to do with these people.’” Though he denies that he was recruited by Johns Hopkins for the express purpose of shutting down the unit, it is clear that he has no regrets about that decision. “When I came here and saw the incoherence of the unit, it became clear to me that it wasn’t serving a good purpose,” he says. “I felt that we’d try to find good evidence for it or against it. The evidence that I found was against it. People weren’t being made better, all of it was anecdotal, there were real problems as to what the nature of this condition was, and even the surgeons were weary of doing it.” McHugh formally based his decision to close the clinic on an outcome study produced by Dr. Jon Meyer, the head of the Gender Identity Clinic at the time. The Meyer study, which was immediately attacked for its poor methodology and which has been refuted by subsequent outcome studies, “was adequate for what it was intended to do,” McHugh says, “which was to show, to find out, whether these people were over their psychological problems. And it turned out that they were no more psychologically stable—stable in their employment or relationships—than they were [before surgery].”
The Meyer study, cowritten with Donna Reter, noted the generally positive (good or satisfactory) outcomes reported by other researchers but reached a different conclusion. “Sex reassignment surgery confers no objective advantage in terms of social rehabilitation, although it remains subjectively satisfying to those who have rigorously pursued a trial period and who have undergone it.” Meyer and Reter based this conclusion on a comparison of fifteen patients who underwent surgery at Hopkins compared with thirty-five who had not completed the Hopkins program but who, in some cases, continued to pursue sex reassignment and later underwent surgery elsewhere. “While not a rigorous