It Still Ain’t a Cat by Pat Conrad MD


A few months back I wrote a short piece on the transgender craze sweeping an ESPY’d nation, and came in for some sharp barbs regarding my lack of sensitivity and empathy for patients seeking to self-mutilate.

Last week in the rush to laud Bruce/Caitlyn Jenner for the courage to publicly cross-dress, self-mutilate, and traumatize his/her family, I came across a column by anti-trans-surgery activist Walt Heyer. “Caitlyn Jenner Needs Therapy, Not Awards” includes the personal regrets of a physician post-gender reassignment surgery; and the dismissive rationalizations of a post-gender reassignment surgeon who him/herself had undergone transition with this fabulous CYA, “I cannot be held responsible when someone makes a bad decision.”

The celebritization (admittedly a made up word, but I like it) of all things “trans” is having an effect. A dear family friend in her eighties is despondent over her mid-twenties granddaughter’s decision to pursue gender reassignment, California lawyers are licking their chops over the coming plethora of bathroom equality lawsuits, and now the White House is forcing the embrace of all things TG on the military. The only “trans” still held up to ridicule is the tasty fat variety used to fry chicken and county fair Twinkies, and that just ain’t right.

Yeah, I digress – what’s the connection to “Authentic Medicine”? Under the guise of hokey, highly arbitrary pseudo-psychology, emotionally fractured patients who deserve real empathy and compassion are being encouraged to seek surgical mutilation of healthy organs. I will continue to make fun of the tragic Bruce/Caitlyn Jenner because he/she holds him/herself out as a public example, whose grotesque self-rationalizations are giving cover to bad surgeons who are harming patients. If the medical community had a fraction of the character it claims, there would be unanimous condemnation of these butchers and they would be shut down.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  12 comments for “It Still Ain’t a Cat by Pat Conrad MD

  1. Bridget Reidy
    August 6, 2015 at 2:51 am

    I noticed when I was a teenager that drag queens talked about liking to dress as women but always dressed as female sex objects. I always found it so insulting to my own integrity that they didn’t accept my or any woman’s definition of what being a woman is. At some points in our lives, being a sex object or wanting to be is a small part of who we are as human beings, at others – not at all. I don’t here anything different these days from transgender people. I really apprecite Lancalots comments on what he sees and likes in women.

    • Sir Lance-a-Lot
      August 6, 2015 at 10:13 am

      I know exactly what you’re saying, Bridget. I used to say exactly the same thing (though I’ve since softened my opinion slightly).

      Men who play as “drag queens” affect the most woman-damaging stereotypes of women, as though those stereotypes were the norm, but with the luxury that they can wipe off their makeup, toss their wigs in a bag, and walk down the street late at night without the fear of being attacked that a real woman has to live with all the time.

      Over the last few years, though, I have eased up on drag queens a bit, as a result of knowing a few. For the most part, these are just guys who found that they have a schtick that goes over well in the bar, and play with it in a limited place, where everyone understands that it’s just a game, then go back to their (often very low-end) jobs, and plan their next appearances, which are pretty much the highlights of their week / month. The ones I’ve known in person have been fairly sad characters, because without all the make-up and clothing, they’re all very unremarkable, and seem to need the drag thing to make themselves stand out.

  2. Jim schlesinger
    July 30, 2015 at 11:45 am

    Finally a voice of reason! I recall a wise teacher in med school who in discussing transgender told us, “we have no idea how to fix a brain, but it is easy to cut a dick off.” Still true.

    • Sir Lance-a-Lot
      July 30, 2015 at 3:35 pm

      It would be hard for me to cut a dick off.

      Even circumcisions make me want to cross my legs.

  3. Fred LaVenuta MD
    July 29, 2015 at 12:25 pm

    Algorithm for determining an individual”s sex:
    1- Analyze person’s DNA
    2- Result: XY chromosome = male
    XX chromosome = female
    Clothing optional

  4. Mary K Freel
    July 29, 2015 at 10:01 am

    These comments remind me of the people who say homosexuals can change to heterosexuals if “they only try”. Sorry the empathy meter is on 0 for the commenters.

    • Sir Lance-a-Lot
      July 29, 2015 at 10:19 am

      The commenters are not asking for your empathy.

      We are telling it like we see it and we are not ashamed or apologetic.

      And nobody suggested that transsexuals could or should “change.”
      Our point, in fact, is just the opposite: That they have no need to change, as they are fine the way they are, and should just accept that they can be accepted for who they are **without** changing (that is: without having disfiguring surgery which may irreversibly damage their sexual function and enjoyment for the rest of their lives).

      So take you empathy to someone who needs it, like the whales or the polar bears, or the victims (or “survivors”) of [fill-in-the-blank].

  5. Sir Lance-a-lot
    July 27, 2015 at 10:21 am

    I’ve had some strong (and perhaps contradictory) opinions on this subject for many years, and they haven’t changed with the latest fashions.

    First, I will say that I bear no ill will toward those who are transgendered, whether pre- or post-op, because the bottom line is that it’s a free country, and you can wear what you want and do what you want with your body.
    You want to spend a whole lot of time and money getting huge tattoos, or extensive body piercings, or to dress like a stuffed animal before having sex? Fine with me. Far as I’m concerned, your right to swing your fist ends at the tip of my (or someone else’s) nose, and up to that point, you can do anything you want. I’ve got enough crap of my own going on, and have no need to concern myself with anyone else’s.

    That being said, I believe that the whole transgender thing is deeply, irretrievably stupid.
    It is a relic of a time, fifty or more years ago, when gender roles were absolute, and crossing those lines was a very big deal; when being the one who “wears the pants in the family” meant something definite, when men in NYC were arrested if they could not be shown to be wearing at least three (if I recall correctly) articles of men’s clothing (this was one of the ways that they charged people picked up on raids of gay bars), and ( a hundred years earlier) when a woman who wanted to have any success of her own had to pretend to be a man (remember, in the 1800s, in the US, women were not allowed to vote, and were generally not even allowed to own property).

    This is the 21st century. Women can be truck drivers, astronauts, lawyers, soldiers, and, yes, even doctors. Women are not violating the law by wearing pants. Men are not violating the law by wearing skirts. Women can have sex with each other, as can men, and can even marry each other, and most people in the US (including me) are absolutely fine with that. Men can stay at home and raise the kids while their wives work (I have known a few female doctors with this arrangement).
    Basically, aside from a few tough guys at the bar, nobody gives a rat’s ass how you dress or act or what you do.

    So, if you’re a woman who grew up liking to climb trees and get in fistfights, you can become a fireman or a cattle rancher, and wear those clothes, and even (if your features permit it) be mistaken for a man in public. Similarly, if you’re a man who grew up playing with dolls, trying out Mom’s makeup, and hanging out with the girls on the playground, you can become a hairdresser, or a… or a… ummmm… all of the “traditionally female” jobs, like teaching and nursing, are now so completely integrated that I can’t even list them. Suffice to say that you can even become a stripper, but only in “certain” bars.

    Because a woman can walk around all day wearing pants (mon dieu!) or a guy can walk around all day in a dress (provided he shaves his legs), there is really no reason for anyone to “transition” to the other sex – just do what you darned well want to do, with the deep understanding that none of the rest of us really cares.

    As far as bathrooms are concerned, sorry, but that’s another big yawn.
    I went to a college that had “unisex” bathrooms exclusively (it was cheaper than building new ones when they went co-ed in the sixties), and, once again, nobody cared.
    It’s a medical fact that neither sex looks particularly attractive while seated on the throne (and there are doors on the stalls anyway), and neither sounds any different when praying to the porcelain god.
    I will admit there are some who are bothered by having to take a leak with members of the opposite sex, but let’s face it, does it really matter? Many, many bathrooms in restaurants and bars in the major cities are “non-gendered,” and the world hasn’t fallen apart.
    Incidentally, I had a patient the other day who told me that she stopped getting recurrent UTIs after a friend told her to pee standing up (no, I did not ask her the mechanics of the thing), so there may be health benefits as well.
    I sure don’t care if I see a person who is apparently of the opposite sex in the bathroom with me, so, once again, this is a non-issue.

    Considering the doctors, I suppose I am of two minds on this.
    On the one hand, I believe that cutting and mutilating perfectly good organs or structures is malpractice, and should be punished.
    On the other hand, I believe that if a person wants to practice “body modification,” it’s his body, and he’s got the right to do it (ever see a patient who’d split his tongue down the middle? Kinda freaky, but kinda cool, because the two sides can move separately).
    I guess that for me the solution would be to ban it in the US, and make them go abroad to get it done. That way no American doctors are doing this sort of thing and pretending it’s “okay.”

    Finally, on a personal note, I have known a number of transgendered people over the years, and the one thing that I can say about them, consistently, is that they’re all completely friggin’ nuts, and that, for that reason, I tend to avoid them like the plague. I really don’t care what they “identify” as, or what kind of equipment they have, but, on an interpersonal level, they’re a bunch of whack jobs. For me, this is consistent with being the sort of personality that has a burning need to hack of your tallywhacker, but I suppose your mileage may vary.

    And here ends the reading.

    • Pat
      July 27, 2015 at 12:45 pm

      Insightful and entertaining as ever, Lance! Thanks ~ P.

  6. Steve O'
    July 27, 2015 at 9:04 am

    It’s easy to sense, but hard to examine, the mess being created for infotainment value. The TransFab spectacular is the processed-food equivalent of human identity.
    Caitlyn Jenner was laid out on the cover of Vanity Fair for the same reason that the Deetroit Steel of 2016 will be laid out on the cover of Car and Driver. Both magazines exist to move dollars for the industry, and Jenner is as perfect as a top-end Mercedes – you move serious cash and you get what you want. C.J. is a brave spokesprsn for millionaires everywhere.
    Modern American Retail Medicine is banking on big profits from the same proposition – that a retail approach to healthcare will roll in the big lucre like a Stage V hurricane rolls water into New Orleans. The proposition is that everyone is defective, and needs to be fixed by the infusion of Product, in exchange for Money.
    Bruce Jenner is “not there yet” – Bruce Jenner needs to be Fixed, says the Common Wisdom. Gays and Lesbians need to be Married. there need to be efficient Rules in our Society.
    Both genuine Christianity and genuine Existentialism cut against the grain of these prejudices. A living person simply IS, as is a tree or a cloud. They ARE, first and foremost – before their particulars should be considered, such as a nimbus cloud or a maple tree. In the matter of fellow humans, it is sublime arrogance to point out how they are different – and how they might change to become better. That bad habit is very often seen in religion, although most religions state the obnoxiousness of such a habit.
    What do LGBIT… people ‘really want?’ They want something no different than the marchers in Selma, the rioters in the Stonewall, the fighters in the Warsaw Ghetto. Do not trip over one word, and miss the rest.
    “We hold these truths to be self-evident, that all humans are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”
    If we “know better than this” about what some other human wants or needs, whether it is a Bisexual Human, a Nurse Practitioner human, a Black human, a Schizophrenic human, we separate ourselves falsely by the sin of hubris. What is in the person? Ask the person. All else is prejudice.

    • Sir Lance-a-lot
      July 27, 2015 at 10:31 am

      “What is in the person? Ask the person. All else is prejudice.”

      Thank you, Steve, that covers it pretty well.

      Thank you also for you mention of Bruce (again) – it triggered one other response from me:
      Bruce Jenner all trussed up like a “real” woman was something I found absolutely disgusting for a very specific reason: I have known MANY women throughout my life who looked NOTHING like that, and who were, nonetheless, COMPLETELY, FULLY real women, in spite of their small chests, narrow hips, blue jeans, uncomplicated hair, running shoes, and lack of makeup.
      All that BS cover stories like that one do is to insult and demean women who are completely female, but who do not subscribe to that ridiculous idea of (overpriced, corporate-sponsored) “beauty.”

  7. Bill Ameen MD
    July 27, 2015 at 7:49 am

    I don’t understand this phenomenon. I’m not sure psychotherapy is the answer for these (usually men) who claim to have women trapped inside any more than psychotherapy “cures” homosexuality. That said, my nurse practitioner’s son had gender-reassignment surgery which cleaned out her savings for $20,000 and, last I heard, he/she is still lying around depressed feeling sorry for himself/herself. Jenner, from all appearances, just seems to be a shameless exhibitionist. Personally, I know THREE male physicians, within a 30-mile-radius of my practice, who had the surgery, all in their 50s or 60s. Damn, why would a man relinquish the right to piss against a tree in his own backyard?? That said, I seem to have heard that Jenner has NOT had his junk removed. Anybody know for sure?? And he/she will continue to like women. Is he/she now a lesbian?? My head spins…

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