This Is Where I Get Off by Pat Conrad MD


No, no, no, I mean it, no way, hell no!

Some of you are going to have a real problem with this piece, in fact, some of you will think very poorly of the author. Too bad.

I predicted earlier this year that societal fashion would soon turn into policy and training that would force broad acceptance of the transgender agenda by the medical community. Well, it’s happening. Two articles in the latest Family Practice News: “Transgender medical care is increasingly important”, and “Caring for transgender youth will require care across specialties.” FP News is now given over to propagating actual harm dressed up as compassion.

Dr. David Shumer at the Pediatric Academic Societies Meeting: “I think it’s incumbent upon (physicians) to figure out how to provide that education to trainees so that the next generation is able to provide excellent care for transgender kids and their families.” No, Dr. Shumer, it is not. Providing care for patients is not, and must not be defined “excellent” by virtue of buying into a harmful agenda and enabling a dangerous self-delusion. “Expect that you will see a transgender patient in your practice in the next few years, and prepare for it now. Don’t just scramble when it happens.” Don’t worry, I won’t, nor will I learn a bunch of gender-neutral communication patterns beyond common courtesy merely to adapt myself to this issue. Call me a dinosaur.

Also at the PAS meeting, child psychiatry resident Dr. Kristen Eckstrand, stated: “We all have a gender, we all have a gender identity, we all have a way to express that to the world around us, and to ignore that part of a human being would be a real detriment to our society.” So if I don’t embrace the transgender agenda as a physician, I’m anti-social? How exactly does Eckstrand determine the social value of individuals expressing fractured self-esteem and false identities? By the logic of the Shumers and Eckstrands we ought not call anorexics ill, but embrace their defined self-image. Eckstrand advises: “We need to ask ourselves how can we help our transgender patients achieve their gender presentation, the gender identification … We use pronouns and significations of gender such as Mr. and Ms., and we need to do so in a way that reflects what patients value in themselves.” I refer the lady to my previous assertions.

Now get ready for this garbage to accelerate. We will see the ABFM come out with Gender Competency modules for their MOC extortion racket. States more easily susceptible to political pressures from vocal minorities will pass mandatory CME’s for transgender issues (That’s how HIV and domestic violence became mandatory CME’s for licensure in Florida where I live). The AMA will furrow its collective brow, and then pass a strongly worded, if cautious statement on the need for respecting the vagaries involved in the protection of the rights and dignity of all those person(s) who at any time might identify with the need for the proper attention and evaluations of those whose position indicate them as being in positions of special trust bestowed upon them by a progressively variable yet diversely compassionate society. Obviously the Affordable Care Act will have to be adjusted to require all states to mandate transgender-counseling services, even for those beneficiaries who may not realize at the time that they might have the need to differently self-identify in the future. Can JCHAO trans-standards and new trans core measures be far behind?

I really can’t imagine how frightening and sad having gender identity confusion is, and like every other patient, these folks ought to get proper medical care. I’m not bashing transgenders and I do not dispute that they have a genuine problem, for which they need very specialized psychiatric care. But I am disgusted by those health care practitioners who promote surgical and hormonal mutilation, and further reinforce their patients’ genuine emotional turmoil in pursuit of some squishy, amorphous compassion that can only be defined by denying the obvious. They will pursue this “care” to promote their own agendas, salve their own confusions, gain public acclaim, or even to make a buck by preying on the vulnerable. Along the way, they will be promoted by willingly duped media sources, which will lead to greater “awareness” and ultimately policy mandates that will further disfigure this profession. This could never be the purpose of medicine, and I want no part of it.

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] 

  4 comments for “This Is Where I Get Off by Pat Conrad MD

  1. Bridget Reidy
    July 2, 2016 at 12:46 pm

    I never thought I’d be opposing the forces that try to make our culture more inclusive, but the problem with this transgender “rights” movement is it does just the opposite. When we tell a child they may choose their gender role, we are telling them there is some validity to gender roles, and even go so far as to equate them with biology when we say they were “born that way”. What male choosing to be or dress like a woman dresses like an ordinary woman? With Monty Python it’s a dowdy petty middle aged woman, and with drag queens it’s a sex symbol, and I don’t see much difference with the more modern versions. I’ve wondered who they are imitating since I was an adolescent, but it certainly didn’t seem to be anyone like me or most of my female friends. Yes sometimes we dress the part too, so maybe every other Saturday in my twenties was the “me” they were imitating, but that was a pretty small part of the total “me”. I think the whole movement is rather antifeminist, and I don’t see any benefit to enshrining traditional “male” gender roles as biologically determined either, choose all or none, either. (Or perhaps more accurately, choose to be included in a minority group while everyone else has to choose “all”) Perhaps learning basic cultural and medical anthropology – not the stereotypical drivel in the ABFM MOC – should be required instead of preaching the latest version of our narrow culture.
    I know the transgender movement will say I need more indoctrination because I just don’t get it, but for them I ask the hypothetical question “Do you want to look like the opposite sex or no sex because of what you see in the mirror, or because of how people interact with you?” I have listened to lots of lengthy interviews with trans people dwelling quite a bit on the former, and rarely if ever even mentioning the latter. So how is it different than any other cosmetic issue?

  2. Steve O'
    July 2, 2016 at 10:35 am

    PS: I suggest that much of the transgender “movement” is driven by some loathsome beliefs in American society which have exploded into common customs – aggression and cowardice. I mean that literally, in the way the Gleiwitz Incident that began WWII was an action of aggression and cowardice.

    Now, all over, many people believe that any action against the Enemy is justified in the name of their cherished beliefs. It is cowardice to act aggressively against a peaceful “enemy.” From the Istanbul Airport to Charlie to our own culture, hateful and vicious intent towards a manufactured “enemy” has become the standard, from ISIS to Indianapolis. Degrade them, depersonalize them, kill them in righteousness’s name. Sometimes the name is Führer and Fatherland – it is only the name that changes.

    Throughout the history of warfare, there have been “butch soldiers” – women who fought who were usually only discovered to be physiologically female when injured or killed, and their genitalia were seen. Perhaps transgender, perhaps filled with martial fury, they have existed in all wars alongside their brothers. In almost all cases, their comrades admired them as brothers, and the incidental discovery of their genitalia was not dwelt upon. Like military comrades who were evidently gay in service, I have yet to hear a veteran disparage former comrades for their orientation. “So what. They fight.” seems to be the common message.

    There have also been awesomely terrifying “cis-gender” women in warfare. The rifle is an opportunity leveler in war. The terrifying Liudmyla Pavlychenko, a Soviet sniper during World War II was confirmed at 309 kills, including 36 enemy snipers. Her career spanned only one year of combat. She retired from the front lines in June 1942 after being injured, and became an army sniper trainer for the rest of the war. She had become such a valuable public asset, the Soviet Army would not risk the humiliation of losing her in combat.

    She had twice as many kills as “American Sniper” Chris Kyle did over his ten-year career.

    She was not male-appearing off-duty. She traveled to America to rally support for the Allies. She noted in her autobiography that “(o)ne reporter even criticized the length of the skirt of my uniform, saying that in America women wear shorter skirts and besides my uniform made me look fat.” She did not kill him.

    Aleksandra Samusenko was a female tank commander the 1st Guards Tank Army. Ironically, while on the spearhead into Berlin at the end of the war, she was killed in Zülzefitz during the East Pomeranian Offensive, crushed under the tracks of a tank in the dark. She never fought under the guise of a male, and her crew respected her greatly.

    It is cowardly to fight against those who do not oppose you. Transgender veterans deserve respect – I have cared for transgender veterans. I suspect that a great deal of the “movement” is a discovery of transgender persons, especially M2F, by the cosmetics and clothing industry, which found a lucrative market.

    What we need is fewer transgender warriors – not fewer transgendered persons, but fewer wars and fewer warriors. I think it is ironic that the “movement” seems all about inclusiveness in a society which is fundamentally inhumane, and getting worse.

  3. Steve O'
    July 2, 2016 at 9:50 am

    The military frequently suffers from mission creep. Ignorant superior authorities engage military forces in matters OTW, Other Than War. Military forces are constructed to find and fight the enemy; that is what they exist. As instruments of absurdity, such as teaching bee-keeping in Afghanistan, are ridiculous. They execute these poorly, as the military is not so designed.

    Healthcare also suffers from mission creep. Ignorant superior authorities engage military forces in matters OTM, Other Than Medicine. A hundred years ago, a woman admitted to the hospital who was discovered to have men’s genitalia, and also appendicitis, had an appendectomy. That is proper care of the Transgendered person. Ditto gangrenous cholelithiasis, ditto many others.

    There have been Transgendered persons, likely as long as there have been persons; and these persons have received medical care from other medical personnel who range in their personal feelings between uncomfortable to comfortable.

    The inner feelings of the surgeon are inconsequential; the quality of their procedure is all that matters.

    With great fanfare, a neighboring city opened the First Women’s Hospital in the State. They discovered that Women’s Hospitals need the capacity for angioplasty and stenting, lap chole’s, and emergent airway management, which they did not pay much attention to when the plan was hatched. It was really a Women’s Genital Hospital at first.

    It is only right to struggle for more compassionate care for all persons. Here in America, I suggest that the ability for compassionate care has deteriorated severely. It may, in fact, be possible that the Transgendered Person has a WORSE hospital experience nowadays than they did in many places in the 1980’s. Is it reassuring that they died of peritoneal sepsis from an undiagnosed appendicitis today, whereas they would have been operated upon promptly and diligently thirty years ago? Or is this only Penis Politics?

  4. John A. Mayer, MD
    July 2, 2016 at 6:35 am

    In the mid-1990’s, I had the good fortune to spend 90 days as a USAF Flight Surgeon on temporary duty co-located with a Marine Corps aviation squadron at Aviano Air Base, Italy. I worked with their Navy flight surgeon and corpsmen, and was impressed by their training and professionalism. I was also impressed by the Marine Corps’ adherence to tradition and strict rules against consorting with different ranks and sexes. To service the needs of their flying and support personnel they had the following latrines set up in Tent City:
    1. Officer, Male
    2. Officer, Female
    3. Senior NCO, Male
    4. Senior NCO, Female
    5. E-6 and Below, Male
    6. E-6 and Below, Female.
    I think I can now understand the look of concern that seems permanently on Chairman of the Joint Chiefs of Staff, General Dunford’s face. He is worried about the additional number of latrines that the Corps must provide to be in accordance with this administration’s social engineering mandates. There must now be:
    1. Officer, Male
    2. Officer, Female
    3. Senior NCO, Male
    4. Senior NCO, Female
    5. E-6 and Below, Male
    6. E-6 and Below, Female
    7. Officer, Gay Male
    8. Officer, Lesbian Female
    9. Senior NCO, Gay Male
    10. Senior NCO, Lesbian Female
    11. E-6 and Below, Gay Male
    12. E-6 and Below, Lesbian Female
    13. Officer, Male Trapped in a Female Body
    14. Officer, Female Trapped in a Male Body
    15. Senior NCO, Male Trapped in a Female Body
    16. Senior NCO, Female Trapped in a Male Body
    17. E-6 and Below, Male Trapped in a Female Body
    18. E-6 and Below, Female Trapped in a Male Body.
    And we haven’t even gotten to the 29 or 37 other genders identified by the Current Committee of College Sophomore Citizen’s Police, to whom General Dunford now obviously must answer.

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