I’ll admit it, this article made me mad. Why? Probably because I have a daughter and could empathize with her and her parents hurt and anger. When does the medical community say enough is enough already? This topic is controversial but I mean no bias, disrespect, racism, nor hate towards any individual or group of people. Another article2 popped up the other day on a news feed and it made me think. As about to be a newly minted MD this month, and applying for psychiatry residency later this year, I figure I needed to be more clear on this subject as it is a topic I will undoubtedly face in the near future. I think the limited review on the topic I did do, raised more questions than gave answers. For one thing, discussion of this topic is politically charged and highly emotional which often blurs objectivity. Rational discussions rarely take place. I would like to think that Dr. Paul R. McHugh, the former psychiatrist-in-chief for Johns Hopkins Hospital,2 would know what he is talking about. He states:
“that transgenderism is a “mental disorder” that merits treatment, that sex change is “biologically impossible,” and that people who promote sexual reassignment surgery are collaborating with and promoting a mental disorder.”
I suspect his position would disallow boys from entering girl’s sports. His position while seemingly politically incorrect, could be backed up by looking at other psychiatric disorders, right? Take for example a man who believes he is Jesus Christ and believes he the 2nd coming and the Messiah and all, he carries a bible in the subway and chants Proverbs intrusively to strangers. We label this man psychotic, diagnose him with schizophrenia and treat this mental disorder accordingly. Or the woman who believes she is infested by parasites with all objective evidence and workups negative, we diagnose with delusional disorder (delusional parasitosis) and treat accordingly. To me it seems legitimate to at least ask the question as to if we are in the same spectrum with transgenderism. There is a belief of something that objective evidence and science refutes. There is from what I’ve read3 a mismatch between ones assigned birth sex (genetics – XY, XX) and gender identification. But is the problem that the body didn’t follow the brain, or the brain didn’t follow the body, or did the body follow the genetics, and the brain didn’t, or was there some deep seated psychological trauma causing a flip-flop? Are we going down the wrong road treating with gender affirming therapies, genital altering surgeries, versus therapy for a mental disorder?3 Are we going down the wrong road allowing biological men to dominate in women’s sports?1,4 As for me, now I have more questions than answers, but at least I hope to be knowledgeable enough with tenants from different points of views to have logical and objective discussions. Regardless, I feel for this young girl and her dreams. Is it enough already, or do we live by political correctness?