Psychiatrist Paul McHugh speaks about decades-long career, opposition to sex-reassignment surgeries
Psychiatrist Dr. Paul McHugh, a distinguished service professor at Johns Hopkins, discussed his career and opposition to sex reassignment surgeries. McHugh stated that research indicates sex reassignment surgeries do not resolve the underlying psychological issues of transgender individuals. He cited his experience closing the Johns Hopkins Gender Identity Clinic in 1979, noting that patients who underwent surgery did not see improvement in interpersonal, family, or job difficulties. The 94-year-old psychiatrist emphasized that his views are based on research, although he acknowledges his Catholic faith may play a role in his perspective.
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Dr. Paul McHugh, a 94-year-old psychiatrist and distinguished service professor at Johns Hopkins University School of Medicine, discussed his career and opposition to sex-reassignment surgeries in a March 13, 2026, interview on EWTN News In Depth.1 2
He emphasized that his views stem from research, not solely his Catholic faith, arguing surgeries fail to address underlying psychological issues.1 2
McHugh served as psychiatrist-in-chief at Johns Hopkins from 1975 to 2001.1 2
In 1979, he shut down the Johns Hopkins Gender Identity Clinic after reviewing patient outcomes from a decade of surgeries.1 2
Follow-up studies showed patients felt satisfied post-surgery but saw no improvement in key problems like relationships, jobs, or family issues.1 2
McHugh described the treatments as an unproven "experiment" lacking sufficient evidence to justify radical procedures.1 2
In 2016, McHugh co-authored a report in The New Atlantis stating no scientific evidence supports biologically fixed sexual orientation.1 2
Johns Hopkins colleagues pushed back via a Baltimore Sun op-ed, which he attributed to resistance against unwelcome findings.1 2
McHugh expressed astonishment at the movement's growth since 1979, criticizing its focus on patients' ideas over biological facts.1 2
He warned psychiatry risks repeating past errors by prioritizing perceptions over evidence.1 2
Surgeries and hormones on minors lack adequate study, especially given puberty's vulnerability.1 2
85-90% of youth desist from gender dysphoria without intervention; McHugh likened affirmation to persuading anorexia patients their bodies need "correction."1 2
McHugh long predicted lawsuits would halt minor surgeries, citing a February 2026 New York case awarding $2 million to a woman for a mastectomy at age 16.1 2
He expects more cases, primarily from women in their mid-20s, with higher payouts ahead.1 2
At 94, McHugh plans no retirement, aiming to witness his grandchildren's growth.1 2
He hopes to be remembered for courageously engaging contemporary issues, proving right on key matters.1 2
Assess Catholic doctrine on gender identity and medical interventions
The Catholic Church teaches that human beings are created male and female as a fundamental aspect of God's design, reflecting a complementary difference that is both biological and anthropological. This sexual dimorphism is not merely physical but essential to human identity, reciprocity in relationships, and the foundation of the family. As articulated in recent magisterial documents, "biological sex and the socio-cultural role of sex (gender) can be distinguished but not separated," and attempts to obscure this "ineliminable sexual difference between man and woman are to be rejected." Pope Francis has emphasized that gender theory "denies the difference and reciprocity in nature of a man and a woman and envisages a society without sexual differences, thereby eliminating the anthropological basis of the family."
This teaching draws from natural law and revelation, viewing the body as a gift from God that reveals the person's identity. The greatest difference between living beings—sexual difference—is "the most beautiful and most powerful," enabling the "miracle" of new life through male-female complementarity.
Catholic doctrine firmly rejects gender theory, often described as an ideology that posits gender as a social construct independent of biological sex. It promotes personal identity "radically separated from the biological difference between male and female," allowing identity to be chosen and changed over time. This view emerged in the 1960s-1970s "constructionist" theories, claiming masculine and feminine identities are products of social factors alone, justifying diverse sexual attitudes and redefining family.
The Congregation for the Doctrine of the Faith (CDF) labels gender theory an "ideological colonization" that cancels differences in the name of equality, leading to grave violations of dignity. It amounts to "desiring a personal self-determination... apart from this fundamental truth that human life is a gift," echoing the temptation to "make oneself God." Scholarly analyses trace its roots to figures like John Money, whose experiments failed catastrophically, yet the ideology persists, severing sex from gender and promoting self-identification.
The Church distinguishes this from legitimate recognition of women's dignity or addressing violence, which should not lead to erasing sexual differences.
While rejecting gender ideology, the Church acknowledges gender dysphoria (GD)—a distress where one's perceived gender does not align with biological sex—as a real human experience rooted in complex biological, psychological, and social factors. Prevalence is low (0.5-1.3%), often onset in childhood, with high desistance rates (80%+ resolve before adolescence); "rapid-onset" cases in teens may be social contagions. Associated with elevated suicide risks, it cries out for universal human needs: identity, freedom, and belonging.
Pope Francis urges listening to these experiences without "pre-packaged answers" like rote citations of Genesis, combating echo chambers. Persons with GD deserve dignity as "unique person[s] of incomparable worth," with rights to life and health care. Catholic health care must serve the vulnerable, including those with mental or physical conditions.
Catholic doctrine prohibits medical interventions aimed at altering one's sex characteristics to affirm a gender identity discordant with biology. The USCCB's 2023 Doctrinal Note condemns "technological interventions... [to] exchange the sex characteristics of a patient’s body for those of the opposite sex," including surgeries, cross-sex hormones, and puberty blockers (especially in children, arresting natural development).
The Ethical and Religious Directives (ERDs) ban direct sterilization, permanent or temporary, as it violates the body's integrity; procedures inducing sterility are illicit unless curing a serious pathology (not applicable to GD). Many scholars deem gender surgeries intrinsically evil: mutilation of healthy tissue, sterilization undermining self-gift in marriage, and rejection of God-given sexuality. A minority explores the "principle of totality" (e.g., removing life-threatening organs), but this does not justify non-therapeutic transitions, lacking evidence of long-term relief and risking harm.
Catholic institutions cannot perform or facilitate such procedures, prioritizing the body's gift-status over self-determination.
| Intervention Type | Catholic Evaluation | Key Rationale |
|---|---|---|
| Puberty Blockers | Prohibited | Arrests natural development; no pathology cured. |
| Cross-Sex Hormones | Prohibited | Alters healthy body for ideological affirmation. |
| Surgeries (e.g., "bottom") | Intrinsically illicit | Sterilization, mutilation; rejects sexual difference. |
| Supportive Care | Encouraged | Therapy addressing underlying distress, dignity-focused. |
Catholic doctrine upholds the inseparability of biological sex and personal identity, rooted in creation as male and female, rejecting gender theory's detachment of the two. Gender dysphoria evokes compassion and listening, but medical transitions violate human dignity through mutilation and sterilization. Fidelity to Church teaching calls for accompaniment, truthful dialogue, and advocacy for holistic care over ideological affirmation. Higher-authority recent documents like Dignitas Infinita (2024) confirm this unchanging stance amid cultural shifts.