I consider Dr. Paul McHugh the greatest living American psychiatrist and neurologist for his many contributions and his adherence to good medical science and practice, advocacy for good sense, and commitment to evidence-based medical practice. When he became chief of psychiatry at Johns Hopkins School of Medicine, he shut down the gender transition medical and surgical treatment programs. He explained that he could not agree with elective mutilating treatments to treat a mental disorder.

Dr. McHugh is an author, clinician, academic, researcher, and medical public health and social policy intellectual. His last three positions before retiring were Chief of Psychiatry at Cornell, Chief of Psychiatry at Johns Hopkins, and a University Professor at John Hopkins Medical School. Even the leftists at Wikipedia must acknowledge his objective credentials, even as they retell all the criticisms against him.

For leftists, McHugh has committed the big sin of calling out sex deviants for having mental disabilities, even as he asserts the societal value of good psychiatry, morality, and good behavior. How uncool, considering the left’s zeitgeist.

Here are some of his ideas and accomplishments:

• Freud and Freudian psychiatry are unscientific and unreliable. They have negatively affected good psychiatric practice, which must be more evidence-based and scientific.
• The Diagnostic and Statistical Manual (DSM) of Mental Disorders skips the hard work of good psychiatric care. He focuses on psychiatry grounded in motivated behaviors, genetics, epidemiology, and neuropsychiatry.
• He supports the Mini-Mental-Status exam for dementia and cognition, which he helped develop and that is widely used to evaluate cognitive capacity.
• In his textbook Perspectives of Psychiatry, which he co-authored with Dr. Phillip Slavney, he advocates evidence-based psychiatry that has support from genetics, neurology, behavioral psych, psych therapy, and social science.
• His research on memories of trauma shows that victims of trauma and abuse are haunted by the experience rather than suppressing it. This debunked the life-destroying theory of recovered memories of childhood sex abuse.
• He describes homosexual orientation as a choice based on desires and influenced by the environment. I think of it as a fetish, which is a paraphilia (that is, intense sexual pleasure from deviant sources). McHugh’s opinions are based on his studies of motivated behaviors.
• He asserted that dysmorphism and gender confusion are mental health disorders, not a person stuck in the wrong body.
• He has written on the negative outcomes of gender transition treatment long before Dr. Cass did her study in the UK. He condemns the surgical mutilation approach, the media/chattering class meme, and cherry-picked stories and scare scenarios that promote gender change treatment.
• He insists that, in medicine, the rule should always be primum non nocere (first do no harm). This applies to the gender transition movement that proposes draconian physical treatments for mental disorders.
• Along with Leon Kass, Dr. McHugh believes that there is a problem of medicalization in America. This is the mindset that believes there is a pill for every problem and a diagnosis for everything. There is an obsession with medical interventions, professional counseling, treatments for the realities of life, and even medical treatments to enhance performance.

Regarding this last point, the reader cannot help but consider what has happened in the matter of gender dysmorphism and appropriate medical management. There have been other mass hysteria epidemics, but this one is certainly emblematic of the societal problem of medicalization.

Medical professionals with a “do something” mandate sometimes jump in with poorly chosen interventions or solutions because professionals sometimes forget the proper methods for assessing the key issue: What is the problem, and do we have an efficacious and safe solution? Alternatively, will our intervention make things worse or create a new problem? Hormone treatments and mutilating surgery have permanent effects that cannot be extinguished.

Dr. McHugh’s wisdom is a product of intelligence, education, and experience. He has provided an insightful and beneficial voice for medicine. Too bad that his advice has often been ignored.

Image: Dr. Paul McHugh (edited). YouTube screen grab.

John Dale Dunn, MD, JD, is a 50-year emergency physician and 40-year attorney who was a consultant and physician with the local public mental health program for two decades.