April 15, 2017 Practice Points

Johns Hopkins Hospital Opens Center for Transgender Health

By Mark Hamby

After nearly 40 years, Johns Hopkins Hospital has officially reversed its policy on transgender health and "is moving forward to take care of transgender people in a supportive, affirming way that's grounded in evidence-based medicine." This is according to Paula M. Neira, the clinical program director for the new Johns Hopkins Center for Transgender Health. Neira, a former naval officer, a lawyer, and an advocate, left the military to transition from male to female.

A little history: In the early 1960s, Johns Hopkins was in the forefront of gender-identity science, and its Baltimore hospital was the site of the nation's first gender-affirmation surgery (then "change of sex operation") in 1966. Hopkins halted surgeries in 1979 while Paul McHugh was the chief of psychiatry. McHugh believed that by conducting surgeries "Hopkins was fundamentally cooperating with a mental illness," concurring with the findings of a study by Jon Meyer, who ran the hospital's Sexual Behaviors Consultation Unit. Meyer hypothesized that sex change surgery conveys "no objective advantage in terms of social rehabilitation." Both McHugh and Meyer remain associated with Hopkins, although McHugh's tenure as head of psychiatry ended in 2001.

As of July 2016, in a letter to the LGBT community, Hopkins announced plans for the Center of Transgender Health. Then in October, the former chief of psychiatry co-authored a report with a Hopkins scholar in residence contending that neither sexual orientation nor gender identity are biologically determined. The report was published in a conservative publication, New Atlantis. McHugh's name was also on an amicus brief opposing the case of Gavin Grimm, the transgender Virginia student, and McHugh has successfully lobbied to keep gender-reassignment surgery from becoming a Medicare benefit.

In response to the gaining notoriety of the report in conservative media, Tonia Poteat, an epidemiologist at Hopkins and expert on transgender issues, and colleagues at the Johns Hopkins Bloomberg School of Public Health denounced the report. Subsequently more than 600 students, faculty members, interns, alumni and others at the medical school also signed a petition calling on Hopkins to disavow the paper and to continue with developing the center. The hospital has continued developing the Johns Hopkins Center for Transgender Health and expects the Center to be fully operational this summer. In response to the notoriety of McHugh's report and the negative publicity, the hospital has stated that it strongly and unambiguously supports the LGBT community but acknowledges the right of individuals associated with Hopkins to express views contrary to its official policy.

Mark Hamby is an attorney with Widdows Law in Tulsa, Oklahoma.


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