Dr. Paul R. McHugh, a plenary speaker at this year’s Mere Anglicanism conference, served as the Henry Phipps professor of psychiatry, director of the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine, and psychiatrist in chief at the Johns Hopkins Hospital from 1975 to 2001. The Johns Hopkins University School of Medicine named him distinguished service professor in 1998.
Lydia Evans, a lay leader in the Diocese of South Carolina, interviewed Dr. McHugh on a variety of topics. They began by discussing the work of Dr. John Money (1921–2006), who was perhaps best known for his supervision and study of David Peter Reimer’s gender reassignment.
When you joined the Johns Hopkins faculty in 1975, Dr. John Money had been there for nearly 25 years. How much of an opportunity did you have to interact with Dr. Money?
Oh, I had multiple opportunities. He was a member of my department, and I was responsible ultimately for [oversight] of his publications at the end of his life because the university had decided they were untrustworthy.
Were there opportunities to achieve a fairly direct exchange of worldviews?
I had enough of a fight putting an end to sex-change operations and saying that we were no longer going to teach sexuality to the medical students the way he was teaching it. It became clear that I was going to confront [Money’s] approach, and he would have to come and present his material at our grand rounds … but we didn’t have a public debate. He didn’t want to have anything publicly to do with my confrontation, as I was restricting more and more his enterprises. By the way, I certainly had plenty of support within [Johns Hopkins], and that could not have been done without some evidence that the patients weren’t any better for [gender reassignment surgery]. And there continues to be plenty of evidence.
While Money’s work significantly shaped Johns Hopkins’ reputation as an institution focused on progressive care for intersex and transgender conditions, your influence led to a decline in surgical intervention and seriously eroded earlier theories of the plasticity of gender identity.
That’s right. [Evidence from longitudinal studies suggests] that gender identity disorder may well be something imposed upon people out of their wish to live the roles, and the lives, within their social cluster.
How do you view the popular assumption that science has somehow proven that sexual orientation is determined early in childhood, if not before birth?
Well, as I have said, there is no gay gene. And there are factors more influential than biology. If you are a man and you grow up in a rural environment, you are four times less likely to have homosexual relationships than if you grow up in a metropolitan area. That’s not left-handedness. If you are a lesbian, you are much more likely to be college-educated. That’s not something that happens at conception. My point is that we now know that the environment is very important.
On another front, as the sexuality debate within mainline churches seems to have shifted so profoundly in favor of the left, how do you see the debates of the broader culture changing in the next five to ten years?
It really is amazing … I mean, 50 years ago [homosexual behavior] was a crime, and now we’re talking about [same-sex marriage]. Anyone who wants to stick with the tradition is accused of being a biblical literalist or a homophobic racist, because, in part, of the more fundamental change in our society towards permissiveness, that is, easy divorce, cohabitation and concubinage, abortion, pornography … and euthanasia. The issue of the homosexual is not separate … it’s all part and parcel of the pandemonium that the permissive movement has brought. We have just licensed all kinds of behavior.
You have noted the critical influence of social behavior clusters on sexual development. You also mentioned that, early on in your medical training, you knew there were certain things that would disqualify you from becoming a doctor, including poor grades, a criminal record or a failed marriage.
Yes, that’s right. Fundamentally, I expected that, if I did marry, I was supposed to make it a go.
Now, wouldn’t some argue that those were societal expectations which were imposed upon you and your generation?
Yes, and they were good ones — and biblically based, and part and parcel of my commitment to really what amounts to loving relationships. You see, what has happened with the permissive movement is that it has picked up the Freudian confusion of desire and love, making them the same. And with the implication, for example, that I must desire my mother. I don’t desire my mother. I love my mother. Now the fact is that in my marriage, of course, I desired this woman and I felt love for her. Now, 50 years into marriage with her, I still desire her, but now I love her. She's irreplaceable. There is this thing that has come and it's different. This person exists for me as irreplaceable. So, there is this confusion of desire and love. [Homosexuality] is erroneous desire.
Much of what you have said seems to underscore the pivotal role that the ecclesial and parish family plays as a behavioral cluster. What more influential environment might there be than the Church?
This is the point. You’ve got to get the churches … not just the Anglican churches, but the Roman Catholics and the Presbyterians … they’ve got to start talking again about their foundational opinions. There’s an idea of there being different kinds of laws in our world: the natural law, the law of desire … but there is scriptural law that comes out of the Old Testament. And they’ve got to get all of this straight.
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4 Comments
Can I get a citation for the Framingham study? Is this the Framinghame heart study?
In responding to "How do you view the popular assumption that science has somehow proven that sexual orientation is determined early in childhood, if not before birth," Dr. McHugh completely avoids answering the question. The question does not ask if there is a "gay gene". Genes code for proteins and cellular processes, and no one protein has ever been said to determine sexual orientation. Saying "there are factors more influential than biology" just shows ignorance of biology. His assertion that that growing up in a rural environment means you'll have fewer homosexual relationships is meaningless: You'll run into fewer people than in the city, mores may keep you in the closet, and anyway you'll be more likely than the metros to have had relationships with sheep. It says nothing about sexual orientation. And maybe lesbians are more likely to be college-educated because they are less likely to drop out because of unintended pregnancy. And he derives this from a heart study? Dr. McHugh clearly puts more stock in Old Testament "scriptural law" and warped Roman Catholic theology ("erroneous desire") than any aspect of biological science. Does Johns Hopkins still let this guy teach future doctors?
RESPONSE to #1:
Begun in 1948, the Framingham Study is a well-known longitudinal study which initially involved 5209 men and women (ages 30-62). Ongoing, the study is now following a third generation. Over the decades, careful monitoring of the Framingham Study population has led to the identification of major risk factors for Cardiovascular Disease, including high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity.
Just as important as its original goal, the study has also gathered a great deal of valuable information on the effects of related factors such as blood triglyceride and HDL cholesterol levels, age, gender, and psychosocial issues. Data gathered has been utilized by social and behavioral scientists, particularly helpful in the study of social behavioral clustering. Here are several links to The Framingham Heart Study -- the first link is a downloaded chart of phenotypicdata. http://www.framinghamheartstudy.org/share/fhsphenotypicdata.xls
The second link offers more general information. http://www.framinghamheartstudy.org/share/index.html
RESPONSE to #2:
When I asked Dr. McHugh the question you reference, "if not before birth" implied the influence of genetic or hormonal factors in utero. So this was really part of the question. Furthermore, not only have Dr. McHugh and other medical and psychiatric professionals made this statement in the past year, the APA also clearly stated last year that "there is no gay gene."
While Dr. McHugh argued that biology is merely one influence upon the individual, he went on to state quite clearly (in his presentation at Mere Anglicanism, as well as in several of his books) that there were a number of other influences on sexual development and human behavior. He noted that psychology may play a part, along with the prevailing political climate. But he was very clear that social clusters seem to play a more pivotal role in shaping behavior. Without hearing his entire presentation, it's easy to misconstrue his meaning. And, having seen the vast amount of research he has gathered (apart from his use of Framingham), he clearly draws from many, many sources in arriving at his position. One important thing to remember: Dr. McHugh spent years working with psychiatric patients and providing student training in a clinical setting. And by the time he reached emeritus status at Johns Hopkins, he had been directing all work in psychiatry and behavioral sciences within both the JH Hospital and Medical School for more than 25 years. And while he is a practicing Roman Catholic, married to an Anglican woman for more than 50 years, he is first and foremost a scientist.
While he referenced the societal expectations of his generation as "good ones" and "biblically-based", he quoted no scripture (New or Old) during our interview. And, in fact, his characterization of homosexuality as "erroneous desire" stems from his work in Clinical Psychiatry. Remember, I spent a great deal of time with Dr. McHugh (and his books), but the length of the printed interview, based on space considerations, was determined by editors at The Living Church. At any rate, perhaps I have helped to clarify the context of his remarks.
Dr. Paul McHugh has seen it all, and, to my mind, his perspective is an important resource to a Church struggling to minister to "all sorts and conditions." We dismiss him at our own peril.
1. The existence of a gay gene has always been questioned; however,
2. The Framingham Study is a longitudinal study related to heart disease in a restricted cohort. While, it is a gold standardb of longitudinal studies, and its results are quite important, any relationship to homosexuality is very tenuous. To reference the study in this context is a disservice (see: http://www.framinghamheartstudy.org/share/fhsphenotypicdata.xls for a complete summary). Instead, presented a well refereed study that supports the opinions
3. The contention that homosexuality is "learned" also has no well performed scientific study as its basis. In fact, work on homosexuality indicates that most homosexuals knew their preferences before puberty. These preferences appeared to have no bearing on their upbringing, friends, or other external influences. In fact, a good question to pose to any hetrosexual who believes that loving someone of the same sex is a "choice" is, "at what age did you decide you would love someone of the opposite sex?"
4. Finally, to suggest that homosexuality can be changed to hetrosexuality also is based on some very limted examples of those supposedly cured. We know, witness such groups as Followers of Christ in Oregon who can convince their children to forgo medical intervention even though they die from a curable disease, or from the followers of Jones who drank cyanide laced Koolaid, that group (especially religious) pressure is a strong motivator.