Paul R. McHugh
Psychiatrist and Johns Hopkins professor
Paul R. McHugh is the psychiatrist who, as chief of psychiatry at Johns Hopkins Hospital, closed the institution's gender clinic in 1979 — a decision that went against the medical current of its time and anticipates the reassessments now under way across Europe. At 94, his long view of how psychiatry repeatedly mistakes social fashion for medical science speaks directly to debates reshaping gender services from Stockholm to Brussels.
Paul R. McHugh spent more than two decades as Psychiatrist-in-Chief at Johns Hopkins Hospital, one of the most consequential posts in American academic medicine. It was from that position that he made the decision, in 1979, to close Johns Hopkins' gender identity clinic — the very programme that had made the hospital a pioneer of sex-reassignment surgery in the United States. His reasoning was methodical: follow-up research showed that surgery was not delivering the lasting psychological benefits its proponents claimed.
In THEY RESTARTED GENDER SURGERY FOR PROFIT??? Paul McHugh on John Money and Johns Hopkins (episode 22, July 2025), McHugh — then 94 — traced a through-line that European listeners will recognise. From the rise and fall of multiple personality disorder to the recovered-memory scandals of the 1990s, psychiatry has in his account a recurring vulnerability: it mistakes the enthusiasms of a cultural moment for settled medical knowledge. The figure of John Money, the psychologist who shaped Hopkins' early gender programme around a theory of psychosexual neutrality at birth, sits at the centre of this story.
For European clinicians and policymakers his retrospective carries particular weight in 2025. Sweden, Finland, Denmark and England have each moved to restrict paediatric gender medicine after systematic reviews found the evidence base weak; the Netherlands — birthplace of the original Dutch protocol — is re-examining its own approach. His books, including Try to Remember (2008), and the co-authored New Atlantis report on sexuality and gender (2016), supplied critical frameworks that now inform European clinical and policy debates.
Now University Distinguished Service Professor of Psychiatry at Johns Hopkins, McHugh embodies a tradition of institutional accountability — the conviction that a department chief's duty is to demand evidence rather than ratify consensus. At a moment when European health authorities are asking how entire cohorts of adolescents received experimental treatments on thin evidentiary foundations, his account of Hopkins in the 1970s reads less as historical curiosity than as a repeating pattern.
