Paul R. McHugh
Psychiatrist and Johns Hopkins chief emeritus
At 94, Paul R. McHugh brings a half-century of clinical reckoning to the gender debate. The psychiatrist who shut down Johns Hopkins' gender clinic in 1979 joined Stella, Mia and Bret to explain why its reopening troubles him — and to map the repeating pattern of psychiatric movements that mistake collective enthusiasm for scientific evidence.
Paul R. McHugh spent decades as psychiatrist-in-chief at Johns Hopkins Hospital, one of the most consequential posts in American medicine. In 1979, after commissioning and reviewing the evidence on surgical sex reassignment, he closed the gender identity clinic that Johns Hopkins had helped pioneer. His conclusion was that surgery was not relieving the underlying psychological distress. Decades later, Johns Hopkins reopened its gender clinic — a decision McHugh finds no more scientifically justified than it was the first time.
In episode 22, THEY RESTARTED GENDER SURGERY FOR PROFIT??? Paul McHugh on John Money and Johns Hopkins, McHugh sat down with Stella O'Malley, Mia Hughes and Dr Bret Alderman to trace the intellectual and institutional history behind that reversal. Central to the story is John Money, the Johns Hopkins psychologist who developed the concept of gender identity and championed hormonal and surgical intervention — a history McHugh is uniquely placed to narrate. What emerges is not a polemicist's brief but the measured account of a clinician who believes he has seen this pattern before.
That pattern runs through McHugh's career: psychiatric movements that expand rapidly, draw true believers, and treat clinical scepticism as moral failure rather than scientific practice. Multiple personality disorder and recovered memories are his earlier case studies — enthusiasms that swept through the profession before the evidence caught up. Gender identity, he argues, is the third wave. The episode probes why each surge is so hard to resist from inside the profession, and what it costs patients when the field gets it wrong.
McHugh is the author of The Mind Has Mountains and Try to Remember, the latter a close account of the recovered-memory movement. Now in his nineties, he speaks to this history as a witness rather than a historian — making his conversation with the Beyond Gender hosts among the most substantive the podcast has produced.
