A Psychiatrist Writing in The New York Times Forgets That First He Should “Do No Harm”

I previously read the opinion piece in the New York Times referred to by this post in The Huffington Post. I was quite upset and angry and was considering how to respond when this post came along. I have excerpted the opening section of this post. Continue reading this piece by following the link at the bottom of this post:

Dana Beyer Headshot

“First, do no harm” (Primum non nocere) is the first ethical axiom all medical students are taught. It takes many years to fully internalize what that means, from learning to respect the patient’s determination of harm to himself, to the restraint a surgeon must exercise when she wants to clip off just a wee bit more tissue to leave a more elegant result (having learned that there may be an arteriole hiding in the tissue which she does not want to cut lest bright red blood spatter everyone within reach).

For physicians who write for a living or avocation, particularly those who write for a globally respected newspaper like The New York Times, the dictum is even more important, as the impact is not limited to just one person but will potentially affect many. It’s even more important when that physician is an academic psychiatrist, such as The Times‘ new science writer, Richard A. Friedman of Cornell Medical College.

Dr. Friedman, a specialist in mood disorders but not human sexuality or sexual development, let loose an op-ed in The Times last week entitled, “How Changeable Is Gender?” The short answer is, “Gender identity is fixed by age four and unchangeable; gender expression often changes on a daily basis.” But the good doctor didn’t bother to learn his basic definitions.

I responded on HuffPo Live, and now in print.The Timesshould have fact-checked Dr. Friedman, who made a gross mistake early on when he stated that transsexualism is very rare, of the order of 5/100,000. When I saw that prevalence ratio, which was derived from long outdated data from the days trans persons were universally treated as sexual deviants, I knew we were in for trouble (the best estimate is 3/1000, a factor of 100 larger). It was unfortunate because he had started well, with a positive tone and promotion of new brain scan data from Georg Kranz of the Medical University of Vienna. Many of us had been waiting for years for the development of this new breed (diffusion tensor) of high-resolution MRI scans, because the classical work done two decades ago was done on neuropathology specimens, and no one wants to die to help advance medical science.

The result was in line with all the older research and confirmed our expectations — trans persons had brain structures consistent with their gender identity, or their brain sex, and not with the sex assigned them at birth based on genitalia. Great!

The results even showed a spectrum, consistent with the spectrum of gender identities as experienced by persons, young and old. But rather than celebrate with the trans community, particularly with us physicians and scientists who’ve been trumpeting similar earlier results for decades, he compared trans persons to gay ones (for whom there is no equivalent scientific evidence of unique brain function, by the way), acknowledged that reparative therapy for gay people is a dismal failure, and then asks, “What do we really know about how happy transitioned trans persons are?” Clearly they’re not crazy, he acknowledges, and while we have to accept gay people and not attempt to change them, must we do the same with trans persons? Doesn’t biology put constraints on a person’s realization of her gender identity?

It’s obvious that he answers that last question in the affirmative, and to such a degree that he questions the utility of gender transition and genital surgeries. He goes research shopping and then misreads data to fit his pre-existing conclusion.

Continue reading this article here at The Huffington Post: http://www.huffingtonpost.com/dana-beyer/a-psychiatrist-writing-in_b_8065958.html

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About Fairy JerBear

A disabled, trans/agender fairy bear living in the American Southwest and passionate about social justice, the environment, Trans/ LGBTQIA+ equality and combating bullying.
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