“This intensely felt sense of being transgendered constitutes a mental disorder in two respects. The first is that the idea of sex misalignment is simply mistaken – it does not correspond with physical reality,” McHugh wrote. “The second is that it can lead to grim psychological outcomes.”

The transgendered person’s disorder, said Dr. McHugh, is in the person’s “assumption” that they are different than the physical reality of their body, their maleness or femaleness, as assigned by nature. It is a disorder similar to a “dangerously thin” person suffering anorexia who looks in the mirror and thinks they are “overweight,” said McHugh.

This assumption, that one’s gender is only in the mind regardless of anatomical reality, has led some transgendered people to push for social acceptance and affirmation of their own subjective “personal truth,” said Dr. McHugh. As a result, some states – California, New Jersey, and Massachusetts – have passed laws barring psychiatrists, “even with parental permission, from striving to restore natural gender feelings to a transgender minor,” he said.

The pro-transgender advocates do not want to know, said McHugh, that studies show between 70% and 80% of children who express transgender feelings “spontaneously lose those feelings” over time. Also, for those who had sexual reassignment surgery, most said they were “satisfied” with the operation “but their subsequent psycho-social adjustments were no better than those who didn’t have the surgery.”

“And so at Hopkins we stopped doing sex-reassignment surgery, since producing a ‘satisfied’ but still troubled patient seemed an inadequate reason for surgically amputating normal organs”.