1966: Gender Identity Clinic , one of the founders of the original Gender Identity Clinic in 2019 In November 1966, the
Johns Hopkins University would publicly announce the founding of the Gender Identity Clinic, led by John Hoopes, who at the time was the chief of plastic surgery at Johns Hopkins Hospital. John Money, professor at Johns Hopkins University, would co-found the clinic with Hoopes. It would primarily receive funding from research organization Erickson Educational Foundation, started by
Reed Erickson in 1964. The clinic was the first in the
United States to offer gender-affirming surgery, and led to the opening of many other throughout the country throughout the 1960s and 1970s. The first
feminizing surgery in the United States would be performed here, and combined with other such clinics founded afterward, would end up with approximately 500 cases six years after the founding of Johns Hopkins's Gender Identity Clinic. One-third of these cases were performed at university medical centers such as the one at Johns Hopkins, and initial studies done showed that the surgeries proved successful; transgender patients who underwent treatment had an increased quality of life when compared to before receiving surgery. Hoopes was the inaugural director of the clinic, and while initially supportive of gender-affirming care, later became more critical of the practice as it became higher-profile and more widespread. He became worried of the potential for the procedures to become a burden on his department, even going so far as to separate the Gender Identity Clinic from the hospital's surgery department several years before its closure, instead moving it under
obstetrics. This decision made it harder for the clinic to operate, depriving it of necessary resources. In 1975,
Paul R. McHugh was appointed chief of psychiatry at Johns Hopkins. McHugh was an outspoken proponent of the
pathologization of
LGBTQ patients, explicitly going to Johns Hopkins with the intent of ending the Gender Identity Clinic. McHugh was against gender-affirming surgery being offered to transgender individuals, saying it offered "no objective benefit", The same day that he sent the letter to Meyer, he also sent a letter to the current chairman of the Gender Identity Clinic, stating his intent to discontinue his and the plastic surgery division's work under the clinic, stating "This action was taken partially, perhaps, on the basis of personal bias, but largely on the basis of long-term clinical data regarding the efficacy of surgical procedures". Magrath notes that while there have been alternate explanations as to why the clinic closed, none are the reason behind it and the troubles leading to it shutting down in 1979. He claims the end of the Gender Identity Clinic came down to rising anti-transgender bias and stigma that grew throughout the 1970s and early 1980s, which McHugh and Hoopes were only part of. He cites a statement in a 1974 paper by Stanford surgeon
Donald Laub for this, stating that "The surgeon's reputation might be brought into question or damaged". This, along with the decreasing facilities and funding given towards the Johns Hopkins Gender Identity Clinic, is what led to its closure. As a result of the closure at Johns Hopkins, Magrath states that there were only two or three university clinics that practiced gender-affirming surgery by the mid-1990s, as opposed to nearly 20 that existed the year the Gender Identity Clinic was closed. He attributes the shift in tone during the 80s towards transgender, and ultimately LGBTQ people as a whole, as the main reason these clinics shut down; Johns Hopkins closing their clinic in 1979 and the Meyer study were a result of the changing times during the 1980s. The group has published the
Standards of Care for the Health of Transgender and Gender Diverse People since its founding in 1979, which aims to provide guidance to healthcare providers on transgender care and methods to improve
self-image and mental health, with the most recent version (SOC-8) released in 2022.
2017–present: Johns Hopkins Center for Transgender and Gender Expansive Health In October 2016, Johns Hopkins Medicine released a letter stating their intent to re-introduce gender affirming care. The announcement came shortly after a 134-page Fall 2016 publication written by Lawrence Mayer and co-authored by Paul McHugh was released in
The New Atlantis, contending that gender identity and sexual orientation are not biologically determined, among other claims. Being published in New Atlantis, a
conservative journal, it received traction among conservative media and was used to oppose support of transgender care and legislation. This led to
Tonia Poteat, a former
epidemiologist at
Johns Hopkins Bloomberg School of Public Health, publicly denouncing the report. Shortly thereafter, over 600 students, faculty members, and others associated with the Bloomberg School of Public Health also denounced the paper, and petitioned the school to do so as well. By the summer of 2017, Johns Hopkins University opened the Center for Transgender and Gender Expansive Health, also known as just the Center for Transgender Health, the successor to the original Gender Identity Clinic. The decision to resume services by the hospital was made "In an effort to reduce health care disparities and improve the overall health of the transgender community", in a Hopkins Medicine news publication. Despite Johns Hopkins's stated commitment to transgender care, as well as the discrediting of works and theories from McHugh and others about the efficacy of such care, both the clinic and the work done by the hospital has received criticism and lingering doubt because of its history. The
Human Rights Campaign, in their 2018 Healthcare Equality Index, deducted 25 points from the total possible 100 due to the hospital's non-acknowledgement of the publication and work done by Meyer and McHugh to discredit gender-affirming care. They cited their 2017
exposé as well as Meyer and McHugh using their former Johns Hopkins affiliations to give weight to these topics, specifically claiming their intent to try and discredit leading scientific opinion, as the reasons for this deduction.
The Washington Post's article about the re-opening of the clinic also cites McHugh's vocal opposition to surgery as treatment, but additionally claims the large gap between the closing of its original Gender Identity Clinic in 1979 and the opening of the Center for Transgender Care in 2017 are reasons why Johns Hopkins has not fully gained back its standing in the LGBTQ community. == References ==