Industrial research: Leaving the jet planes

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Transgender Surgery Isn’t the Solution – Former psychiatrist in chief at Johns Hopkins Hospital

first_imgWall Street Journal 12 June 2014Dr. McHugh, former psychiatrist in chief at Johns Hopkins Hospital, is the author of “Try to Remember: Psychiatry’s Clash Over Meaning, Memory, and Mind” (Dana Press, 2008).The government and media alliance advancing the transgender cause has gone into overdrive in recent weeks. On May 30, a U.S. Department of Health and Human Services review board ruled that Medicare can pay for the “reassignment” surgery sought by the transgendered—those who say that they don’t identify with their biological sex. Earlier last month Defense Secretary Chuck Hagel said that he was “open” to lifting a ban on transgender individuals serving in the military. Time magazine, seeing the trend, ran a cover story for its June 9 issue called “The Transgender Tipping Point: America’s next civil rights frontier.”Yet policy makers and the media are doing no favors either to the public or the transgendered by treating their confusions as a right in need of defending rather than as a mental disorder that deserves understanding, treatment and prevention. 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. The second is that it can lead to grim psychological outcomes.The transgendered suffer a disorder of “assumption” like those in other disorders familiar to psychiatrists. With the transgendered, the disordered assumption is that the individual differs from what seems given in nature—namely one’s maleness or femaleness. Other kinds of disordered assumptions are held by those who suffer from anorexia and bulimia nervosa, where the assumption that departs from physical reality is the belief by the dangerously thin that they are overweight.With body dysmorphic disorder, an often socially crippling condition, the individual is consumed by the assumption “I’m ugly.” These disorders occur in subjects who have come to believe that some of their psycho-social conflicts or problems will be resolved if they can change the way that they appear to others. Such ideas work like ruling passions in their subjects’ minds and tend to be accompanied by a solipsistic argument.For the transgendered, this argument holds that one’s feeling of “gender” is a conscious, subjective sense that, being in one’s mind, cannot be questioned by others. The individual often seeks not just society’s tolerance of this “personal truth” but affirmation of it. Here rests the support for “transgender equality,” the demands for government payment for medical and surgical treatments, and for access to all sex-based public roles and privileges.With this argument, advocates for the transgendered have persuaded several states—including California, New Jersey and Massachusetts—to pass laws barring psychiatrists, even with parental permission, from striving to restore natural gender feelings to a transgender minor. That government can intrude into parents’ rights to seek help in guiding their children indicates how powerful these advocates have become.How to respond? Psychiatrists obviously must challenge the solipsistic concept that what is in the mind cannot be questioned. Disorders of consciousness, after all, represent psychiatry’s domain; declaring them off-limits would eliminate the field. Many will recall how, in the 1990s, an accusation of parental sex abuse of children was deemed unquestionable by the solipsists of the “recovered memory” craze.You won’t hear it from those championing transgender equality, but controlled and follow-up studies reveal fundamental problems with this movement. When children who reported transgender feelings were tracked without medical or surgical treatment at both Vanderbilt University and London’s Portman Clinic, 70%-80% of them spontaneously lost those feelings. Some 25% did have persisting feelings; what differentiates those individuals remains to be discerned.We at Johns Hopkins University—which in the 1960s was the first American medical center to venture into “sex-reassignment surgery”—launched a study in the 1970s comparing the outcomes of transgendered people who had the surgery with the outcomes of those who did not. Most of the surgically treated patients described themselves as “satisfied” by the results, 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.It now appears that our long-ago decision was a wise one. A 2011 study at the Karolinska Institute in Sweden produced the most illuminating results yet regarding the transgendered, evidence that should give advocates pause. The long-term study—up to 30 years—followed 324 people who had sex-reassignment surgery. The study revealed that beginning about 10 years after having the surgery, the transgendered began to experience increasing mental difficulties. Most shockingly, their suicide mortality rose almost 20-fold above the comparable nontransgender population. This disturbing result has as yet no explanation but probably reflects the growing sense of isolation reported by the aging transgendered after surgery. The high suicide rate certainly challenges the surgery prescription.There are subgroups of the transgendered, and for none does “reassignment” seem apt. One group includes male prisoners like Pvt. Bradley Manning, the convicted national-security leaker who now wishes to be called Chelsea. Facing long sentences and the rigors of a men’s prison, they have an obvious motive for wanting to change their sex and hence their prison. Given that they committed their crimes as males, they should be punished as such; after serving their time, they will be free to reconsider their gender.Another subgroup consists of young men and women susceptible to suggestion from “everything is normal” sex education, amplified by Internet chat groups. These are the transgender subjects most like anorexia nervosa patients: They become persuaded that seeking a drastic physical change will banish their psycho-social problems. “Diversity” counselors in their schools, rather like cult leaders, may encourage these young people to distance themselves from their families and offer advice on rebutting arguments against having transgender surgery. Treatments here must begin with removing the young person from the suggestive environment and offering a counter-message in family therapy.Then there is the subgroup of very young, often prepubescent children who notice distinct sex roles in the culture and, exploring how they fit in, begin imitating the opposite sex. Misguided doctors at medical centers including Boston’s Children’s Hospital have begun trying to treat this behavior by administering puberty-delaying hormones to render later sex-change surgeries less onerous—even though the drugs stunt the children’s growth and risk causing sterility. Given that close to 80% of such children would abandon their confusion and grow naturally into adult life if untreated, these medical interventions come close to child abuse. A better way to help these children: with devoted parenting.At the heart of the problem is confusion over the nature of the transgendered. “Sex change” is biologically impossible. People who undergo sex-reassignment surgery do not change from men to women or vice versa. Rather, they become feminized men or masculinized women. Claiming that this is civil-rights matter and encouraging surgical intervention is in reality to collaborate with and promote a mental disorder. read more

Shooter sentenced to 25 years

first_imgA 22-year-old man will serve a 25-year prison term for shooting a USC student in the chest at a party in September 2011, according to a statement from the Los Angeles County District Attorney’s Office.Tyson Tyree Smith was sentenced Monday after pleading no contest to one count of attempted murder and admitting to using a firearm.Los Angeles Superior Court Judge Patricia Schnegg dismissed a second attempted murder charge and two counts of assault with a semiautomatic firearm, according to the statement.Officials said the shooting took place at about 1 a.m. on the first story of a two-floor apartment on the 1200 block of West 37th Place. The shooting occurred on Sept. 4, 2011. Smith has stayed in custody since he was charged Sept. 15, 2011.Smith fired one round and hit two students, both of whom survived. The bullet first hit a female student in the hand before hitting a male student in the chest.last_img

Syracuse ‘encouraged’ by 3-3-5 defense after 31-6 loss to North Carolina

first_img Facebook Twitter Google+ The Daily Orange is a nonprofit newsroom that receives no funding from Syracuse University. Consider donating today to support our mission.He said it multiple times leading up to the season, and he said it again postgame. Dino Babers didn’t know what to expect out of his defense — nobody’s ever implemented this style during a pandemic. Now, Babers knows. Engineered by defensive coordinator Tony White, SU’s 3-3-5 held the high-powered UNC offense that averaged 33.1 points per game in 2019 to 10 in three quarters. The 3-3-5 confused quarterback Sam Howell, who holds the record for most touchdowns in a season by a true freshman (38). It won the turnover battle and gave SU multiple short fields.The defense played more than well enough to put Syracuse (0-1) in position to upset No. 18 North Carolina (1-0). But the Orange offense failed to capitalize on the prime chances the defense provided, and the Tar Heels took advantage of an overtaxed unit in the fourth quarter. Still, after the season-opener, SU can return home with a strong defensive foundation to build on.“Now after seeing (the defense) against good personnel, we’re starting to get an inkling of what we’ve got,” Babers said.AdvertisementThis is placeholder textBefore every play, Syracuse’s defense would look over to the sideline for White’s signal. The combination of signs was like a third base coach in baseball — a sequence could be a “three” signal followed by a double-fisted flex and a clap.A fixture of the 3-3-5 is the confusion it causes. Although there are only three defensive linemen on the field, SU varied how many linebackers joined them in the trenches and how they lined up. Four players lined up sometimes in a heads up three-point stance, meaning they’re right across from a blocker. Other times they’d line up in a gap. No matter what, it was almost never clear which players were blitzing and which were dropping into coverage.For much of the first three quarters, Howell appeared lost. After he orchestrated a precise 10-play, 65-yard touchdown drive to open the game, Howell went 20-for-26 for 234 yards and two interceptions.The first of Howell’s two giveaways came on the Tar Heels’ second drive, when he forced a ball into a tight window on a drag route. Cornerback Ifeatu Melifonwu stretched his arm, tipping Howell’s pass right to linebacker Mikel Jones. SU’s offense took over on UNC’s 31-yard line, but turned the ball over on downs.“Obviously, the defense did a fantastic job of getting the ball back to us,” Babers said. “We had numerous opportunities to punch it in on offense and make this thing a game.” SU’s defense then forced a three-and-out. On third down that drive, Syracuse forced Howell out of the pocket by sending four rushers, and Howell checked down to a receiver nowhere near the first down marker.The 3-3-5, which puts five defensive backs on the field at all times, suits the Orange since the secondary is their strongest position group. Preseason All-American Andre Cisco, playing the rover position, picked off Howell in the third quarter by watching his eyes and undercutting a deep post. His 13 career interceptions are the most out of any active FBS player.Melifonwu, Garrett Williams and Trill Williams also made plays. Williams, a redshirt freshman, was often tasked with defending wideout Beau Corrales. Despite Corrales’ size advantage (6-foot-3, 205-pounds to 5-foot-11, 184), Williams held his own. Corrales finished with five catches on seven targets for 47 yards, but Williams largely limited his yards after contact. He also led SU with nine total tackles.Trill Williams, on the opposite side of the field as Garrett Williams, was hardly — if ever — targeted. The secondary allowed Syracuse to get pressure on Howell, since he had to hold the ball longer as his receivers struggled to get open. On one play, defensive end Kingsley Jonathan beat his matchup with a speed move to blindside sack Howell, flexing his bicep on one knee to celebrate.“As a unit, our main goal is to disrupt the quarterback,” Jonathan said. “Our back end had holded it up for us to get to the quarterback and help each other as much as we can.”But the pattern of the defense getting stops and the offense failing to capitalize continued. In total, Syracuse scored just six points off three turnovers generated by its defense and special teams — each of which gave SU possession in UNC territory. Had the Orange turned those field opportunities into touchdowns, they would’ve entered the fourth quarter up multiple scores instead of down 10-6.Instead, SU’s defense wore down in the fourth quarter. Since the offense struggled to move the chains — Syracuse had just one drive of over three minutes — the defense was forced to stay on the field. Four consecutive three-and-outs put immense pressure on the defense.“Those guys are going to get their conditioning, their legs are going to get fresher and fresher,” Babers said. Twenty-one unanswered fourth quarter points turned a 10-6 game into a blowout. Babers said postgame that he’s not even sure everyone’s playing in the right positions at the moment. Two or three weeks of shuffling may be needed to optimize the defensive lineup, he added. It’s an unfinished product, which should encourage the coaching staff.“Take off those camp legs and put on a new pair of legs to get ready to play in the ACC,” Babers said. “I think they can get better. I think in two to three weeks, you’re going to see a better defense. As long as we stay healthy. I was really encouraged with what I saw defensively.” Commentscenter_img Published on September 12, 2020 at 6:25 pm Contact Danny: [email protected] | @DannyEmermanlast_img read more