The Healthcare Equality Index 2017 used new scoring criteria that were announced in 2015 and implemented during the 2016 calendar year survey. For the first time ever, HEI participants were given scores in four criteria that represent how many policies and best practices from each section they have implemented. In addition to these four criteria, there is a fifth criteria section called “Responsible Citizenship” that focuses on known activity that would undermine LGBTQ+ equality or patient care. Healthcare facilities will have 25 points deducted from their score for a large-scale official or public anti-LGBTQ+ blemish on their recent records.
A similar criteria category has been part of the scoring system for the Corporate Equality Index (CEI) and has been used on rare occasions during the CEI’s 15-year history. Similar to the CEI, we hope to have to rarely apply this point deduction and we will only do so after giving ample notice to a healthcare facility and giving them an opportunity to address the HRC Foundation’s concerns.
In the HEI 2018, Johns Hopkins Hospital received this point deduction for Johns Hopkins Medicine’s failure to address HRC’s concerns regarding deeply disturbing anti-LGBTQ+ misinformation voiced and published by faculty members Paul McHugh and Lawrence Mayer. As advocates for anti-LGBTQ+ laws and policies, including California’s ban on same-sex marriage and North Carolina’s law restricting restroom access for transgender people, Drs. McHugh and Mayer have repeatedly promoted disproven claims about LGBTQ+ people. For example, they suggest that LGBTQ+ people have inherent psychological difficulties and that LBGTQ+ sexual orientations may be caused by sexual abuse during childhood. These assertions and a series of other claims McHugh and Mayer have made in legal testimony and political publications are not consistent with the current state of science on gender or sexual orientation. Dr. McHugh has also described transgender people in disturbing terms, including as “counterfeits,” “impersonators,” “confused” and “mad.”
Although neither McHugh nor Mayer have published original research on sexual orientation or gender identity, they use their Johns Hopkins affiliations to imply that they have scientific or clinical expertise on these topics. As a result, these assertions depend on the Johns Hopkins name for their credibility. The result is to do damage to both LGBTQ+ people and Johns Hopkins’ perceived ability to provide quality, culturally competent care.
It is important to understand the historical context in which these actions have taken place. In 1965, Johns Hopkins Hospital became the first academic institution in the United States to perform gender affirmation surgeries and was considered a pioneer in the field. In the late seventies, Paul McHugh, then the Psychiatrist-in-Chief at Hopkins Hospital, shut the program down. Although not a scholar of gender or sexual orientation, Dr. McHugh has become the go-to “expert” for those organizations and publications seeking to support conversion therapy for LGBTQ+ people and opposing transition-related healthcare and restroom access for transgender people. This history and the fact that Dr. McHugh prominently uses his Johns Hopkins title in these activities has created a sense of uncertainty and fear—particularly among transgender people, who question the type of care that they might receive at Johns Hopkins.
The HRC Foundation expressed our deep concerns about the impact of the work of Drs. McHugh and Mayer with the leadership at Johns Hopkins Medicine and Johns Hopkins University and since May of 2016 have called on them to issue a statement to clarify their position on this work. Specifically, we have asked that they make it clear that while Drs. McHugh and Mayer are free to pursue their areas of interest and express their point of view and opinions, their opinions on LGBTQ+ people are their own and do not reflect the views of the Johns Hopkins University or Johns Hopkins Medicine. Furthermore, we have asked them to publicly confirm that Johns Hopkins Medicine operates in accordance with the positions of leading medical organizations such as the American Medical Association, the American Psychiatric Association and other leading medical organizations that support affirming care for LGBTQ+ people.
HRC values scientific integrity and academic freedom, and we have not asked Johns Hopkins to do anything to restrict the academic freedom of these faculty members. We have not asked that they punish Drs. McHugh or Mayer or censor their work in any way. We have simply asked Johns Hopkins to clarify that the opinions shared by Drs. McHugh and Mayer are just that—their opinions—and that these opinions are not reflective of the positions of the institution or the care that is provided to LGBTQ+ people within the Johns Hopkins Medicine health system. This step will help to restore the LGBTQ+ community’s trust in the University and Johns Hopkins Medicine.