You might remember the post here about “Moralistic Therapeutic Med School,” in which medical schools are starting to remove or relocate images of white men affiliated with the school who accomplished great things. This is about something related, but much more serious.
A reader who is a physician sent me this WSJ op-ed column the other day. He said that this is bad news for the medical profession. The author is Stanley Goldfarb, a former administrator at Penn’s medical school. Excerpts:
A new wave of educational specialists is increasingly influencing medical education. They emphasize “social justice” that relates to health care only tangentially. This approach is the result of a progressive mind-set that abhors hierarchy of any kind and the social elitism associated with the medical profession in particular.
These educators focus on eliminating health disparities and ensuring that the next generation of physicians is well-equipped to deal with cultural diversity, which are worthwhile goals. But teaching these issues is coming at the expense of rigorous training in medical science. The prospect of this “new,” politicized medical education should worry all Americans.
The zeitgeist of sociology and social work have become the driving force in medical education. The goal of today’s educators is to produce legions of primary care physicians who engage in what is termed “population health.”
This fits perfectly with the current administrator-rich, policy-heavy, form-over-function approach at every level of American education. Theories of learning with virtually no experimental basis for their impact on society and professions now prevail. Students are taught in the tradition of educational theorist Étienne Wenger, who emphasized “communal learning” rather than individual mastery of crucial information.
Where will all this lead? Medical school bureaucracies have become bloated, as they have in every other sphere of education. Curricula will increasingly focus on climate change, social inequities, gun violence, bias and other progressive causes only tangentially related to treating illness. And so will many of your doctors in coming years.
Read the whole thing. At some point, reality will take its revenge, and the woke will be banished. But how much suffering will innocent people have to endure before it does? And how many people of faith will be deterred from seeking a medical career because the militant left has placed absurd barriers to keep out the politically incorrect.
This morning, on the drive to the airport (I’m on my way to New York City now), I heard a radio piece talking about the need for transgender health care, and how medical educators in Oregon are meeting it. There’s not yet a transcript available for the broadcast, but I can tell you that it begins with the reporter framing transgender surgery in a politically correct way — something like, “the patient had surgery to realign her body with her gender identity.” This, by the way, is an example of how the media re-engineers society by changing language. Later in the piece, a doctor says that in years past, people with gender dysphoria would typically have been referred for mental health treatment. Today, though, they get surgical intervention.
This is massively important! What if psychiatric treatment, or some adjacent treatment, is what is better for them than gender reassignment? What if that is what would restore them to health?
Here’s a little personal story that came to mind as I was listening to this piece.
The transgender person in the story says that he (a biological male presenting as female) always felt uncomfortable in his body. No doubt this is true. I think this accounts for the disproportionate number of autistic people among gender dysphorics. Autism is often accompanied by something called “sensory processing disorder.” Nobody knows why this is, but it is common.
As I learned about autism and sensory processing disorder in my own family, a number of things about myself became clear. I am confident that I would not meet the threshold for a formal autism spectrum diagnosis, but I am equally confident that I have many of the traits of people who are (and that includes a member of my family). In fact, the sensory stuff is fairly widespread in my family.
As a child, I had very strong legs. My father recalls me doing 400 deep knee bends when I was nine years old; he stopped me because he thought I would hurt myself. But no matter how hard I tried, I could not strengthen my upper body. I had poor muscle tone, and nothing could fix that. Decades later, I learned that this is something that people on the spectrum sometimes have.
I have never felt comfortable in my body, though I thought for most of my life this was simply neurosis. No, I have never had the faintest thought of gender dysphoria, but it manifested itself in something feeling … not right. Something hard to define. To be frank, one reason I drank so much in college — aside from the fact that LSU in the 1980s had a massive binge-drinking culture — was to overcome that sense of not-rightness, so I could talk to girls. The point is, when I read about officially-diagnosed autistic young people seeking sex changes because they say they don’t feel right in their bodies, I get that. I can’t pretend to know about that from a sexualized point of view, but that sense that things aren’t right is quite familiar to me. And it never goes away. You just have to learn how to cope with it. For me, it got better as I grew older.
I can remember in my childhood, how my mom had a big heart (still does), but was not particular physically affectionate. I couldn’t understand that at all, especially when our father was physically demonstrative. Once I started learning about autism and sensory processing a decade or so ago, and began to understand things about myself, and why I could be so prickly about ordinary bodily things, I understood her in a new way. This was almost certainly not an emotional disposition for her, but a neurological-sensory disorder. Maybe I’m wrong about that, but my mom and I are so much alike in so many ways that I think this is what was going on. It’s how it is with me. I can see this trait — sensory processing disorder — manifesting to some degree in most of my mom’s six grandchildren too.
I bring this up only to say that at least some of these young spectrum people who seek gender dysphoria treatment, including radical, irreversible steps (e.g., mastectomies, hormone treatment that arrests sexual maturity) could surely benefit from ordinary therapies to help them cope with their sensory issues. If I had known as a teenager and a young adult that what I was feeling in and about my body was due not to a character or psychological flaw, but probably due to neurobiology, it would have been much easier to manage it, and to learn how to live with it.
I’ve come to see, for example, the fact that I have unusual superpowers when it comes to taste and smell to be an advantage. This is why I love food and wine so much: I can experience aromas and flavors more intensely than most people. And I’ve stopped feeling so bad about my inability to tone my upper body, though I am also sure that I will never feel quite at home in my body (I have always been terrible at dancing and athletics; I can be a graceful writer, but in the flesh, am a shambling galoot). Fortunately for me, this is all relatively minor — discomforting, not tormenting. I wouldn’t judge the subjective experiences of spectrum people suffering from gender dysphoria.
My point here is simply this: for whatever cultural reasons, young people who report a serious disjunction between themselves and their bodies are being encouraged to express and to affirm that disjunction in sexual ways — and now the medical profession is eager to confirm that concept. Often this results in permanent surgical or hormone-driven alteration to the body. Dr. Goldfarb’s column makes me afraid for those young people and their families, being driven by the popular culture and the culture of medicine into asking for life-changing procedures that will not actually cure them of their sense of alienation from their bodies, because it may not really be about gender.