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Jon K. Meyer vs. transgender people

Jon K. Meyer is an American psychiatrist and a key historical figure in anti-transgender activism. Formerly affiliated with Johns Hopkins, Meyer shut down all trans surgeries there in 1979. At the time, there were three large “gender clinics” in the United States, so Meyer’s decision contributed to a cascade of anti-trans decisions in medicine, insurance, and employment. It took nearly 40 years before the university resumed complete trans healthcare in 2017. The damage Meyer caused to generations of trans people is incalculable.

Background

Jon Keith Meyer was born May 6, 1938. Meyer’s parents Finela Hermoine Roehl (1915–2013) and Samuel B. Meyer (1913–2002) married in 1936. Meyer married Eleanor “Ellie” Yamashita Meyer, an American public health researcher. Meyer’s sibling Jeffrey Kent Meyer died in 2001.

Meyer earned a Bachelor’s degree in Chemistry from Dartmouth College in 1960, followed by a medical degree at Johns Hopkins in 1964. In 1969 Meyer was appointed Chair of the Hopkins Gender Identity Clinic. Meyer’s first published paper on gender dysphoria was in 1974. Later papers showed increasing skepticism of surgical options for trans people.

Meyer was Special Assistant to the Director, National Institute of Mental Health (NIMH), and Chief, National Clearinghouse for Mental Health Information. Meyer was the founder of the Sexual Behaviors Consultation Unit.

Meyer later went to the Medical College of Wisconsin in Milwaukee to develop its Division of Psychoanalysis and Psychotherapy Center. Meyer served on the faculty there, becoming Chair in 1996 and retiring in 2003. Meyer was appointed Emeritus Professor of Psychiatry and Psychoanalysis that year.

Meyer served as president, American Psychoanalytic Association, and Chair, House of Delegates, International Psychoanalytic Association. Meyer was Erik Erikson Scholar in Residence at the Austen Riggs Center, was awarded the Edith Sabshin Teaching Award, served on the Editorial Board of JAPA, and was invited to the Center for Advanced Psychoanalytic Studies.

Meyer later returned to Baltimore, serving on the Board of the Washington Psychoanalytic Center as training and supervising analyst, and as teaching analyst at the Baltimore-Washington Center. Meyer also held appointments as Clinical Professor of Psychiatry at the University of Maryland and Georgetown University.

After retiring, Meyer moved to North Carolina and pursued photography.

Anti-transgender activism

John Money founded the Gender Identity Clinic at Johns Hopkins University in 1966. Meyer was named head of the clinic in 1969. After pioneering psychiatrist Joel Elkes was replaced by anti-transgender activist Paul McHugh, Meyer began a long-term follow-up study of 50 trans people who underwent surgery at Johns Hopkins.

Historian Meagan Day described Meyer’s efforts:

“Skeptical of the benefits of surgery, he began conducting his own research on the clinic’s patients. Over time, he became convinced (if indeed he needed convincing) that being transgender was a mental illness that required a purely psychological approach.

Day (2016)

Over the next decade, the surgeries dwindled under Meyer. Meyer issued his report in 1977 and published it in 1979. Although the paper was widely criticized as flawed, it led McHugh to close the Johns Hopkins Gender Identity Clinic in 1979, reported by The New York Times:

“To say that this type of surgery cures psychiatric disturbance is incorrect. We now have objective evidence that there is no real difference in the transsexual’s adjustment to life in terms of jobs, educational attainment, marital adjustment and social stability. My personal feeling is that surgery is not a proper treatment for a psychiatric disorder, and it’s clear to me that these patients have severe psychological problems that don’t go away following surgery.”

Meyer, quoted in Brody (1979)

Publications

Derogatis LR, Meyer JK, Vazquez N. A psychological profile of the transsexual. I. The male. J Nerv Ment Dis. 1978 Apr;166(4):234-54. http://dx.doi.org/10.1097/00005053-197804000-00002

The present research introduced standardized psychological measurement into the clinical assessment of the male transsexual. Thirty-one males with a presenting complaint of gender dysphoria were carefully screened as to their correspondence with current nosological conceptions of transsexualism, and administered the Derogatis Sexual Functioning Inventory (DSFI) as part of their clinical psychometric work-up. The DSFI is an omnibus self-report scale providing measurement in the primary domains of sexual information, sexual experiences, sexual drive, sexual attitudes, psychological symptoms, affects, gender role definition, and sexual fantasy. Transsexual profiles were contrasted with those of a comparison group of 57 normal heterosexual males. Results of the comparisons revealed the transsexuals to show a significant decrement in accurate sexual information, and a marked reduction in the variety of sexual experiences they have been involved in. They also revealed a reduction in drive levels; however, this was qualified by which indicator of drive was used. Significant elevations in psychological symptoms and dysphoric affect were also noted, particularly of a depressive nature. Gender role definitions were markedly polarized in the feminine direction for male transsexuals, and their fantasy endorsements revealed some of the classic transsexual themes. The ability to develop this quantified and standardized psychological profile is viewed as an important step in accurately assessing the nature of these complex individuals, and developing a more accurate understanding of their condition.

Meyer JK, Reter DJ (1979). Sex reassignment. Follow-up. Arch Gen Psychiatry. 1979 Aug;36(9):1010-5. https://doi.org/10.1001/archpsyc.1979.01780090096010

Although medical interest in individuals adopting the dress and life-style of the opposite sex goes back to antiquity, surgical intervention is a product of the last 50 years. In the last 15 years, evaluation procedures and surgical techniques have been worked out. Extended evaluation, with a one- to two-year trial period prior to formal consideration of surgery, is accepted practice at reputable centers. Cosmetically satisfactory, and often functional, genitalia can be constructed. Less clear-cut however, are the characteristics of the applicants for sex reassignment, the natural history of the compulsion toward surgery, and surgery’s long-term effects. The characteristics of 50 applicants for sex reassignment, both operated and unoperated, are reported in terms of such indices as job, education, marital, and domiciliary stability. Outcome are reviewed. The results of long-term follow up data are discussed in terms of the adjustments of operated and unoperated patients.

Meyer JK (1982). The theory of gender identity disorders. J Am Psychoanal Assoc. 1982;30(2):381-418. https://doi.org/10.1177/000306518203000204

Experience with more than 500 patients over the last decade has led to the conclusion that the quest for sex reassignment is a symptomatic compromise formation serving defensive and expressive functions. The symptoms are the outgrowth of developmental trauma affecting body ego and archaic sense of self and caused by peculiar symbiotic and separation-individuation phase relationships. The child exists in the pathogenic (and reparative) maternal fantasy in order to repair her body image and to demonstrate the interconvertability of the sexes. Gender identity exists not as a primary phenomenon, but in a sense as a tertiary one. There is, no doubt, a tendency to gender-differentiate in a way concordant with biological endowment. Nevertheless, gender formation is seriously compromised by earlier psychological difficulty. Gender identity is a fundamental acquisition in the developing personality, but it is part of a hierarchical series beginning with archaic body ego, early body image, and primitive selfness, representing their extension into sexual and reproductive spheres. Gender identity consolidates during separation-individuation and gender pathology bears common features with other preoedipal syndromes. Transsexualism is closely linked to perversions, and the clinical syndromes may shade from one into another. However, what is kept at the symbolic level in the perversions must be made concrete in transsexualism. In this regard there is a close relation to psychosis. The clinical complaint of the transsexual is a condensation of remarkable proportions. When the transsexual says that he is a girl trapped in a man’s body, he sincerely means what he says. As with other symptoms, however, it takes a long time before he begins to say what he means.

References

Denny, Dallas (2013). The Campaigns Against Transsexuals: Part I. http://dallasdenny.com/Writing/2014/03/06/the-campaign-against-transsexuals-part-i-2013/

Brody, Jane E. (October 2, 1979). Benefits of Transsexual Surgery Disputed As Leading Hospital Halts the Procedure. New York Times https://www.nytimes.com/1979/10/02/archives/benefits-of-transsexual-surgery-disputed-as-leading-hospital-halts.html

Meyer JK (2012). What divide? Johns Hopkins Magazine

Day, Meagan (November 15, 2016). How one of America’s best medical schools started a secret transgender surgery clinic. Medium https://timeline.com/americas-first-transgender-clinic-b56928e20f5f [archive]

Basseches, Harriet (2003). Chair of Psychoanalysis, Uncommon or Not? THE AMERICAN PSYCHOANALYST • Volume 37, No. 4 • Fall/Winter 2003 http://www.apsa.org/sites/default/files/TAP%202003%20vol37no4.pdf

Resources

Wisconsin Psychoanalytic Institute (wisconsinpsychoanalytic.org)

Washington Baltimore Center for Psychoanalysis (wbcp.org)

Jon Meyer Photographic Art (jonmeyerphotographicart.com)

  • Personal site

Flickr (flickr.com)