Have you read Christopher Rufo’s June 6 essay City Journal article “DOJ Indicts Doctor Who Exposed the Barbarism of ‘Gender-Affirming Care’”? It’s about a courageous surgeon, Eithan Haim, who blew the whistle on doctors at Texas Children’s Hospital who continued performing procedures on children (as young as eleven) after CEO Mark Wallace shut down the hospital’s child gender clinic (see Rufo’s May 2023 article “Sex-Change Procedures at Texas Children’s Hospital for background”). Earlier this week, US marshals appeared at Haim’s home and summoned him to court to face an indictment on four felony counts of violating HIPAA. His initial appearance is next Monday, where he will learn more about the charges against him.
When on X (formerly Twitter) I criticize the practice of endocrinologists using chemicals to alter physiology and surgeons altering the appearance of genitalia to produce a simulate sexual identity, practices that go under the cover of “gender affirming care” (GAC), I am inundated with appeals to authority, often in the form of screen shots of Google summaries, showing medical associations and governmental bodies promoting the practice with success stories or dubious studies. Since GAC is a for-profit industry organized by corporate medicine and pharmaceutical companies, I ask people to take a critical view of such promotional materials, reminding them that this is not the first time that doctors, their associations, and governmental bodies have promoted atrocities.
One of my go-to examples is the lobotomy (also known as leukotomy). Lobotomy, a neurosurgical procedure severing connections in the brain’s prefrontal cortex, emerged as a popular treatment for mental illnesses in the mid-20th century. The procedure was widely adopted and routinely performed on individuals for more than thirty years, mostly on women, but disproportionately on gay men. It is still performed, albeit rarely. In its heyday, the procedure was performed on tens of thousands of Americans. The contemporary judgment that the practice was largely abandoned because of side effects and ethical problems is something of a revisionist history. For the most part, it was the development of antidepressants, antipsychotics, and other pharmacological agents that replaced the practice—agents carrying their own side effects and ethical problems.
The promotion of the lobotomy is a paradigm of why skepticism of the claims of medical science is an imperative if our commitment to human rights is to meaningfully translate into effective safeguarding practices. In this essay, I briefly discuss the history of the lobotomy and the difficulty opponents of the procedure faced from both professional and popular forces. Then I turn to the matters of medical practices under Nazi Germany and contemporary practices known as gender affirming care. These matters comprise the bulk of this essay.
Neurologist António Moniz developed the lobotomy in 1935. Reports of lobotomy’s success in reducing symptoms of conditions such as chronic anxiety, schizophrenia, and severe depression were quickly disseminated by the medical profession. Prominent figures in the field of psychiatry played a significant role in popularizing the procedure. For example, in the United States, Walter Freeman became a staunch advocate, pioneering the transorbital lobotomy (popularly known as the “ice pick” technique). Professional associations, such as the American Medical Association (AMA) and the American Psychiatric Association (APA), played a major role in legitimizing the practice. The AMA provided a platform for the dissemination of techniques. The APA promoted the procedure at medical conferences and in psychiatric journals. Moniz was awarded the Nobel Prize in Physiology or Medicine in 1949 for his work on lobotomies.
Not everyone in the medical community shared this enthusiasm, however. As those critical of GAC today, critics of lobotomy faced significant opposition and marginalization. They were characterized as traditionalists who were dismissed as resistant to new ideas. The procedure’s proponents held substantial influence and had the support of the medical community. This made it difficult for dissenting voices to gain recognition to influence policy and practice. Those who raised concerns about lobotomy’s efficacy and safety were not only labeled as impediments to progress; speaking out against the practice risked professional isolation and reputational damage. Critics could find themselves marginalized within their professional circles, losing opportunities for research funding, publication, and career advancement.
The medical community’s enthusiasm for lobotomy was one of the factors that created an environment where criticism was not easily tolerated. However, vocal opponents of lobotomy also faced public criticism. Proponents of the practice framed the procedure as a necessary and humane advancement in the treatment of mental illness. Critics were portrayed as unsympathetic to the plight of patients and their families desperate for any form of relief from severe psychiatric conditions, conditions that were associated with harm to self and others, seen, for example, in higher rates of suicide. Many patients and families reported improvement from the surgery; some patients were said to have been cured. Public perception and the practice of emotional blackmail thus further isolated critics and undermined efforts to caution against the widespread use of lobotomy. (For more on this, see Mical Raz’s 2013 The Lobotomy Letters: The Making of American Psychosurgery.)
Recently on X, user Gays Again Groomers (@againstgrmrs), hashtag #SaveTheTomboys, posted a video of a young woman at an outdoors Pride event dramatically removing her shirt to reveal her bandaged chest (see the video here). She has recently undergone a double mastectomy. Those in attendance, just off screen, applauded to express their affirmation. User Thomas Willett, whom I have cited before (A Zealot’s Attempt to Appear Reasonable and the Unreasonableness of Zealots), asked, “Why are you recording a suspected minor undressing?” I responded, “The woman was celebrating her mutilation publicly. People need to see the atrocity. It’s like asking why we see children in Holocaust or lynching photography.” Objections to my comment denied the analogy with the Holocaust because the victims of the Nazis did not seek the procedures performed on them, while the victims of GAC did. Moreover, those opposed to GAC were accused of caring about a decision somebody made about their body that has nothing to do with them, one user asking rhetorically, “Why do you transphobes always believe you have authority over everyone else’s bodies?”
Opposition to GAC has nothing to do with claiming authority over the bodies of others. At the heart of the opposition is an essential tenet of human rights: criticizing ideologies and disrupting practices that destroying the lives of people. Female genital mutilation (FGM), also known as female genital cutting (FGC), is a harmful practice that involves the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. It is recognized internationally as a violation of the human rights of girls and women. The exact number of women affected by FGM around the world is difficult to determine due to underreporting, lack of data in some regions, and the clandestine nature of the practice in certain communities, but it is estimated that over 200 million girls and women worldwide have undergone FGM. FGM is most prevalent in Africa, the Middle East, and Asia, but it also occurs in communities around the world, including diaspora communities in Western countries. The practice is rooted in cultural, social, and religious beliefs and is often perpetuated as a rite of passage, despite its harmful physical and psychological consequences. Do efforts to stop this practice move from a desire to control the bodies of girls and women?
To return to the point about GAC being different because this is what the individual wants, many of the women who undergo FGM look forward to it, and often those who groom women for the procedure and sometimes perform it are other women who willingly had the procedure performed on them. Are we to quit our objections to FGM because millions of women look forward to it or feel it as a cultural imperative? It is, after all, a type of gender affirming care. I don’t mean this in a flippant way; FGM affirms the woman’s identity and role in societies that mutilate genitals. The difference with GAC is that, in industrial societies, the mutilation of genitals is to produce simulated sexual identities rather than to affirm tribal identity and membership in the community of women. It’s a different ideology that results in genital mutilation, but the ideology can’t make the practice okay; ideologies only motivate and rationalize associated practices. GAC marks one as a member of the tribe, as we see with the young woman in the video. One is witnessing there the behavior of a cult member.
Ethically speaking, whether atrocities perpetrated by Nazis doctors are to be regarded as crimes against humanity has never depended on victims being happy, sad, willing, unwilling, whatever. Many of those maimed or killed by Nazis didn’t know what was happening to them. Many of them thought the doctors were helping them. In many cases, the victims suffered from developmental and psychiatric disorders that made them oblivious to the acts performed on them. This is why we don’t blame crime victim for what happened to them. We blame the perpetrator, the individual or group who victimized them. The man who takes advantage of the vulnerable, the emotionally damaged, and the psychologically confused, who grooms, deceives, and manipulate others—this is the wrongdoer. Even if he is working under the cover of authority, law, policy, expertise, and reputation, he is doing wrong. The wrong in question is mala in se, Latin for “evil-in-itself.” The focus is therefore properly on the organizers of the system, those who pull the levers, and those who enable them. These are acts individuals profit from or advance the movement goals. The young woman in the video is the result of a society that tolerates atrocities to continue under the guise of health care.
When objections were made about sharing a video of an alleged minor, I reminded those in the thread that holocaust photography, like lynching photography, is documentation of atrocities in a fixed medium, and this documentation sometimes contained images of children because children are often the victims of atrocities. History teachers us that evil does not spare children, and we need to see the evil for ourselves and for what it is to understand why we need strong safeguarding systems. Indeed, it was photographs of GAC, why is coming to be regarded as the greatest medical scandal in American history, that finally convinced me of the irresponsibility of treating the movement politics around trans ideology as “gay adjacent,” which was how I thought about it before 2018. I won’t share the documentary evidence here, as you can find it online and I do not wish to shock the reader with something he may not wish to see, but upon reviewing that evidence—the images of phalloplasty, vaginoplasty, etc.—I was immediately reminded of the photographs I reviewed in my studies of the crimes against humanity perpetrated by the Nazi doctors.
It is crucial to emphasize the fact that the emotionally troubled and psychological disordered, many of whom think they are being helped by drugs and surgeries, don’t realize they’re being experimented on and modified for the sake of movement ideology and, in the case of GAC, corporate profit. The doctors prescribing the drugs and performing the surgeries claim to be operating within the norms of Western medical science. The Nazi doctors, for example Erwin Gohrbandt, were also confident that they were practicing within the norms of German medical science. Not surprisingly those who object to my argument try to derail it by deny the analogy. But it’s not an analogy. It’s the thing itself. Gohrbandt worked with Magnus Hirschfeld, a pioneer of GAC, the same man held up a saint by those seeking to prevent the removal of pornographic and child grooming materials from public schools and libraries by evoking the Deutsche Studentenschaft raid on the Institut für Sexualwissenschaft in 1933. It was Gohrbandt who practiced vaginoplasty on the transvestites who frequented Hirschfeld’s estate, using Hirschfeld’s kitchen as his operating theater. (See Fear and Loathing in the Village of Chamounix: Monstrosity and the Deceits of Trans Joy. See also Thomas Szasz, Medical Freedom, and the Tyranny of Gender Ideology; The Exploitative Act of Removing Healthy Body Parts; Simulated Sexual Identities: Trans as Bad Copy.)
The work of Nazi doctors on individuals suffering from emotional trauma and psychiatric disorders represents one of the most disturbing chapters in medical history. Driven by a perverse ideology and a blatant disregard for human life, their activities were characterized by unethical experiments and inhumane treatments. One of the most notorious aspects of Nazi medical practices was the Aktion T4 program, established in 1939, aimed at those individuals deemed “unworthy of life” due to mental and physical disabilities, chronic illnesses, congenital deformities, and psychiatric disorders. The notion of fitness was central to the progressive program of eugenics, which we can define simply as the practice of breeding for good genes. Those deemed as unworthy of life were subject to extermination and sterilization. Today, GAC targets the same populations. Most of those subjected to GAC suffer from autism, mental retardation, and psychiatric disorders. The chemicals (puberty blockers, cross sex hormones) and surgical procedures sterilize them. The alterations made to their physiology and genitals are irreversible and typically rob them of sexual pleasure. They are made into permanent medical patients. (See Making Patients for the Medical-Industrial Complex; Disordering Bodies for Disordered Minds; The Body as Primary Commodity: The Techno-Religious Cult of Transgenderism.)
Nazi doctors conducted numerous inhumane experiments on psychiatric patients, often without their consent (with many of them incapable of consenting) and with no regard for their well-being. Patients were subjected to untested and dangerous drugs to observe their effects. These trials lacked ethical standards and proper oversight, frequently resulting in severe suffering and death. Crude forms of psychosurgery, including lobotomies, were performed on patients without medical justification, often resulting in permanent damage and severe side effects. As part of the Nazi eugenics program, many psychiatric patients were forcibly sterilized under the Law for the Prevention of Hereditarily Diseased Offspring (Gesetz zur Verhütung erbkranken Nachwuchses) enacted in 1933. This law mandated sterilization for individuals with mental illnesses and other conditions deemed hereditary.
Gohrbandt and Hirschfeld were both advocates of eugenics, Hirschfeld traveling to the United States to meet with Paul Popenoe and Ezra Gosney, praising them as “the vanguard of improving humanity by sterilizing unfit men and women.” Popenoe co-founded the Human Betterment Foundation in 1928, an organization dedicated to promoting eugenics through research and advocacy. He believed in the sterilization of individuals deemed unfit as a means of improving the genetic quality of the population. Popenoe’s views on eugenics influenced legislation and policies related to sterilization in several US states. Gosney was a philanthropist who played a significant role in promoting eugenics-based sterilization laws in California. He funded research into the hereditary aspects of mental illness and feeble-mindedness, believing that sterilization could prevent the transmission of undesirable traits to future generations. Gosney’s research, conducted through the Popenoe’s foundation, contributed to the development of California’s sterilization law, which was one of the most extensive in the United States, and became the model for other states. The law inspired the 1933 German eugenics law. (See Fred Sargeant’s article in Spiked! “The dark legacy of Magnus Hirschfeld.” Sergeant is a veteran of the 1969 Stonewall riots and one of the founders of the first Gay Pride marches in New York City.)
Medical abuse was rampant in the concentration camps, with patients used as subjects for training and experimentation, reflecting the broader dehumanization of individuals with mental illnesses under the Nazi regime. Although neglected by historians for years after the war, when attention was finally turned to the fate of homosexuals during this period the consciences of morally upright people were properly shocked. Nazis considered homosexuality as a threat to Aryan superiority and masculinity and sought to eradicate it through various means, including through medical experimentation. For example, medical experiments involving castration were performed on men at the Buchenwald concentration camp, near Weimar, Germany, at the Hygiene Institute of the Waffen SS. Doctors there also attempted to “cure” homosexuality by administering hormones to prisoners.
Several Nazi doctors were later tried for their crimes, most notably during the Doctors Trial, held at Nuremberg in 1946-1947. For example, Karl Brandt, Hitler’s personal physician and a key figure in the Aktion T4 program, was executed for war crimes and crimes against humanity. It’s worth noting that, from 1944 onward, Hirschfeld’s house surgeon Gohrbandt served as a member of the scientific advisory board under General Commissioner Karl Brandt for Sanitation and Health Services. The evidence indicates that Gohrbandt was involved in the planning of the “freezing experiments” conducted on prisoners at Dachau concentration camp. We know that, in October 1942, at the Deutscher Hog Hotel in Nuremberg, Gohrbandt was present at a clandestine conference where doctors and scientists delivered presentations on topics related to the freezing experiments. Gohrbandt himself published their findings in the journal Zentralblatt für Chirurgie in 1945.
The Nuremberg trials prosecuted twenty-three leading Nazi doctors and administrators for war crimes and crimes against humanity. Sixteen were found guilty, and seven were executed, highlighting the international community’s condemnation of their actions. The atrocities committed by Nazi doctors led to significant changes in medical ethics and human rights. The Nuremberg Code, established in 1947, set forth principles for ethical medical research, emphasizing voluntary and informed consent, scientific validity, and the imperative to avoid unnecessary suffering. These principles have profoundly influenced modern medical ethics, reinforcing the importance of prioritizing subject welfare and medical freedom. The legacy of Nazi medical practices underscores the need for robust protections for vulnerable populations. It has shaped contemporary human rights frameworks, ensuring that such abuses are not repeated.
Whatever happened to Gohrbandt? In the aftermath of World War II, Gohrbandt, despite being a known war criminal, enjoyed acclaim in the post-war period. He continued his career in medicine and research, ascending to prominent positions within the medical field. He maintained his reputation as a skilled surgeon and made notable contributions to medical literature and research, earning recognition within academic circles. Despite his controversial past, he remained affiliated with prestigious medical institutions and organizations. He even enjoys a Wikipedia page, where he is identified as an associate of Hirschfeld’s and credited with pioneering vaginoplasty. You can see at the bottom of the page a list of his postwar honors. As Bill Hicks would put it: “Is life fucking weird or what?”
Critics of lobotomy highlighted the lack of robust scientific evidence supporting lobotomy’s efficacy and raised ethical issues related to its invasive character and irreversibility. They questioned the procedure’s long-term outcomes and warned of the significant cognitive and personality changes observed in many patients. These concerns were overshadowed by the immediate and visible improvements reported in some cases, which were heavily publicized and celebrated by proponents wielding the manufactured clout of the healthcare industry. This strategy works because of a religious-like faith wrapped around medical science and the physician, the modern-day shaman. One can write an identical paragraph concerning gender affirming care. The difference is only a matter of scale.
Faith in the system has only deepened in the years since the lobotomy, the result of a comprehensive decades-long corporate propaganda campaign (see, e.g., this 2022 Reuters’ piece typical of the genre), as profit -seeking has vastly expanded the industry, finding opportunity in the ubiquity of gender ideology and the historic rise in mental disorders in the West, developments the industry played a role in producing. Propaganda inducing vulnerable populations to loathe their bodies has been pressed into public education. The culture industry, corporate press, social media platforms, and the Democratic Party are relentless in pushing the techno-religious cult of gender identity. The startling fact of a historic rise of mental illness in America’s youth is sounding the alarm (see, e.g., social psychologist Jonathan Haidt’s new book The Anxious Generation: How a Great Rewiring of Childhood is Causing an Epidemic of Mental Illness).
As the medical community’s understanding of mental health and neurological science advanced, and the harm of lobotomy became obvious, the claims of the industry grew increasingly untenable. This is the story, anyway. Certainly, the growing awareness of the procedure’s severe side effects and the ethical issues surrounding its application played important roles in the reevaluation of its use. As noted earlier, the development of antidepressants, antipsychotics, and other pharmacological products played a major role in replacing the practice. These generated far more profit than the lobotomy, which had by then become an office procedure. The horrific experiments of the Nazi doctors were brought to an end and Europe was denazified. However, medical abuses continued, e.g., in the long-running Tuskegee syphilis study (see my 2009 essay Jeremiah Wright and Suspicions About the Origin of AIDS), and in the 2020 coronavirus pandemic, where experimental mRNA gene therapies were used on the population at large (see COVID-19 and the Corporate State; The Future of a Delusion: Mass Formation Psychosis and the Fetish of Corporate Statism; Biden’s Biofascist Regime). What will be the story when—if ever—faith-belief around gender affirming care gives way to the reality of medical atrocities?
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I have been studying the history of medical abuse since the late 1980s, swept up in the subject almost as as soon as I had returned to college after a long hiatus from education. Peter Heller’s Medical Sociology class was a change of paradigm and the reason I became a sociologist. Robert Jay Lifton’s 1986 The Nazi Doctors: Medical Killing and the Psychology of Genocide was my scholarly introduction to the topic. This book provides a detailed examination of how medical professionals became involved in the atrocities of the Holocaust, including the euthanasia program and the experimentation conducted in concentration camps. Lifton explores the psychological and moral dimensions of how ordinary people, including doctors, became complicit in such heinous acts. Another book I recommend is Vivien Spitz’s 2005 Doctors from Hell: The Horrific Account of Nazi Experiments on Humans. This book focuses specifically on the medical experiments conducted by Nazi doctors on concentration camp inmates during World War II and the subsequent efforts to hold the perpetrators accountable at Nuremberg. Spitz was a court reporter during the 1946 doctors trial.
freedom and reason 