Sex-change? Transgender?

I have always been agnostic about transgender transformations. But not everyone is:

"As for the adults who came to us claiming to have discovered their “true” sexual identity and to have heard about sex-change operations, we psychiatrists have been distracted from studying the causes and natures of their mental misdirections by preparing them for surgery and for a life in the other sex. We have wasted scientific and technical resources and damaged our professional credibility by collaborating with madness rather than trying to study, cure, and ultimately prevent it."

That is Paul McHugh, a psychiatrist, writing in First Things, a journal of religion [thanks to Ben and Jack for the link]. He also says,

Having looked at the Reiner and Meyer studies, we in the Johns Hopkins Psychiatry Department eventually concluded that human sexual identity is mostly built into our constitution by the genes we inherit and the embryogenesis we undergo. Male hormones sexualize the brain and the mind. Sexual dysphoria—a sense of disquiet in one’s sexual role—naturally occurs amongst those rare males who are raised as females in an effort to correct an infantile genital structural problem. A seemingly similar disquiet can be socially induced in apparently constitutionally normal males, in association with (and presumably prompted by) serious behavioral aberrations, amongst which are conflicted homosexual orientations and the remarkable male deviation now called autogynephilia.

The entire piece make fascinating reading.

For a very different perspective, see the links provided by the brilliant and well-known economist, Deirdre McCloskey.

In light of the questions raised by McHugh, under what conditions can gubmnt-sponsored health care be justified in providing transgender surgeries?