In 1935, Portuguese neuroscientist Dr. Egas Moniz pioneered a new procedure to treat symptoms of psychiatric illness. Using a thin instrument, a surgeon could sever the delicate neural connections between the frontal lobe and other parts of the brain. The procedure resulted in significant changes to the patient’s behavior. Despite a mixed reception by the medical community, Moniz received a Nobel Prize in 1949.
In the ensuing decades, the practice of transorbital lobotomies was championed by American psychiatrist Dr. Walter Freeman. He operated on over 4,000 patients and remained a fierce advocate for the procedure long after it fell into disrepute. While some patients seemed to be cured of their psychiatric distress, the main effect of lobotomies was the dismantling of the patient’s personality. According to Freeman’s own numbers, about 73% of his patients remained hospitalized for life or “in a state of idle dependency.” Another 5% died during the operation.
Recently in The Washington Post, columnist Megan McArdle pointed to the history of lobotomies as a cautionary tale.
The first lesson Freeman offers the modern reader is not to rush past the point of no return—to move by inches, rather than leaps, when the stakes are high. Freeman and his partner lobotomized 20 people in their first four months, and with every operation, I suspect it became more necessary to believe in the good of them, rather than admit you had killed one person and irreparably scarred the brains of 19 more to no good effect.
Today, another kind of surgery is increasingly being used in an attempt to fix psychological distress, though, to be clear, the comparison isn’t exact. Operating directly on the brain is categorically different from operating on the rest of the body, and those who seek help from so-called “gender affirmation surgery” do not typically think of their identity struggles in the same way as people who suffer from schizophrenia or manic depression. Likewise, lobotomies were never a centerpiece of a massive social movement. Most importantly, while Freeman’s work involved a stripping away of autonomy, transgender-affirming medicine reinforces radical autonomy, unhinged from age restrictions, biology, even the purpose of medicine.
As McArdle warns, the lesson to be learned from the history of lobotomies is to not rush forward when research is vague and consequences of being wrong are so high. Despite the concerns of the medical community, enthusiasm for lobotomies reached a fever pitch between the mid-1940s and 1960s, mostly due to efforts of a zealous few. That history is echoed today in the efforts of transgender activists.
As Reuters reports, thousands of families are lining up for “gender-affirming care,” even as evidence mounts that hormone treatments and surgery, especially for minors, has horrifying consequences. At the same time, cultural voices continue to proclaim that the science is “settled” and to oppose the agenda is bigotry. The stakes are high, and yet thousands continue to rush forward into irreversible damage.
In his book Great and Desperate Cures, psychologist Elliot Valenstein wrote that,
Psychosurgery was not a medical aberration, spawned in ignorance. In a real sense, the history of psychosurgery is a cautionary tale: these operations were very much a part of the mainstream medicine of their time, and the factors that fostered their development and made them flourish are still active today.
Psychosurgery was recommended by distinguished psychiatrists and neurologists and performed by equally prominent neurosurgeons, many of whom were affiliated with highly respected medical centers and universities. …
Editorials in the most influential and prestigious medical journals praised these operations and their scientific foundations, even while at times suggesting the need for caution and more research. All this support from within the medical profession increased the demand for these operations, leading to their ultimate accolade when, in 1949, the man who had introduced psychosurgery was awarded the Nobel Prize in Medicine.
Today, 70 years after Egas Moniz received the Nobel Prize, we recoil at the damage done by the pseudo-medical science of lobotomies, but it doesn’t seem like we actually learned the lesson we should have. Though brain surgery to cure patients of schizophrenia seems cruel and ridiculous today, we’re perfectly willing to operate on healthy bodies as if we can change them to align with a psychological disorder.
The most likely outcome of transgender surgeries will be broken and ruined lives, and a cautionary tale that will serve as a warning to future generations.
This Breakpoint was co-authored by Kasey Leander. For more resources to live like a Christian in this cultural moment, go to colsoncenter.org.
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