Originally published: . Volume 14, No. 7. Source pages: 2.
At the end of April, Dr. Clifton Mixon, a young psychologist who works in Ochsner's gender care clinic, posted on the Louisiana Psychological Association listserv, encouraging people to lobby against HB 648, which would ban sex-change surgery and hormone blockers for minors.
I felt that psychologists could support LGBTQ+ children struggling with gender dysphoria without supporting medical, potentially permanent interventions. There is no research method to provide predictive validity on lifelong consequences of these procedures.
But most of all, I wanted organized psychology to stay out of medicine's fight, and mind its own business. I was afraid that Dr. Mixon, who leads the LPA Legislative Committee along with another Ochsner employee, would drag us in to a highly political, controversial issue that has nothing to do with psychology. So, I waited, hoping someone else would object, but no such luck. I finally replied with the following:
I am concerned about the powerful forces at work in this area that can confuse and distort our scientific reasoning.
Supporting trans children does not necessarily mean supporting surgery or chemical interventions for minors. Some of those supporting these bills–that have been passed across several states now–believe that the medical industrial complex is exploiting these children for financial gain. That possibility cannot be dismissed.
Psychologists must keep strict control of ourselves when we have a conflict of interest, financial or political.
For this, I was disciplined––losing my right to post for 30 days. A letter from the Communications Committee Chair, Dr. Parkinson, another young psychologist, said I violated the rules, because "There is no evidence provided regarding the alleged nefarious actors involved or exploitation from reputable sources."
I violated another rule, "being unsupportive or disrespectful" because, Dr. Parkinson wrote, "This comment was construed by Dr. Mixon and others on the listserv as disrespectful and negative towards a member's character and motives for sharing an opportunity for advocacy. Dr. Mixon has explicitly expressed previously that he does not have a conflict of interest, but rather has asserted that he is an expert in the area about which the call for advocacy was made."
It dawned on me that these young psychologists may not be cognizant of the medical–pharmaceutical industrial complex. They may even have been captured by it, the fate of an embedded group.
In the 70s, we were regularly warned about the problems with the medical model, treating the symptom. The concern remains: Medical Nemesis: The Expropriation of Health, by Ivan Illick; Unaccountable, What Hospitals Won't Tell You and How Transparency Can Revolutionize Healthcare, by Dr. Marty Makary; or Overdiagnosed, Making People Sick in the Pursuit of Health, by Dr. H. Gilbert Welch, et al. Some attribute the atrocious ranking of health in the U.S. to the medical industrial complex.
It also dawned on me that these young psychologists don't understand what it means to have a financial conflict of interest. It has nothing to do with character, but rather with context. One either has a financial interest or doesn't. The resulting bias is often unconscious.
To assert that a person has no conflict of interest, is not the correct assertion. Dr. Mixon does not hide the fact that he is employed by Oschner's gender affirming care clinic, so he has a financial relationship. He can only assert that he does not allow it to bias his judgment. But he cannot be the judge of that, since the bias can be unconscious.
That is why rules of the Louisiana State Ethics Board, as one example, prohibit appointed officials from not only voting on the matter when they have a financial relationship, but from even participating in the discussion.
While I wish I'd have crafted it better, did I somehow harm my colleagues by expressing my opposing views? Did I somehow confuse their thought processes and lead them astray?
Or did centralized power oppress my dissenting voice?
I disagree that I broke the rules, but if I did, the rules need to change. Open debate with differing views is the correct way to move toward consensus, and help us avoid motivated reasoning.
Free speech is a core principle of psychology and an essential element of problem-solving in a healthy society.
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