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Spain 'wakes up' to gender contagion
Renowned Spanish psychiatrist calls on lawmakers not to make things worse
One of Spain’s most renowned psychiatrists, Dr Celso Arango, has warned that an alarming surge in young people mistakenly declaring themselves transgender may result in a great deal of harm.
"This is madness, it's going to hurt a lot of people, a lot of young people who have disorders think they're going to fix them by becoming trans — when they're not [trans],” he told the mass market newspaper El Mundo on Saturday October 8.
Dr Arango, head of child and adolescent psychiatry at one of the country’s leading public university hospitals, argued that the national government’s draft Trans Law allowing self-declared sex change in official records from the age of 12 would add fuel to the fire.
“On a day-to-day basis at the Gregorio Marañón Hospital [in Madrid] we are witnessing an explosion, a boom, an exponential increase in adolescents who say they are trans — many for fashion,” he said.
On that same Saturday, the parents’ group AMANDA staged a historic rally in the capital and packed the great amphitheatre of the Madrid College of Physicians, with people brandishing posters such as “Less Surgery, More Psychology” and “Trans Law = Danger for our Children.”
The college issued a statement expressing concern “about the current situation of Rapid-Onset Gender Dysphoria” and it noted that the parents of AMANDA were calling for a cautious response to their trans-identifying children.
The group — whose name “AMANDA” is a Spanish acronym incorporating a reference to the ROGD concept of America’s Dr Lisa Littman — was founded last year by eight isolated mothers who discovered one another on social media and now represents some 300 parents across Spain.
The group, which calls for exploration rather than medication of gender distress, said the intervention by Dr Arango and the college of physicians was a milestone, and families affected by ROGD had been “given a public voice.”
“For the first time [in Spain], an organisation representing the medical profession has spoken out publicly in favour of a prudent, scientific and non-ideological stance on this issue,” a spokeswoman for the group told GCN.
“And one of the greatest representatives of psychiatry at the European and Spanish level [Dr Arango] has exposed that there is indeed a crisis of social contagion in relation to gender identities that can irreversibly damage adolescents and young people.
“The breakthrough that is needed is for our policymakers to adopt a prudent stance, to understand that in the present context a trans law cannot be passed as a matter of urgency, without listening to the experts and families affected.” — Parents’ group AMANDA
Dr Arango, who is a former president of the Spanish Society of Psychiatry and has an international profile with university appointments in the U.S. and U.K. as well as in Spain, sponsored the October 8 event at the college of physicians.
“Years ago, we would have only one case a year of someone who claimed to identify with the other sex,” he told the audience.
“This last year, the boom is such that we already have 20 per cent of adolescents admitted who declare themselves to be trans.
“It is dangerous to push confused young people towards an irreversible hormonal change. Experience says that until the time of mental maturation, [young] people should be protected from decisions that may affect the rest of their lives.”
Within 72 hours of the October 8 event, the group AMANDA was contacted by 35 new families.
The draft Trans Law allows a change of sex in the official register — with no need for psychological assessment — from the age of 12 with judicial approval; from the age of 14 with parental support (but a judge can override parental refusal); and from the age of 16 independently.
The law enacts a “conversion therapy” ban that purports to protect “gender expression”, “sexual orientation” and “sexual identity”.
This grouping of terms is unclear, but critics say that anything other than the “gender-affirming” treatment approach is likely to be banned. Mental health professionals found guilty of conversion therapy would face a maximum fine of €150,000.
The bill also also targets “LGTBI-phobia”, with “derogatory” speech attracting fines up to €10,000. Critics say this could outlaw good-faith dissent from gender ideology or mere statements of biological reality.
“The main objective of the [Trans Law] is to impose on Spanish society as a whole, by legal imperative, the [quasi-religious] belief that there is a ‘felt sexual identity’ in each person,” says an umbrella group, known as La Confluencia Movimiento Feminista, which defends the rights of girls and women based on their biological sex.
“That ‘felt sexual identity’, completely separate from the [biological] sex of each person, is [proposed as] the source of ‘authentic’ information — prevailing over the material reality of the body — in determining whether a person is a man or a woman.
“The [draft bill] intends that this ‘felt sexual identity" should have legal recognition in the Spanish legal system, replacing the biological category of sex.”
Spain’s lower house of parliament, the Congress of Deputies, has approved use of an emergency procedure to fast-track passage of the draft Trans Law, and delegated the full Congress’s power of approval to the Equality Committee. (The next step would be consideration by the upper house, the Senate.)
Fast-tracking was calculated “to prevent public debate of the bill and make it more difficult for everyone to understand its aim and scope,” said Amparo Domingo, a Spanish representative of the feminist organisation Women’s Declaration International.
The Spanish government led by prime minister Pedro Sánchez of the Socialist Party says urgency is warranted to protect “LGBTI people” from discrimination and to depathologise trans identity.
But his Socialist colleague and former deputy prime minister Dr Carmen Calvo — who is in charge of the Congress’s Equality Committee — has declared her opposition to the self-identified sex change of the Trans Law.
She said the law “could destroy the powerful equality legislation of our country”; legislation which protects females according to biological sex, not self-declared sex.
Dr Calvo, who is legally trained, has the power to call experts to give testimony before her committee.
Video: Amparo Domingo on the politics of Spain’s Trans Law
Dr Arango said mental health professionals had not been consulted on the draft law by the Spanish government, which presumably saw no need because of its campaign against “pathologisation” of trans identities.
“The fact that I say that trans people are not trans because of a mental disorder — that is, that [trans identity] is not an illness — does not necessarily mean that many people with mental disorders will not say that they are trans without being so,” he told El Mundo.
“The two things are compatible — and they are happening. Let me give you an extreme example: if I have a schizophrenic person whose voices tell them they are trans, what do I do? Do I put them on hormones?”
Dr Arango said the exponential trend in trans identification among young people had only been noticed within the last three years in Spain, and was different from the long-standing condition now known as gender dysphoria or gender incongruence (which involves a sense of disconnect between the body and an inner concept of “gender identity”).
“Knowing the psychopathology of adolescents, this immediate search [by trans-identifying young people] for a response, for gratification [and change] worries me a lot,” he said.
“One of the first things we learn in child psychiatry is to wait before acting.”
“[These young people say], ‘I'm in a body that isn't mine and being trans is going to cure me of all my ills'. It's a classic adolescent, magical, here-and-now solution, frontal lobe disinhibition, doing rather than thinking.
“There is a pattern of, let's say, false cases: an excluded child, with autism, perhaps bullying, adaptation problems, Asperger's, social relationship problems, who suddenly finds a group of people who take him in and support him.”
Dr Arango raised the possibility of profit-driven private clinics responding to the surge in adolescent demand with easy access to hormones that make irreversible changes to young bodies.
He attributed the dramatic rise of “false positive” trans identity to fashion, the yearning for group acceptance and the same ideology underlying the new law allowing self-identified gender to overwrite biological sex in official records.
“Mixing gender with sex, and creating the image that one can choose the sex one has ... No, that's madness. You are either XX or XY [chromosomes]. Live as you want, but sex is what it is, and doctors have to know what sex a person is, because treatment is sometimes different depending on one or the other.” — Dr Celso Arango
Addressing the audience in the college of physicians’ amphitheatre, Dr Arango described what appeared to be social contagion of trans identities at work in his own hospital.
"We have cases of instantaneous transitions on the [hospital] floor itself,'“ he said.
“I’m talking about girls who were admitted with mental health problems, thinking their life was not worth living, feeling that nothing makes sense, not talking about gender dysphoria [and in fact having Austism Spectrum Disorder or Asperger’s], when suddenly they declare themselves trans.
“It is very painful to sit in front of them, ask them what is going on with them, and they tell you that coming out as trans is the only hope they have of being accepted and heard. They ask you not to take away the only thing they have to hold on to, in order to fit in.”
Dr Rafael del Río, president of the ethics committee of Madrid’s college of physicians, called on Spain’s politicians not to legislate in haste but “to act with great caution in the face of transgenderism, given the scant scientific evidence that it involves.”
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The breakthrough events of October 8 took place against a background of a few years of attempts to raise awareness by a number of lawyers, endocrinologists, feminist writers, psychologists and philosophers, according to Dr Laura Redondo, a specialist in judicial and legal psychology.
“It’s important that more people join in, both the general public and professionals,” Dr Redondo told GCN.
She said a key development was the creation of the Alliance Against the Erasure of Women in 2019.Hace 4 días comentaba que una compañera psiquiatra alucinaba con el aumento de casos de disforia de género. Como se ve en los comentarios lo tacharon de invent y me atacaron. Hoy sale el propio jefe de psiquiatría del GM a decir lo mismo. ¿Hasta cuando se negará esta realidad?Una psiquiatra me comenta preocupada que los pacientes que antes venían por anorexia y trastornos somatomorfos ahora vienen por disforia. Que no ha visto nada igual durante su carrera. Lo peor, es que van varias que me lo comentan. Cuando veamos la magnitud real será un escándaloLaura Redondo @LauraRdondo
In February 2022, psychologist and feminist Carola López became the first person in Spain to face an accusation of carrying out conversion therapy.
She denied the allegation, which was made under a law in the autonomous region of Andalucía. The maximum penalty was €120,000 and five years’ suspension as a psychologist.
A trans activist group had targeted López’s tweets, including one that said, “If someone is disgusted with their body, the logical thing is to help them accept it with the least invasive treatment possible.”
In a media interview, she said: “What surprises me about all this is that a frequent task of psychologists is to help people to accept their body, to love and respect it in order to be happy and not to feel shame or self-hatred; and for these [trans activist] associations, that is something negative — then I think they will have to close all the psychology offices in the world.”
The Andalusian authorities dropped the case in August, saying the opinions stated by López were protected by freedom of expression.
Dr Redondo said the draft national Trans Law disdained the expertise of Spain’s psychologists and psychiatrists who could help the emerging group of young people coming to regret medicalised gender change.
“These minors try to detransition and find themselves without support, without recognition of the damage and the permanent outcomes [of these medical interventions],” she said.
She said the Trans Law “even vetoes the parents themselves, such that if they try to defend their children from this unscientific and harmful phenomenon, they can be denounced for abuse.”
Video: The group AMANDA explains the ROGD trend, as well as the shifts to caution in Finland, New Zealand, Sweden and the U.K.
Caution, not reaction
“We are not conservative, not far-right, not religious,” one mother from the group AMANDA told El Confidencial last year. “Many of us are feminists. And none of us care if our children are gay, bisexual or whatever.
“If they come out of the closet — and some did before they became obsessed with gender dysphoria — we accompany them. Not all of them have a homosexual orientation. My son, for example, says he is a lesbian woman.
“What we want is for our children not to suffer. And that they don't destroy their bodies, that they don't become sterile, that they don't mutilate themselves, that they don't make irreversible decisions on the spur of the moment in a stage of life characterised by its fickleness.
“But none of us can talk to our sons and daughters about this subject. It is taboo in our homes, and we are afraid.”
At the October 8 public debut of AMANDA, families affected by ROGD were joined by health professionals, teachers and feminists.
The group fears that the Trans Law may increase medicalisation of young people.
Its spokeswoman said the national Trans Law referred to laws on medical treatment in Spain’s autonomous regions. When it came to trans treatments, those regional laws were based on protocols such as the World Professional Association for Transgender Health’s standard of care.
“Since the latest version of this protocol [SOC 8] has completely eliminated the minimum age of treatment for children, it is to be expected that the use of blockers will skyrocket,” she said.
Tweet: Lioness Mothers v Hormones in Madrid
Some of Spain’s autonomous regions have already enacted self-declared gender change. In the southern region of Andalucía, the 2014 trans rights law created five gender clinics for children under 14, according to reportage by El Independiente de Granada.
From 2015-21, the official number of first appointments in these clinics rose by 136 per cent to a total of 291 children.
However, journalist Cristina Prieto reported that “the perception of several primary care professionals, who preferred to hide their names for fear of reprisals, indicates that there is a much higher number of cases.”
“The passing of gender identity laws, the pressure of trans activist groups, the support of a large part of the media and the massive dissemination on social networks of queer ideology, which promotes the belief that both sex and gender are a cultural creation and therefore sex can be chosen at will because the importance lies in the gender identity that each person feels, push children to manifest the opposite sex to the surprise of their families and to begin pharmacological treatment with serious consequences for their health,” she wrote.
The trans care protocol in Andalucía reflects the right “not to be forced to undergo treatment, medical procedures or psychological examinations that restrict their freedom of self-determination of gender.
“In other words, the psychological or psychiatric diagnosis is eliminated in order to move directly to pharmacological treatment consisting of puberty blockers and cross hormones if the minor so decides,” Prieto reported.
“The patients themselves self-diagnose and go to the transgender unit to receive medication without any other specialised assessment, while psychology and psychiatry professionals are forced to follow protocols that prevent them from making accurate diagnoses.”
An endocrinologist, speaking anonymously, told Prieto that “hormones and puberty blockers are being given to those who ask for them, without psychological assessment.
“The entrance door to the transsexuality units is endocrinology because the Andalusian law establishes it like this, and the minors, already instructed through social networks, arrive with their own self-diagnosis and with a perfect knowledge of what they have to ask for.”
The group Amanda said there was no orderly national collection of data on youth gender medicine, with treatment delivered by Spain’s autonomous regions. Regional data was often not broken down by sex or age.
GCN sought comment from Spain’s Ministry of Equality, and the LGBT+ group el Colectivo COGAM