Celso Arango, one of Spain's most renowned psychiatrists, argues that the number of teenagers who call themselves trans without being trans has multiplied due to ideologization, and believes that the trans law "can cause enormous damage". Sponsor the Amanda Association, of people affected by this "fashion", which is presenting itself today.
Psychiatrist Celso Arango. BERNARDO DIAZ
"It's crazy, it's going to hurt a lot of people, a lot of young people with disorders think they're going to fix them by becoming trans when they're not. Trans law can't move forward like that."
This is said by no activist of any kind, by no opponent of Minister Irene Montero , nor by any political rival of the government that is trying to implement the norm that will regulate transsexuality in these months.
Says Celso Arango ( Palma de Mallorca , 1968), one of the foremost authorities on Spanish psychiatry, head of the pediatric and juvenile department at Madrid's Gregorio Marañón Hospital , professor at Complutense and Maryland universities , and former president of the Spanish Psychiatric Society .
Arango is very alarmed by the possible approval in the Congress of Deputies of a trans law that excludes the supervision of mental health professionals over adolescents, he says, that in reality "they are not trans, but rather have other disorders and believe that being trans they will overcome them. Since the WHO has depathologized transsexuality, they haven't asked us for our opinion. But what they want to do is outrageous, and the vulnerable, the usual, could suffer a lot. That's why today, at the College of Physicians in Madrid, he is sponsoring the presentation of the Amanda Association, which brings together some 300 parents from all over Spain who claim to be suffering from the situation he denounces. What is your vision of Droit Trans as proposed in the government's plan?
Professionally, I'm watching the gestation of this law with concern, because it's so far removed from reality. Day by day at the Gregorio Marañón Hospital, we are witnessing an explosion, a boom, an exponential increase in the number of teenagers who call themselves trans, many for fashion, and they are not. In our inpatient unit, if we used to have one or two teenagers a year who said they were trans, now we have 15%, or 20% of admissions. Obviously, this is not a normal figure; it doesn't reflect reality.
How do you explain this?
When something like this appears and it's not viral or contagious, you ask yourself: what is it responding to? I'm very concerned, knowing the psychopathology of adolescents, this immediate search for response, gratification, variability, change... One of the first things we learn in child psychiatry is to wait before acting. When a child comes in and says his life is worthless, before you start pharmacological treatment, what you do is make an appointment with him a week later. And maybe the problem has disappeared.
Just wait.
Yes, these changes in the pediatric population, in minors, are very common. What used to be called gender dysphoria, which is now called incongruence, does of course exist, and I'm all for it being depathological and "depsychiatric", in cases where it is real. But what worries me is that most of the teenagers I see, when I study them longitudinally, say they're trans and they're not. And the problem is, if that leads to a wait-and-see situation, or starting psychotherapy, well. But if we're talking about someone who pretends to be trans for three weeks and goes to a private center and is given hormones.... Well, that's outrageous. We're doing something that's difficult to reverse, when it's not irreversible. And we, as healthcare professionals, have learned that our first obligation is to take care of our patients' health. In two visits you don't meet a patient, imagine those who call themselves trans.
Although they express it with total rotundity.
Logically, no. You have to follow the protocols: wait, listen, make differential diagnoses... The fact that I say that trans people aren't because of a mental disorder, i.e. that it's not a disease, doesn't necessarily mean that many people with mental disorders won't say they're trans without being trans. The two things are compatible, and they do happen. I'll give you an extreme example: if I have a schizophrenic person whose voices say she's trans, what do I do: do I give her hormones?
You reject gender self-determination.
Since then. And mixing gender with sex, and giving the image that you can choose the sex you have... No, that's crazy. One is either XX or XY. Live as you like, but sex is what it is, and we doctors need to know what sex a person is, because treatments are sometimes different for one or the other.
What would be the cause of this avalanche or boom you're talking about?
For those of you who see teenagers at the Gregorio Marañón Hospital, well, look, there's a pattern of, let's say, false cases: an excluded child, with autism, perhaps bullying, adjustment problems, Asperger's, social relationship problems, who suddenly finds a group of people who welcome and support him. And that by saying he belongs to soccer team X or political party Y, they welcome him and he finds himself...
Accepted.
Exactly, accepted. Well, that's it. That was the problem, that I was trans. Everything will be fixed now. When you ask these guys what it means to be trans, what it means to be a woman, what it means to be a man, it's easy to pick them apart. Those who are really trans can be seen from the age of four or five. At that age, they're already telling you that their sex disgusts them, that if they could they'd take it off, that they'd never wear underpants in their lives. And in two years, they're still the same. And in five, the same. And they dismantle everything you discuss with them. We've seen these seconds all our lives, they suffer from that dysphoria we were talking about, and the treatments for them are totally justified. But that's the proportion I told you at the beginning: in our hospital, maybe three cases a year. The problem is the first one. Now there's an explosion of the former.
The reader will ask: but how can such a law reach Parliament without anyone from the scientific community raising a hand?
Legislators need to listen to those of us who serve these people. Careful, you can do a lot of damage with this. And I'm the first to support the World Health Organization when it says that gender dysphoria is not a mental disorder, although it's also true, mind you, that people with gender dysphoria suffer from many mental disorders as a result. If hormone therapy and surgery are good for these people, then fantastic, that's what science is for. But I'm obliged to tell those in the hemicycle to come and see what's going on in our unit. I invite you to come.
But why don't psychiatric professionals come and say that?
They haven't asked us. Since it's depathologized, they think they don't have to ask us. It's also true that this phenomenon, the boom, is very recent, something in the last three years. The Spanish Society of Psychiatry has just set up a group on the subject. It's the easy way out: run away. This is what's happening to me. I'm in a body that isn't mine and being trans will cure all my ills. It's a classic teenager's magic solution, here and now, frontal lobe disinhibition, do before you think. Then there are two other aspects. It's ideology that has blinded the promoters of this law, but nature is what it is, there is no ideology that imposes itself. No ideology, I specify, that of any party, neither one nor the other. On the other hand, the way this is being proposed carries the risk that private medicine will get involved in certain actions and benefit from them. Be careful with that.
But then, to your knowledge, what scientific criteria were used to compose this law as it is written?
Well, I don't know. They didn't contact the learned societies. I imagine the criterion was ideological. If I don't think trans people have mental health problems, why should I tell doctors? I don't need to. It's like applying ideology to euthanasia. You can't euthanize someone suffering from major depression, because you give them medication and suddenly they feel fine. If you allow euthanasia, it would be called suicide. A differential diagnosis must be made. To someone who has come to euthanasia after thoughtful reasoning, weighing, etc., this can be applied.
Also
Les mères du collectif Amanda, Espagne
tribune qui fait état de leur mobilisation, parue lundi 17
A lire le témoignage de mères espagnoles
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