This story was written by guest author Amy Holden.
A Spanish psychologist who has never treated trans patients has been accused of promoting gender identity conversion therapy. It could result in her being barred from practice, and a fine of up to €120,000.
How did we get here?
In the summer of 2021, Spain’s far-left wing party Podemos proposed a national law on trans issues, called “Real and effective equality for trans people to guarantee LGBT rights”. The Trans Law would make gender identity take legal precedence over sex, allowing anybody legally to become the opposite sex, for any reason, at any time, and without any prerequisite medical or psychological assessment or diagnosis, social transition or medical intervention.
It’s enough to make a simple self-declaration at the Births, Deaths and Marriages office to a registrar – who is not allowed to ask any questions. There are obvious safeguarding issues, and significant consequences for women’s and children’s rights: any male has the ability to be a legal woman/girl, and therefore access jails, refuges, wards, grants, sports and private spaces such as changing rooms and dormitories.
With this law, it also becomes illegal to challenge a gender identity declaration under any context, removing entirely the role of psychology and psychiatry in gender dysphoria treatment and diagnosis. Additionally, the law allows fines to be issued to healthcare professionals who promote or undertake therapy that is directed towards the “conversion” of a patient’s gender identity, even if the patient desires such a form of therapy. This particular article of the law is the one that has given rise to Spain’s first case, a vexatious complaint that I will come back to shortly.
This law also implements gender ideology in schools, turning teachers into gender identity recruiters who will teach kids that everybody has a gender identity, and that some people are born in the wrong body. Teachers can also affirm a child’s chosen gender identity behind the family’s back. They can change kids’ names and genders in school records, concretising identities and thus pushing children further towards transition. It is now legal for children to consent to puberty-blocking or cross-sex hormonal treatment without parental consent from as young as 14, and to full gender reassignment surgery at 16.
These treatments will be provided for free on the public health system, with the government potentially acting as a young child’s guardian in order to authorise these treatments, if the child’s parents disagree. This flies in the face of evidence, including the UK’s NICE review, which found that the majority of gender-non-confirming and trans-identifying youth reconcile with their sex over time; that transition treatments can have harmful, irreversible and life-changing side effects; and that these treatments do not alleviate gender dysphoria, and are fraught with multiple ethical issues about consent which have been lived out in various court cases in the UK, Australia, and Canada, as well as other countries.
Recent evidence shows that there is a large number of people who have had gender reassignment treatments who experience profound regret. These individuals feel they were not properly listened to, assessed, challenged or counselled. Many now realise their dysphoria was an undiagnosed mental health illness, not an authentic identity.
All of this is happening in Spain at the exact moment that other countries are reversing their stance on gender “self-ID” and affirmation treatment. Instead, these jurisdictions are limiting the teaching of gender ideology in schools, and adding longer limits before children and youth can access hormonal or surgical treatments. Acting from a better evidence base, these countries are directing vulnerable young people them towards more neutral support and exploratory therapy.
Despite all the evidence to the contrary, the Spanish government pushed forward, ignoring the many warnings which were raised. The public consultation period for this law was chosen as August 2021, which is when most Spaniards are on holiday. Even more sneakily, this was not publicised in the media.
Even so, thousands of medical professionals, psychologists, teachers, parents, and individuals like me wrote to the government to air our concerns. We are fearful of a dangerous regression towards affording legal imprimatur to gender stereotypes, something that Spain has committed to eradicate via co-education and equality legislation, such as the Istanbul Convention. The power of diagnosis and mental health interventions is now out of the hands of psychiatrists and psychologists; instead, this responsibility is thrust onto children. Where adults are involved, they may have no mental health qualifications at all – as is likely true, for example, of teachers, newly empowered by this law.
I was one of the people who published my opposition to the law in an open letter co-signed by other individuals, which you can read here. In this letter, I specifically warned that, if passed, the law would be used to coerce, harass or cancel gender critical health professionals, rather than to protect LGBT people. Unfortunately, this is now the case.
Someone else who publicly opposed the law was Carola López Moya, a fellow perinatal psychologist and therapist. Carola is also an author, and the founder of an association for mothers who have suffered obstetric violence, grief, or have children with severe disabilities. She maintains that gender stereotypes are damaging for women, and that, in reality, trans women are actually men. While it may seem like the simple statement of an obvious fact, we both received harassment and accusations of transphobia and conversion therapy on Twitter. These pile-ons came from associations representing trans people. Our only crime was to hold the view that sex matters, and should be upheld in law.
For those misogynists who care about my patients because I am critical of gender identity, tell them that they are making progress precisely because I help them get rid of the psychological discomfort produced by gender, a cultural construction that subordinates women.@mamaresiliente
Even though she is neither transphobic nor actually provides gender therapy services, she was reported to the regional government for promoting gender identity conversion. The equality department has since opened a case against her, based on the recently implemented law. However, Carola was never formally informed of the case against her: she only became aware after documents relating to her case were leaked to the press by trans activists, and journalists contacted her for a response.
You can read more in detail about Carola’s case here: the case sanctioning her could end her career as a psychologist, and even land her with a fine of between €60,000 and €120,000.
It is now for the Junta de Andalusia’s equality department to consider the reality that learning about gender and how it is oppressive does not invalidate any person’s gender identity; nor is it the promotion or execution of conversion therapy. Conversion therapy is therapy with the intention to change a said person’s sexual orientation or gender identity.
Gender, and how it oppresses women, is the subject of hundreds of books and academic studies. Also, much of this is just plain common knowledge. If understanding gender helps people lessen their discomfort and understand their own relation with their own gender, why on earth should psychologists be prevented from doing so? Why would universities teach courses on it? And why would that be considered the promotion or execution of conversion therapy, especially if it is done in the context of working with mothers?
It would be an absolute miscarriage of justice if a psychologist who has never treated a trans person were found guilty of the vexatious complaint of having undertaken or promoted conversion therapy for those with a gender identity. In fact, nobody really believes that she will be fined – because it did not happen. It was just an intentional manipulation of her words, because the trans activists in question are against radical feminists having freedom of thought and speech.
In any case, the damage to her reputation, the financial cost of having to represent herself, and the length of the process will all take their toll. Will the vexatious complainants cover the costs? Doubtful. This kind of harassment, aiming for total “cancellation”, is not just a far-left publicity stunt at the cost of a private citizen’s career, seeking to generate a series of headlines. It’s designed as a warning to other professionals and the public to toe the line on the new trans law – or else.
For this reason, I am doing the opposite of lying low. Every time I see this kind of harassment, it gives me the wings I need to speak up.
Far from saving any trans person from conversion therapy – which has not been practiced professionally in Spain for decades – we should be concerned that the trans community is receiving less support than ever. In this toxic environment, healthcare professionals may either turn trans-identifying people away, or simply affirm everything they say. And what is the point of therapy if questioning, challenging and exploring are all avoided?
Both the trans community and the health professionals should ensure that the best support is available, working together from an evidence base to do so. As it stands, with the trans law that we are now subject to, that is practically impossible.
Amy Holden, BSc (hons), Psych. MBPS, is a politically active mother, psychologist, children’s brand entrepreneur and author. You can hear more from her at @amyworldalive.
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