"First complaint against a hospital for a change of sex to a minor" - translated from El Mundo

On April 27, 2022, El Mundo, the leading conservative newspaper in Spain, published a paper issue cover story titled “First complaint against a hospital for a change of sex to a minor”, by Quico Alsedo.

The complaint detailed in this story was made by a mother who is part of Agrupación Amanda, a group of parents of ROGD children and adolescents from Spain. It has been translated into English, below, by a PITT parent. This story deserves to spread far and wide!

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"They say that my daughter is a boy but she actually has depression"

Rosario has sued the Ramon y Cajal Hospital in Madrid for starting, without the necessary approval, gender-affirmation treatment for her 16-year-old daughter, who has suffered bullying, anorexia, self-harm and a suicide attempt. The girl asked for it and her father supports her.

Let’s suppose that you, the reader, have a daughter who has been in full adolescent confusion for a couple of years. First, she suffered bullying at school for her physical appearance. From there she developed anorexia, which later turned into bulimia that has kept her in treatment for two years, medicating daily, and self-harming to channel her frustration. Things escalate, there’s a suicide attempt with pills, and a couple of hospital admissions to control what seems uncontrollable.

One day, when she is fifteen years old, the girl tells you that she likes girls. A month later, she tells you that she is actually a boy in a girl's body. That is the cause of all her ills; she is transsexual. You think she’s actually having a “major mental meltdown” but you go along with it. The girl is sixteen years old and stormy are the paths of adolescence.

Psychiatrists refer her daughter to the Gender Identity Unit of one of the main Spanish hospitals. She feels calmer. She has never seen the slightest hint that her offspring is a child in the wrong body. She is sure that this will come to light when the specialists see her. 

But I find just the opposite. On the first visit, the first thing they do is give her father and me the informed consent for my daughter to start the sex affirmation process, without establishing if she really needs to change her sex and have surgery, hormones and to amputate her body parts. They treat our daughter like a boy, calling her by her preferred boy name and encouraging her confusion, when what’s really happening is that she is depressed. They only seek to affirm what she says and ignore all her pathologies, the years on medication and the suicide attempt. Moreover, they tell me that I am the one who is wrong for opposing it. They do not have her see a psychiatrist, but they tell me that I am the one who needs one. At first glance, without studying if my daughter really needs to change her sex or if she is really mentally ill, they tell me “Ma'am, you have to accept it: your daughter has died and your son has been born”.

Last March 9th, Rosario, a 56-year-old lawyer from Madrid, denounced the Ramon y Cajal Hospital in Madrid before the Justice. She alleged that the center's Gender Identity Unit is attacking the health of her 16-year-old daughter, without the minor being able to understand what she is doing. It is the first lawsuit of this nature that has occurred in Spain.

In addition, she alleges that the hospital has acted without judicial control.

Since I refused treatment, they, as they have admitted to me, should have obtained the authorization of a judge and they have not done so. They have even told me “Madam, all the judges are giving the authorizations”. Okay, but they don't have it yet and they've already started treatment. They are playing with my daughter's health and are not even really protecting her.

Rosario demands that a psychiatrist see the minor to assess the pathologies that have required two years in Mental Health treatment at the Hospital Niño Jesus. From there she was referred to Ramón y Cajal Hospital “when almost immediately, they assured her daughter that she was actually a boy, without ever having shown signs of it before”, says the mother. 

In the Gender Identity Unit, they tell her that a psychiatrist cannot intervene, because that would mean pathologizing transsexuality. That is, turning something into a disease that is not considered as such by the scientific community. "But I say what if there are other ailments that make the child believe that transsexuality is the solution, but it’s not?" recounts Rosario, lawyer with the Madrid City Council, “this is like a cafeteria menu in Madrid”.

Both the legislation that currently regulates transsexuality, which dates back to 2016, and the bill that is being discussed now in Parliament, strictly prohibit psychiatrists from intervening in gender affirmation processes. The intent of this rule is to avoid a return to therapies that tried to cure homosexuals of their nature. "But the fact is that a homosexual does not have to amputate his body parts so that he can express his sexuality freely, but my daughter, if she is transsexual, does," Rosario replies. "And if she makes such a tremendous mistake as a minor, without the ability to understand what she is doing, she will pay for it the rest of her life."

This has been the case, for example, for Keira Bell, and English woman. At the age of 16, she was treated by the British National Health System to reassign her sex. Keira: “I was convinced that I was a boy in a girl's body.” Seven years later, she denounced that same health service for having listened to and operated on her. “I wasn't mature enough to make that decision”, she alleged.

The British courts not only agreed with her, they established new security measures based on her case and another analogous case, so that this would not happen again. Among others, these security measures include a judicial authorization which, in the case of Rosario's daughter, has not yet been produced, according to her complaint.

The debate is very deep and heated, at a time when transsexuality plays an important role in the West’s cultural battles. Few doubt the need to socially liberate transsexuals, who have historical been subject to the most absolute discrimination. But the dilemma is broader. How can it be established, with the most scientific and medical certainty, that a minor does indeed need to block his hormonal development and undergo surgery to change his sex, because the one he was born with causes him suffering?

“I don't know that.” replies Rosario, who is part of Agrupación Amanda, made up of a group of parents in the same situation. “What I know is that many many minors are being seduced by the idea that they can free themselves by changing their sex, and many of them, and I know because I have seen it, have previous mental pathologies, histories of discrimination or abuse, and are interacting with people on social networks making them believe that their problems will be solved by changing their sex: they find a refuge there… My daughter began to suffer when her body changed with puberty and she was harassed by those around her. That was the root cause of her suffering. So how can she not think that she should change her body to fix herself?  I must prevent a public hospital from failing in its duty to protect my daughter's health and, instead of curing her, inflicting more harm, by following an extremist ideology and absurd indoctrination.” 

Asked by this newspaper about Rosario’s reports, the Community of Madrid, under which Ramon y Cajal falls, remains silent. But they admit that the facts are being studied in a contentious court in Madrid, to which the minor has been summoned. Also, that the protocol to follow kids like Rosario's daughter is still being developed. "They assured me that the protocols were already being followed," says the complainant, "so this does not prevent minors from being treated there."

However, the court that sentenced the Keira Bell case condemned the absence of real medical controls in treatments that are still, due to their novelty, considered experimental.

Rosario: “When I told the director of the Unit that it seemed incredible to me that, on the first appointment, they gave me informed consent and began to affirm my daughter's willingness to change sex, she told me that she also thought it was extreme, but that the law says that it is what must be done and that they followed the protocol. They ended up admitting to me that they still do not have the protocol developed. My opinion is that they are experimenting with minors.”

The Unit was created in 2007 and, in the past, before the 2016 law, it did have psychiatrists on its medical team. Rosario's first contact with the Unit was on July 21, 2021.

“We sat down with the endocrinologist. My daughter says she wants to transition as soon as possible. Her father, from whom I am divorced, supports her. He supports what she says: that her suicide attempt was because we did not accept her transsexuality. I say that I do not agree, that my daughter suffers from dysmorphia, that she does not like her body, since she gained weight and began to suffer harassment for it at school and that she has seen changing her body as a way out, but that this is misguided. As her mother, I explain all this and show her clinical history to a professional. The endocrinologist listens and immediately offers the informed consent form. When I tell them that I’m going to sign as "not in agreement", I found that disagreeing is worded as “I do not consent and I reject the proposed procedure and by doing so I release the service from all responsibility related to my case.” That is to say, you do not consent, but at the same time you release them from responsibility if they obtain judicial authorization… Unbelievable”.

In the following visits to the Unit, last fall, the health workers already called her daughter with the boy name she had chosen. They also let Rosario know that "he already feels like a man" despite the fact that she has her daughter's medical history and, based on it, requests that she be treated psychiatrically. Rosario tells them that the girl has stopped taking medication – centralin and tranxilium - and is not supervised by any specialist because, having turned 16, she no longer falls under the umbrella of the Hospital Niño Jesús, her former pediatric hospital. She is told, “Well, go see your family doctor or someone who will refer you, there is no longer a psychiatrist here”, that is the answer”. And they say that I must accept that my daughter is a boy, that she has declared this and they have the obligation to accept it and affirm it, without further ado.”

The center is defending the autonomy of the young woman as a patient, as she is 16. However, Rosario defends in court that this autonomy has an exception for serious interventions and treatments, such as a sex change.

Ramon y Cajal’s Gender Identity Unit is applying the theories that permeate the 2016 law, approved with Mariano Rajoy in the Government, and also the current project. Both assume that gender is a social construction, a cultural creation—that is, each person should be free to choose their gender and we all have the right to surgically change our sex to match the gender if we so wish, since it is medically possible.

I tell them that since my daughter is 16 years old, if I do not give my authorization, they must seek that of the judge. And they answer me that the justices are authorizing them all”, she remembers. "That's when I clearly saw that I have to report this because if I do not, they will not stop.

First, she administratively requested that the treatment stop and, when this did not happen, she filed a complaint to protect her daughter's fundamental right to health.

Last February they even asked me to withdraw the lawsuit. They told me that it [the lawsuit] would make the relationship with my daughter even more difficult, that it would hinder her process… In other words, they believe that they would take better care of her than me. Then, when they saw me going ahead and not stopping, the Unit Director told me that they realized they had gone too fast and that they would not touch my daughter until she is 18 years old. But I am not going to stop: how many girls have they operated on without knowing what they are doing, irreversibly damaging them for the future?

Rosario provided documentary proof to the Paper of all of the actions she has taken. In a letter to the hospital last fall, they refer to her daughter as “hije” – my son – specifically.

She looks out the window and shrugs her shoulders.

Truly this is all unbelievable: when they already declare her a boy, because they are the ones to do it, if you refer to her as a girl, they can sue you for committing a hate crime. Against your own daughter! I was so scared then that…” She laughs. “Now I've gone back to saying and writing “my daughter”—what the hell—if I don't defend her, who's going to defend her!”.