Clarification: “The care of transgender children and adolescents in France”

The Trans Youth Trajectories platform has published in the journal Neuropsychiatrie de l’enfance et de l’adolescence a clarification on recent controversies and ethical issues related to the care of transgender children and adolescents in France.

This publication, freely accessible here, presents the medical consensus on the elements of this care that are most criticised, namely social transition, puberty blocking, hormone transitions, and surgical transitions.

Most of the clinical studies cited in this article report a positive impact of medical care for transgender adolescents on their psychological outcomes, and a finding that the treatments are safe.

If no medication can be prescribed for pre-pubescent children, the situation is different for adolescents. It is necessary to determine whether long-term intervention is indicated or contraindicated depending on the clinical situation, knowing that the average duration between the first consultation and a possible prescription is about one year.

The authors recall the context of particular vulnerability of transgender children and adolescents, where the ethical principle of non-maleficence does not systematically equate to withholding care; each clinical situation must be evaluated in its uniqueness with caution and discernment at each encounter. Psychodynamic support remains essential.

Finally, the authors discuss ethical aspects of care and remind that any option for medical transition is discussed and validated, if relevant, since 2015 in France within the framework of Multiprofessional Consensus Meetings (Réunions de Concertation Pluridisciplinaire).

The Réseau de Santé Trans has published a critical synthesis of this publication here.