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JIM (International Journal of Medicine)

Publié le 07/08/2023


(Deepl)


HAS infiltrated by pro-trans activists?

According to Le Figaro, most of the members of the group of experts from the French National Authority for Health (HAS) due to issue its recommendations on the treatment of transgender people are activists in the trans cause.

Next September, the French National Authority for Health (HAS) is due to publish its updated recommendations on the care of transgender people, particularly minors. The task has been entrusted to a working group of around twenty members. The new recommendations are eagerly awaited, as the issue of care for transgender people has become particularly controversial in recent years.


The facts about the problem are well known: transsexualism seems to be an increasingly common phenomenon, with the number of requests for sex reassignment operations and hospitalisation for transsexualism having risen sharply over the last ten years. There are now almost 9,000 people on long-term care (ALD) for gender dysmorphia, including around 300 minors. Faced with this growing phenomenon, the medical world finds itself caught between two movements: on the one hand, the desire to take into account the requests of transgender people wishing to change their sex, especially as certain data plead in favour of an increased risk of suicide if no response is forthcoming; on the other, the desire to move forward cautiously, in an area where scientific studies are few and far between and sometimes tainted by bias, particularly when it comes to treating minors.

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CADA orders publication of HAS experts' names


Unfortunately, positions on the subject are so clear-cut that it seems impossible for a calm scientific debate to take place. This is illustrated by the latest controversy over the composition of the HAS working group responsible for drawing up these new recommendations. While the health authority does not wish to reveal the names of the expert members of this panel, in order to "guarantee the serenity of the work and avoid outside pressure", the conservative association Juristes pour l'enfance (JPE) obtained an order from the Commission d'accès aux documents administratifs (CADA) on 20 July for the HAS to disclose the list of members of this working group.

What the children's rights association fears is that the composition of this working group does not reflect the diversity of opinions in the medical world on the "trans issue" and only includes members who support the demands of trans activists. According to these activists, only transgender people are in a position to know what care is appropriate for their situation, and doctors are there to support them, never to question certain expectations. "Our concern is to ensure that the rules of good practice that could in future apply to all patients, including minors, take account of the scientific controversies that exist on this subject and urge caution in order to protect these young people", explains Olivia Sarton, Scientific Director of JPE.

This fear of bias on the part of HAS experts seems well-founded. Last June, Le Figaro newspaper managed to access a list of the members of the HAS working group, which leaves little doubt as to the direction the institution's recommendations are likely to take. The panel of experts is co-chaired by Clément Moreau, a transgender psychologist and member of the Espace Santé Trans association, and Dr Nicolas Morel-Journel, a specialist in sex reassignment operations.

Predictable recommendations?


The members of the group also include seven transgender people and several doctors who have publicly expressed their support for access to hormone treatments for minors, such as Dr Marc Fillâtre, who defends MAP for transgender men, and Dr Thelma Linet, also a transgender woman, who is calling for "medical autonomy for adolescents wishing to transition". According to Le Figaro, the Observatoire de la Petite Sirène, a group of practitioners calling for caution in the treatment of transgender adolescents, asked to join the working group, but was refused by the HAS.

If the information in Le Figaro is accurate, it seems hard to believe that a genuine scientific debate will take place within the HAS working group, which is likely to confirm the ideas already shared by its members. In its recommendations next September, the HAS could therefore advocate broad access to hormonal and surgical treatments for sex reassignment, including for minors, even though several of our European neighbours (notably the UK and Sweden) have decided on a moratorium on minors' access to hormonal treatments.

For Le Figaro, the presence of such a large number of trans activists at the highest levels of public health is a sign of the success of their "entryism" into the medical world. Trans-activists are demanding the right to "self-organisation" in the field of healthcare, so that "the legitimacy of experiential and community knowledge" can be put forward. But while it is obviously desirable and necessary for the voices of transgender people to be heard (not least because there is still a great deal of discrimination in the medical world), this should not be at the expense of scientific debate and good medical care for patients.

Quentin Haroche

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