The Call of the Observatory of Ideological Discourses on Children and Adolescents: Impacts of Medical Practices on Diagnosed Children

“gender dysphoric”

 

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I – The Context

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The evolution of the diagnosis of "gender dysphoria" in children and adolescents in recent years is puzzling: for ten years, requests for sex reassignment have, in this age category, increased exponentially according to the countries (1).

What should child and youth professionals, pedagogues, doctors or psychologists, understand of the recent explosion of this demand or even claim?

Has free speech on the subject of so-called “transidentity” alone allowed the phenomenon to take on such magnitude? Or does the sometimes very offensive and very divisive activism of certain LGBTQI activist associations - potentiated by social networks - not induce political pressure on young people and their families?

We are witnessing the emergence of ideological discourses on the "gender transition" of minors, ideological in that they preempt any debate: the slightest doubt about the practices is immediately qualified as "transphobic" while the superior interest of the he child is at stake in particular with regard to the irreversible medical consequences on the child's body (see below).

The Call of the Observatory essentially concerns the protection of children and the preservation of their physical and psychological integrity. It is precisely on this point that it is urgent to alert politicians (Ministry of Health, Ministry of National Education, State Secretariat for Child Protection) and the National Council for 'Doctor's orders.

Indeed, the "gender dysphoria" of children and adolescents testifies both to an intimate question posed by a child or an adolescent but also to the way in which children and adolescents become a sounding board, even an instrument of social body which immediately validates their request.

Young people explain that they feel they belong to the other sex and certainly see in it the answer to their discomfort.

Would medical practices therefore give in to the injunction of new social norms without possible debate, without concerted reflection between the various childhood professionals, without elementary observation of the precautionary principle?

Is it not permissible, without seeing ourselves struck by the anathema of “transphobia”, to question beforehand this malaise of young people in search of identity and in the grip of all kinds of anxieties?

 

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II – The symptomatic case of the documentary “Little Girl”

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The documentary Petite fille, by Sébastien Lifshitz, broadcast on Arte in December 2020, and which follows another film, Girl, by Lukas Dhont, released in 2018, revealed to the general public this very sensitive subject of "gender dysphoria ".

This subject of the gender "transition" envisaged in a young child is linked to the vulnerability of the child and the distress of families confronted with this problem. This film presents the desire of a little boy to become a girl as an indisputable fact without taking into account the family complexity even though the construction of the child's identity is consubstantial with the environment in which he evolves.

In this documentary, we are presented with a child, Sasha, 8 years old, whose mother reports the words according to which he would have expressed (very early) the desire to become a girl "like her" when he grows up, which is interpreted as “to become a woman”. In other words, when the child voices his dream of becoming like his mother, the response given is that of medical treatment, authorized and even recommended, and which would begin at an early age:

• At first, the child's entourage, including the school, is invited to consider, in terms and in fact, Sasha as a little girl and no longer as a little boy.

• Puberty blockers will be prescribed to him even before puberty, to prevent secondary sexual characteristics from setting in.

• Hormones of the opposite sex may be offered to him before he comes of age (from the age of 14, in France).

• Surgical interventions will be possible, with the consent of the parents, from before the age of majority.

 

This sequence of events raises, in our view, several crucial questions:

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1.     Documentary or docu-fiction? The staging of the medical protocol

The militant bias of the documentary questions. We hear only one point of view (rarely that of Sasha in the end, rather that of her mother) and no other professional who normally gravitates around a child is questioned: pediatrician, psychologist, teachers, etc

Even more astonishing, the course of care by the specialized center that Sasha's mother consults. Indeed, either Little Girl is a partial, committed, staged creation, which should then be presented as a “documentary-fiction”(2)composed of inaccuracies, caricatures and ellipsis, and denounced by the specialized consultation of Robert Debré as not representing the reality of their work; either this documentary is realistic and in this sense, it seems very worrying to us to discover that a diagnosis of "gender dysphoria" can be made from the first interview by a child psychiatrist:

• without an interview alone with the child,

• without the child having ever met a psychologist before referral to one of the specialized French centers known for their doctrinal approach

• without the child psychiatrist meeting both parents,

• without specific investigation (complete psychological assessment: projective tests, questionnaires, look at schooling, questions with other adults who know the child),

• without the child saying more than a few sentences,

• without even letting him answer the questions put to him by himself.

 

This is the director's view of the problem and it is this point of view (partial and biased) that is shown to the general public. This is the medical protocol that the director restores.

 

If we compare with more common diagnoses, having much less medical consequences, we realize that the process, strangely, is much stricter:

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• For a child to benefit from a third time for examinations in the event of dyslexia, a file must be submitted to the MDPH, including a speech therapy, psychological assessment and a pediatric report.

• For a child to be diagnosed with ADD/h and to benefit from an appropriate drug treatment, he needs a medical recommendation and a neuropsychological assessment before even obtaining an appointment with a child psychiatrist, exclusively hospital, who will be the the only one who can prescribe methylphenidate (better known as Ritalin) the first time AND the following times.

 

The film, which requires thoughtful and focused editing, shows that, at the second appointment with the child psychiatrist, two or three months later, the child is still not seen alone, he still has not benefited from least psychological investigation whereas, on the other hand, an appointment with the endocrinologist will be made the same day in order to prepare the sex change protocol.

 

What is it about ? To offer puberty blockers and allow Sasha to maintain her reproductive abilities despite this (3), either by stopping the treatment which inhibits his puberty for the time necessary for the collection of spermatozoa (but this option seems less favored by the doctor), or by in vitro maturation of the testicles, all of this “explained” in a few words to a child eight years old. It is therefore already planned that Sasha, 8 years old, enters a course of "gender transition" which leads to a radical change in her appearance, implying her future castration and consequently her definitive sterility.

The implementation of these first protocols for children (understood within the meaning of the International Convention on the Rights of the Child, as under the age of 18) is beginning in several countries to generate legal proceedings initiated by certain adults who have undergone these treatments before their majority and having then started a "detransition". These plaintiffs argue that the protocols were put in place when, as children, they lacked the capacity to understand their implications (Bell / Tavistock judgment) (4) and therefore to give informed and real consent to these protocols.

We can believe that Sasha dreams of being a girl; we already doubt a little more that he understood what puberty blockers were, what taking such a treatment implied in terms of renunciations and complications until the end of his days, and we can be certain that he cannot conceive of the reality of an ablation of his genital apparatus, the sexual use of which is still unknown to him, just as much as the sexuality of the adult.

With regard to medical ethics, it is clear that there is a double transgression (of the device as it is presented by the director):

• Failure to listen to parents and especially the child before making the diagnosis of “gender dysphoria”

• Performing interventions before puberty

 

2.     The Bad Object: The School of Intolerance

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Another very problematic aspect in the presentation of the facts raises, in our opinion, a failure of political ethics in addition to the problem of medical ethics: Sasha's school is immediately presented as a reactionary and resistant institution in the face of the parents' request for see their child considered as a girl, because she would be intolerant and hostile (this is the view of the director through the speech of the parents).

If we can understand the anger and frustration of Sasha's mother, it seems surprising to us that the common sense of the school establishment is not praised:

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• Firstly, educational institutions do not have to systematically accept special requests from parents when these are not justified and recognized by a specialist (it should be noted that the school accepts without problem the protocol recommended by the Robert Debré hospital for the following school year). The school is required to respect the articles of the Civil Code relating to the change of sex (art. 61-5 et seq. of the Civil Code) and change of first name (article 57 and 60 of the Civil Code). If a student asks to be designated by a first name that does not appear on his civil status, the school is not required to comply with this request.

• Secondly, we can be pleased that the school, a rare third party between the child and his parents, does not take the speeches of the parents at face value, and makes a dilatory response while waiting for a medical and psychological expertise. The School, as a public service of education, representing the State, provides assistance to children, supposed to prevent and protect students and their freedom of conscience against any attempt at pressure, indoctrination (5) and violence, whether they take place in the establishment or in the family.

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Thus, it clearly appears that a political bias underlies the arguments of the film: caught in a radical and militant rhetoric, the child is here transformed into a spokesperson for the trans cause in the face of a society required to comply without flinching at the community injunctions imposed by LGBTQI associations under penalty of hindering social progress and the rights of future citizens. However, this essentialist thought which determines and freezes sexual identities from childhood is profoundly contrary to the universalist and humanist principles to which the School adheres.

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The teachers' mission is not to automatically accede to the specific demands of each community to the detriment of the founding principles of the Republican School, but on the contrary to protect the students from group pressures (religious, community, political, etc.) , to ensure their bodily integrity and to preserve their spirit still in formation, from sectarian, radical discourse or external influences. It is in this spirit that the rules of our school secularism are inscribed, and it is on the basis of these that one could as well interpret the reluctance of Sasha's teachers in the face of her parents. Would we have so many prejudices in front of the refusal of the school institution in the face of the grievances of a fervent Amish student, were he supported by his parents?

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III – The child, a developing being

 

Above all, it seems fundamental to us to be attentive to the developmental process specific to childhood and adolescence and to take the time before any indication of medical treatment. The urgency to intervene is attributed to the occurrence of puberty transformations, which would modify the potential “success” of future surgical transformations.

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On December 3, 2020, a column published in The Guardian(6), highlighted the case of Bell, a former patient who regrets the gender transformation treatment she received during her teenage years and argues that she was too young to consent to the medical treatment that began her female-to-male transition at that time. early in his life. In its 38-page decision quoted above(7), the High Court in London, found that children under the age of 16 who are considering gender reassignment are not mature enough to give informed consent to be prescribed puberty-blocking drugs. And for young people aged 16 and 17, she said that even though (UK) law establishes for them a legal presumption of capacity to consent to medical treatment(8), she is aware that physicians may feel that they need to seek permission from a court(9) before starting treatment. It thus seems by this conclusion to recommend to the doctors not to begin treatment for the young minors of 16 and 17 years, before having obtained a legal opinion. With this High Court ruling, medical intervention for minors - and particularly those under the age of 16 - with gender dysphoria will hopefully be more cautious.

 

1.     Associated mental disorders

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“Transidentity” among minors is presented by some as a right, a societal advance, which it would be discriminatory to question, to consider as a symptom. However, our experience after a century of work in child psychology obliges us to consider it first of all as transitory or even symptomatic.

In adolescence in particular, the questioning of one's sexual identity is part of a questioning specific to this age. However, this adolescent quest, the usual motor of the maturation process essential to the subjective construction of the future adult, would now be likely to find a mode of nomination that social networks establish as subjective truth. The technical-medical offer largely relayed by social networks and communitarian propaganda deny and would like to abolish this fundamental stage of subjective construction.

The increase in requests calls into question their supposed consistency and above all the unequivocal response given to them. This recent multiplication (less than 10 years) could have been favored by two factors, very different but not necessarily incompatible:

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• the subjects concerned by a questioning about their sex finally feel authorized to express their distress thanks to a greater tolerance of society towards them;

• a significant portion of these requests come from a societal phenomenon(10), where "transidentity" appears as a response to a deep malaise in adolescence, a radical, medicalized response, which would solve the difficulties once and for all.

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It is to this second point that we wish to draw attention. Indeed, it appears that since the desire for "gender transition" is no longer considered a psychopathological entity by the new version of the DSM, it is also no longer considered as a symptom of a vulnerable psychic structure, whereas even that we find, in these young people, a very large number of associated psychiatric disorders: anorexia, autism, depression, psychotic disorders, trauma related to sexual assault, etc.

 

2.     A child is not a miniature adult

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Our questioning does not arise on "transidentity" as such, nor on its diagnosis or its etiology, but on the continuity, which seems too obvious in the militant discourse around this question, between the disorder of childhood , that of the adolescent and that of the adult.

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• Indeed, a child – and even an adolescent – is not an adult: he is a developing being, his neural system is maturing, his cognitive and intellectual capacities are immature, his psychic functioning is labile, his suggestibility to adult speech is significant, his life experience is limited. To sum up, the psychopathology of the child is unique, the nosographies differ between children, adolescents and adults, so we cannot apply the same criteria or the same amplitude of decision.

• On the other hand, puberty is not only a physical phenomenon but a process of development and psychological maturation, involving psychic changes, allowing the individual to become more of a “subject” when this stage is going well enough. Conversely, puberty and more broadly adolescence is a period of significant psychological risk, and we have all known for a very long time how important this part of life is in the appearance of psychiatric pathologies.

 

3.     Child's request?

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It seems crucial to us to question the request, supposed to be that of the child, to change sex.

We know how the child is influenced by the discourse of adults and his peers. This does not call into question his ability to think for himself, but denying external suggestions, sometimes of influence, would be bad faith.

Without even trying to discuss the fact that the child "feels" to belong to the other sex, we point out as not self-evident the principle of the implementation of an irreversible transformation that would begin before and during puberty. and the process of adolescence.

Many studies on this subject show that the majority of children with questions about their sexual identity and the criteria for belonging to a gender, will not continue their transformation after puberty (85%)(11). These data being known, why is it immediately planned, as soon as dysphoria is diagnosed, to initiate a protocol over several years involving meetings with endocrinologists, forecasts on the maturity of the sexual organs at birth, surgical projects, etc ?

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IV – Injury to the body of the child or adolescent

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1.     Alleged Psychic Benefits

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Some psychiatrists systematically brandish a supposedly major suicidal risk in this young population, to disqualify as having criminal consequences all behaviors that are prudent and question the radicality of the treatment, or simply suggest the need to take time.

Thus, the father of a young girl who has decided to change sex, testifies to the way in which he is asked, each time he questions the urgency of the care"Sir, do you prefer a dead girl or a living boy?" » (12). This formula, regularly repeated by various interlocutors, takes hostage this father who is summoned to choose between being a good father or a bad "transphobic" father, who is moreover responsible for the supposed suicide of his child.(13).

However, it is important to underline:

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• That studies claiming such a risk are limited and controversial(14), because they cannot demonstrate that other factors are not involved. They are not based on any scientific device such as the holding of control groups, or longitudinal studies

• We can see a beneficial effect of hormone treatment at the time, but we don't know what happens in the following years.

• That the risk of suicide is indeed greater in the trans population, but this even in adults, even after the social and physical transformations carried out.

• Finally, even if this treatment seems relevant in certain cases, it turns out that the reality of regrets is obvious in certain subjects.detransitioners »(15).

 

2.     Puberty inhibitors

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puberty blockers(16), allowing the non-appearance of secondary sexual characteristics, are presented as having an apparently reversible effect once they are stopped. Doctors have so far only a few studies when administered between 12 and 16 years of age.

On the other hand, studies show short and medium-term side effects in children, we can note:

Moderate effects:

• headache,

• hot flashes,

• abdominal pain,

• vaginal bleeding in the girl,

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• weight gain

• mood changes,

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Stronger effects:

• decrease in bone density (1% per month),

• risk of depression

 

These puberty blockers, combined with antagonist hormones, can lead to permanent sterility, even if the genitals are preserved. It seems very surprising to imagine that a child or an adolescent is able to renounce, for the rest of his adult life, a possible conception of a child.

Finally, puberty in humans does not only correspond to the access to adult genitality, but it is simultaneously a period of intense psychic reorganizations which contribute to the process of subjectivation: each adult knows to what extent this period of his life is the foundation of his personality, his sexual orientation, the discovery of his body and genital pleasures, the necessary separation from parental figures, etc.

The question is vivid: can we, without this experience, ensure that the individual develops in such a way that he can know what he really wants? The question of real life experience is major and cannot be secondaryised. Ethics imposes these questions on us which, moreover, are currently very acute as regards consent, the possibility of deciding freely when we are still living, which is the case for every child, under the authority of adults to whom one lends knowledge.

 

3.     antagonistic hormones

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Hormone therapy followed as part of a sex change is not without danger to health.

Estrogens are not recommended in case of high blood pressure, diabetes, epilepsy, lupus, hepatic disorders, severe migraines, otosclerosis. They lead to long-term risks: increased percentage of strokes, venous or even arterial thromboembolic accidents, metabolic problems with hypercholesterolemia, gallstones and weight gain.

The metabolic and vascular risks of synthetic progestins are added to those of estrogen and lead to an increase in meningiomas secondary to treatment with chlormadinone acetate or nomegestrol acetate, frequently prescribed progestins.

With regard to testosterone, the effect is definitive in terms of virilization, in particular hairiness and voice. The existence of numerous side effects requires a thorough medical examination before any prescription, as well as biological monitoring: high blood pressure and risk of myocardial infarction, hypercholesterolemia, venous thromboembolism, hypercalcemia, weight gain, caution in the event of thrombophilia , in migraine sufferers, diabetics, epileptics, liver failure among others.

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Frequently are noted mood swings, aggressiveness, impatience during treatment.

According to a 2018 study(17), transgender women are almost twice as likely to develop venous thromboembolism. This risk increases even more over the years. Regarding the risk of having a stroke caused by a thrombus, the odds were 9.9 times higher in transgender women than in the control group.

 

4.     Surgery

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The surgery is undeniably heavy,risky and very imperfect (18). Depending on the country, it is possible before the age of majority. This is the case in France even if it still seems to be little practiced at the moment. It would be necessary to know the number of operations performed on minors with “gender dysphoria” since these surgical operations are mutilating (mastectomy in girls in particular, removal of the testicles in boys).

It emerges from all this that in the current context, we are faced with medical experimentation on children, which is strictly prohibited, and contrary to medical ethics (the primum non nocere of the Hippocratic oath)

 

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V – Common sense recommendations

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It is obviously not a question of leaving a child alone in the face of his real distress in a gender conflict. If the suffering of the child must obviously be heard, welcomed and supported, adults must, for their part, ensure protection for children and this sometimes to the detriment of the immediate satisfaction of their desire. Waiting for a solution often seems unbearable suffering, especially since it adds to an initial distress. And yet we all know very well that waiting allows a work of reflection without haste, introspection detached from the influences of the environment, it also allows to overcome critical moments and to continue its development, its personal evolution. Psychic and somatic are intimately linked, and there is never a unilateral and immediate response to a psychic problem. It is therefore essential in any approach to preserve the possibility of a long period of time, which is currently being abused by the idea of a supposed medical emergency, and to know how to wait, in particular, for the age required to ensure the ability to discern these subjects

 

1.     From a medical point of view

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It seems to us very worrying and problematic to deal with subjects in the making by denying them access to a stage of development essential to their psychic construction. The best interests of the child, linked to his physical and cognitive immaturity, should prohibit us from any intervention on his body that is not a vital emergency or care essential to his health. Verbal, family and individual therapies should take precedence throughout childhood and adolescence to help the child find specific responses to his suffering (and not offer him a systematized medical protocol) by preserving or opening up his the possibility of a doubt on its problematic.

 

We recommend :

 

• Of themultidisciplinary public health studies carried out in hospital departments, colleges and high schools in order to show the quantitative importance of “gender dysphoria”

• Of themedical and psychiatric studies and researchserious, without conflict of interest or ideological aim, must be undertaken to better understand this new and very young population, to determine the physical and psychological impact of this type of treatment in adults before applying it uniformly in child and adolescent, to observe the impact of the family environment but also of recent societal influences.

• It would be relevant, as the United Kingdom has done and as other countries are beginning to think about it (United States, Sweden, Switzerland), to submit to a Reflection and Ethics Committee composedpsychiatric and legal experts, but also people concerned with child protection, this question so that, also in France, we legislate on this attack on the body of the minor.

• Finally, the creation of long investigative consultations and/or specialized psychotherapies independent of hospitals, places of neutral consultations and independent of any ideological influence, carried out by specialized personnel who have followed multi-criteria training (medical, psychological, sociological, legal, etc.) adapted to these issues, in order to welcome these families in question and often in crisis, and who must account for their work before the appropriate courts. This task cannot be limited to medical acts consisting in signing treatment authorizations carried out by endocrinologists, however efficient they may be, as can be seen in a number of psychiatric services dedicated to gender dysphoria.

 

2.     The role of the school

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Trusting the educational community

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In any case, the School cannot in any case become a place where society could force the doors with threats or anathemas on the school community: we therefore strongly reject the envisaged approach consisting in addressing these questions by injunctions or the shadow of sanctions against the teaching teams.

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Moreover, the treatment of these problems is eminently complex and certainly cannot be reduced to a single rule or a systematic response: each case is by nature a particular case and requires real consultation of all the adults who surround and accompany the child - parents, educators, doctors, psychologists.

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However, this consultation can only see the light of day in a climate of trust, and not of distrust: the most appropriate measures must be able to be discussed freely between the various protagonists, without going through legal processes on the subject, at the risk of unnecessarily heightening tensions. It seems to us essential in such circumstances that the institution trust the educational community to work together with the families and students concerned.

 

To conclude

On the one hand, we want to depsychiatrize "gender dysphoria" and at the same time we seek child psychiatry for a diagnosis that will probably lead to a treatment: puberty blockers and/or hormonal treatments that are prescribed to minors who do not "feel" not to belong to their biological sex. The diagnosis is necessary for the recognition of the harm suffered and the opening of “rights”.

It is a reconsideration of the discourse on childhood that we are witnessing, guided by ideologies which are translated into facts by new diagnostic categories and the treatments that accompany them, treatments which certainly already exist but not in this context where they can be considered experimental.

With a redefinition of human rights, it is the notion of inclusion that is essential at all levels of society and in particular at school. The School must adapt to all students, it must create systems for all students according to various categories and sometimes not very objective. It is no longer the pupil who must adapt to a model valid for all (universalist and republican) but the School which must concern itself with all the particularities of its pupils at the risk of having to face the disagreement of the parents ( and their respective associations). But once again, these new standards are only effects of speech.

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We observe a gap between these discourses and clinical practices which are to be understood on a case-by-case basis and which are much more complex and contradictory than we let it be understood.

Wouldn't one think that "gender dysphoria" as defined in the DSM would be more of a "political agenda" like ADHD?(19) ? There is a passion for assessments, diagnoses in order to label children. And with each labeling, there is a risk of producing protocols or even a new language or a vademecum (cf. transphobia) so as not to stigmatize children who fall into these categories (autistic, ADHD, trans, etc.). But isn't this reducing these children to necessarily fixed identities? Isn't there a risk of making these children-identities banners for the cause of adults? What is projected onto the childhood of society and the trouble that runs through it, the crisis of culture?

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It is necessary to take care of the child, that is to say to give him the possibility of growing up by preserving him from the projections of adults so as not to confuse the language of adults with that of the child.

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Document produced by the Observatory working group

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Céline Masson, university professor, psychoanalyst, Anna Cognet, clinical psychologist, teacher at Psychoprat, Delphine Girard, professor of Classics, Claire Squires, psychiatrist, HDR lecturer at the University of Paris, Laurence Croix, psychoanalyst, Master of Conferences at the University of Paris Ouest Nanterre, Anne Perret, child psychiatrist, hospital practitioner, Pascale Belot-Fourcade, psychiatrist, psychoanalyst, Caroline Eliacheff, psychiatrist, psychoanalyst, Jean-Pierre Lebrun, psychiatrist, psychoanalyst, Xavier Gassmann, psychoanalyst, René Dubos Hospital , Hana Rottman, pediatrician, psychiatrist, Olivia Sarton, lawyer, Anne-Laure Boch, neurosurgeon, philosopher, Salpêtrière Hospital.

 

 

NOTES:

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(1)https://tradfem.wordpress.com/2020/02/07/dossier-trans-les-agents-bloqueurs-de-puberte-de-plus-en-plus-contestes-the-economist/

According to Jean Chambry in his conference of February 3, 2021 at the Cercle Freudien, ten years ago when the CIAPA (Intersectoral Center for Teenagers in Paris) opened, there were about ten requests per year, in 2020 it is rather ten requests per month (only for the Ile de France region).

 

(2) As is the case for the films of Michael Moore for example, because he does not respect the codes of the documentary contract, cf. Lipson, D. (2015). Michael Moore and the new documentary contract: from info-argument to info-tainment. French Review of American Studies, special 145(4), 142-158.https://doi.org/10.3917/rfea.145.0142

 

(3) The documentary does not appear to show that the child and his mother were fully informed of the consequences of the choice of medical transition with regard to the capacity to have children. If Sasha became a trans woman, she could not, under current French legislation, have children using her gametes. Indeed, alone, she could not use them (even by having recourse to medical surgery, she will not obtain a woman's body allowing her to bear children). If she was in a relationship with a biological woman, she could only use her gametes by resorting to assisted reproduction. However, PMA is currently only possible in France for heterosexual couples. If she was in a relationship with a biological man, she could only use her gametes by resorting to surrogacy, which is prohibited in France.

 

(4) These implications were clarified as follows by the High Court in London on December 1, 2020 in Bell v. Tavistock, [2020] EWHC 3274: (i) the immediate consequences of the treatment in physical and psychological terms; (ii) the fact that the vast majority of patients who take puberty blockers subsequently take cross-sex hormones and therefore are on the path to much greater medical interventions; (iii) the relationship between taking opposite-sex hormones and ensuing surgery, with the implications of that surgery; (iv) the fact that taking hormones of the opposite sex may well lead to loss of fertility; (v) the impact of opposite-sex hormone intake on sexual function; (vi) the impact of the choice of this treatment on relationships in the future and throughout life; (vii) the unknown physical consequences of taking puberty blockers; and (viii) the fact that the basis for this processing is still very uncertain. (free translation).

 

(5) Article L141-5-2 of the Education Code

 

(6)https://www.theguardian.com/society/2020/dec/03/puberty-blockers-ruling-curbing-trans-rights-or-a-victory-for-common-sense-

 

(7) London High Court on 1 December 2020 in Bell v. Tavistock, [2020] EWHC 3274

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(8) Section 8 of the “Family Law Reform Act” of 1969

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(9) Possibility created by judgment Re W (Medical Treatment: Court’s Jurisdiction) [1993] Fam. 64

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(10) As exposed by Dr. Lisa Littman, in a study on the influence of social networks on sudden gender dysphoria. See Lisa Littman: Rapid Onset Gender Dysphoria in adolescents and young adults: A study of parental reports, 2018.

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(11) Cf. Thesis of Philosophy, Devita Singh, A Follow-up Study of Boys with Gender Identity Disorder, Toroonto. & “If left unchecked, the majority of dysphoric children come to terms with their biological sex at puberty and realize that they are just plain gay. But if you put them on blockers, that doesn't happen. Dr. Susan Bradley.

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(12) Written testimony of a father who for the moment has remained anonymous but who is ready to testify openly.

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(13) On this subject see this articlehttps://www.transgendertrend.com/suicide-by-trans-identified-children-in-england-and-wales/. This article by Pr. Mickael Biggs (Sociology, Oxford) on the suicide rate of transidentified young people tends to show a) that if transidentity can be an aggravating factor, it nevertheless remains well below anorexia and depression and b) that it cannot be considered without taking into account the autism-transidentity link (autism being in itself an aggravating factor in suicide).

 

(14) Studies rejected, incomplete, or which extrapolate the results. seehttps://medicine.yale.edu/news-article/26859/, but also the investigations carried out for the Bell judgment against the Tavistock Clinic as well as the investigation of the Swedish documentaryTrans-train.

 

(15) Cf. Bell vs. Tavistock but also testimonials from adults. Also this Swedish documentaryTrans-Train which recounts the testimonies of transgender people who share their questions and even their criticisms with regard to medical treatments

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(16) See Vidal, for example the sheet concerning Decapeptyl, a puberty inhibitor.

 

(17)https://pubmed.ncbi.nlm.nih.gov/30073551/

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(18) Testimony of a trans man: https://quillette.com/2020/10/06/forget-what-gender-activists-tell-you-heres-what-medical-transition-looks-like/

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(19) T. Garcia-Fons, “The Denial of Childhood”, to appear in Solving the Mental Health Puzzle: Charting a Course from Mental Disorders to Humane Helping, USA, 2021.