TRIBUNE. At a time when other countries are backtracking on gender transition for minors, the French High Authority on Health is favouring measures that now appear to be serious mistakes, deplores child psychiatrist Christian Flavigny*.
Trad. DeepL/ChatGPT
Le journal du Dimanche - 16 décembre 2024
In recent days, there has been a lot of talk about a report prepared by the French National Authority for Health (HAS) recommending measures to help ‘transgender people’. Without actually saying so, these measures suggest that feeling of the other sex is equivalent to being of the other sex, the theory being that nature made an error in assigning a body to a person, putting ‘a girl's soul in a boy's body’ (or vice versa), an error that should be corrected, as is the case with any bodily anomaly. But this explanation, based on a ‘natural bug’ that would have placed a soul in the ‘wrong body’, remains a hypothesis that is, to say the least, risky.
The HAS report omits another explanation: it refers to the establishment of gendered identity in childhood and adolescence. Children learn early on that there are boys and girls. This motivates them to observe their parents in order to understand what makes them tick: the masculine in their father, the feminine in their mother. They identify with them, in the hope of fulfilling their expectations of having a son or daughter. The filial bond can then become confused, through no fault of the parents or the child, if at puberty the child finds these expectations difficult to meet. This can lead to transgender suffering, the bodily reality felt to be ‘incongruent’ with this hope.
Psychodynamic understanding does not involve psychiatric labelling, but a reweaving of the embarrassed construction of identity. The wish expressed to transition to the other sex is understood as a pubertal sexuation anxiety, addressed by the psychologist without preconceptions and with strict respect for personal development, which is made possible by an in-depth understanding of the confusion from which it emanates. It should be noted that it also sheds light on the demand for detransition, which we know often occurs later, with appalling regret - something that the HAS report avoids.
Many countries that were pioneers now advise against gender transition for minors
The omission of psychodynamic understanding is an ethical error on the part of the HAS. Does this mean that the group of commissioned ‘experts’ did not respect the balance of an ongoing debate in French and international society? Or that they were unaware that many countries that wanted to be pioneers are now advising against the recommendations they are making? This leads to two other truly serious errors.
The HAS overlooks the fact that the slow maturation of the sexual establishment in children, then its gradual implementation in adolescents, is the basis for rejecting the idea that a medical and surgical transition process should be initiated before legal majority: the young person cannot measure the impact of such a decision on his or her future life. The ‘experts’ have undoubtedly realised this, however: whereas the aim is to avoid immediacy in response to the impatience of young people to be relieved, their report recommends ‘going quickly’ with minors aged 16.
Their recommendation is an attack on the physical and mental integrity of young people - even if their suffering must of course be listened to with empathy and seriousness - without validating the precipitation of a response with irreversible effects. In addition, the recommendation to exclude parents from a young minor's decision to go through ‘transition’ reflects the same attempt to hinder all reflection: it claims to protect young people from their parents' disagreement.
In the best interests of the young person, this disagreement should be made known and discussed, without the young person being subjected to parental diktat. The child psychiatric interview can play this role, with no bias other than to help project the future. This will help them to mature, so that once they have reached adult maturity (around the age of 25), they can understand that there is never a ‘sex change’: just a change in sexual appearance, even if it may then appear to be beneficial in guaranteeing a happy life.
Comments