A vote to prod debate
The French Senate opts for caution on gender medicine, the government demurs
The French Senate has passed a draft law to restrict puberty blockers and prohibit cross-sex hormones and transgender surgery for minors.
The May 28 result was carried by the Senate majority of the centre-right Republican and Centrist parties1, with near total opposition from socialist, ecological and progressive parties which cried “transphobia”, although one communist senator did abstain from voting out of uncertainty over the issue.
Opposed by the Macron government, the bill is thought unlikely to get the approval of the Lower House, the National Assembly, which is necessary for it to come into force as law.
Republican Senator Jacqueline Eustache-Brinio, who introduced the bill in the Upper House, said its purpose was to “prevent minors questioning their gender from regretting medical treatment or sexual reassignment surgery following a wrong diagnosis”.
“This [bill] is neither a transphobic text, nor a desire to psychiatrise trans identity, nor an attack on children’s rights… [I denounce] attacks by activist associations that operate like many activist associations: through threats and intimidation.”
Under the bill, a minor seeking puberty blockers would have to go to a specialised multidisciplinary centre, be assessed for contra-indications and capacity to consent, and treatment could not start sooner than two years2 since the first appointment at the centre.
In its original form, the bill proposed an outright ban on puberty blockers, the same as for cross-sex hormones and “gender reassignment” surgery, but this was amended to secure votes for a majority.
Clinicians ignoring the bill’s prohibitions could be imprisoned for two years and fined €30,000.
“Today I have taken bold action to protect children following the Cass Review, using emergency powers to ban puberty blockers for new treatments of gender dysphoria from private clinics and for all purposes from overseas prescribers into Great Britain.”—UK Health Secretary Victoria Atkins, tweet, 30 May 2024
Outrage v debate
The fortunes of the Republican bill have been covered in national media, including Le Figaro and Libération, at a time of aggressive street protests3 for “trans rights” and against “TERFs”4. Supporters hope the Senate vote will open up what has been mostly an emotive, rights-driven debate and focus the minds of health professionals on the risks and harms of medicalised gender change for minors.
The Macron coalition government made its opposition to the bill clear late in Tuesday’s Senate proceedings5. After four hours of sometimes heated exchanges in the Senate on Tuesday, Health Minister Frédéric Valletoux tweeted a critique of what he called “a dogmatic and subjective approach” by advocates for the bill.
“When it comes to medical issues, I will never allow political decisions to take precedence unless they are informed by scientific debate,” he said.
The minister also argued the bill should not pre-empt the gender treatment recommendations expected within months from the French National Authority for Health (HAS)6; these are to cover patients aged 16 and older.
Given the politics, commentators say it is unlikely that the National Assembly will debate or pass the bill, which is necessary for it to become law.
The bill followed March’s expert report on the “trans identification of minors” and an almost year-long inquiry in which Republican senators heard evidence from 67 people including gender clinicians, doctors, psychologists, health and education officials.
The expert report arising from the Republican inquiry was written by clinical psychologist Dr Céline Masson and child psychiatrist Dr Caroline Eliacheff, who are co-directors of the Little Mermaid, a watchdog group on youth gender medicine bringing together researchers and professionals.
They have received many messages congratulating them on a victory over woke obscurantism following more than three years’ of work spreading awareness of the nature of international concerns about youth gender medicine.
Campaigns run by the Little Mermaid also drew strength from a 2022 statement by the French National Academy of Medicine that the rising demand for treatment of gender-distressed minors called for “great medical caution”.
Even if the Republican bill does not reach the National Assembly, its passage by the Senate should “open up a real debate and encourage doctors to take an interest, because many doctors are unaware of these [gender medicine] practices,” Dr Masson told GCN.
“It’s true that in France today, we’re talking about [gender medicalisation of minors]— there’s cautious discourse and not just trans-affirmation,” she said.
“We are now talking about ‘trans-identified’ and not ‘trans’ adolescents, and we have even formulated a new clinical proposal, ‘pubertal sex anxiety’ (ASP), which is of interest to professionals, particularly psychiatrists, psychologists and psychoanalysts.”
A statement by the Little Mermaid group suggested that the majority of gender-questioning young people “are not trans and should receive appropriate care”, rather than medical transition.
“This [bill] only concerns minors who are questioning and suffering from what we now call ASP,” the statement said.
“The accusation of transphobia is extremely effective. It strikes a chord: everyone wants to be (perceived as) a good person. So, even when we want to protect children from mutilating treatment, we feel emotionally compelled to waste more energy defending ourselves against this accusation than explaining why this treatment is mutilating. The material and objective facts then take second place, and the children with them.”—Feminist author Marguerite Stern, tweet, 30 May 2024
It’s a start
Dr Aude Mirkovic, of the group Lawyers for Childhood (JPE), said the bill was a necessary first step.
“We’re going to try to convince the deputies [of the National Assembly], but it’s already a victory that the Senate recognises the need to protect children from medical transitions,” she told GCN.
In a statement, the group JPE said the Senate had “agreed to move away from ideology and take account of medical and scientific studies that highlight the dangers of so-called sexual reassignment treatments and call for a cautious approach, ruling out early medicalisation with irreversible consequences in favour of psychiatric or psychological treatment of children’s disorders and difficulties.”
“In particular, JPE welcomes the regulation of the prescription of puberty blockers, which takes account of very recent studies revealing what was already suspected: puberty blockers do not constitute a ‘break’ and, on the contrary, have serious consequences.
“Taking blockers does not seem to allow the child to reflect, but rather freezes him or her in the desired identity, even though identity fluctuations during childhood and adolescence are a long-established fact.”
JPE cited the decision by England’s National Health Service to end routine treatment with blockers. The group’s statement also referenced the recent scientific review by British neuropsychologist Professor Sallie Baxendale, who argues that puberty blockers cannot be said to be “reversible” while their effects on the still developing adolescent brain remain unknown.
Video: French feminist and journalist Dora Moutot talks to Unherd magazine about the backlash against the best-selling book “Transmania”, which she wrote with Marguerite Stern, a fellow critic of the excesses of trans activism
The ‘wrong puberty’
During Tuesday’s Senate debate, Senator Mélanie Vogel of the ecological party (EELV) argued against the Republicans and their bill, saying that trans-identifying children needed puberty blockers to protect them against the irreversible effects of puberty.
This prompted a sharp response from one observer, feminist author Marguerite Stern, who tweeted—
“But Madame Vogel, of course puberty is irreversible, as is old age and the passage of time. It’s the natural order of things. You call yourself an ecologist, but you reject nature (our inner eco-systems).
“Puberty is not an illness. It’s a necessary stage of physical and mental life. There are things you can’t escape. They can be hard to live with, but you have to face them. As in the UK, we simply have to help dysphoric children get through it, rather than keeping them in a prepubescent juvenile stage (which is disturbing, isn’t it?) until they’re 18.”
Ms Stern and her colleague Dora Moutot—co-authors of the new book Transmania—have become targets for activist complaints, protest marches and implied threats of violence.
“At the beginning of May, there was a demonstration ‘against transphobia’ in many towns in France, and this demonstration was against our book Transmania, as well as this [Republican] law against the transitions of minors. The two are currently intertwined in the minds of quite a few people,” Ms Moutot told GCN.
“Our position on the transition of minors is very clear in our book, and we’ve been relaying [news of] the Tavistock case, the Cass review, the [gender treatment] changes in Sweden, etc, for a long time on our networks.
“Given that we have a certain influence with the success of our book, it’s making the trans-affirmative community mad, as well as certain politicians.
“We feel in danger. My address has been leaked on Twitter by some transgender people and I’ve received death threats from people who said they knew my address. It’s been a month since I had to leave my home to protect myself.”
She said she and Ms Stern had filed complaints about death threats. Protest chants such as “Dora Moutot at the bottom of the Rhine” and “one TERF, one bullet, social justice” have spread on social media.
Solidarity: Writer JK Rowling tweets her support for Dora Moutot
Transmania
In a section of their book under the heading “What happens when public hospitals embark upon medical experimentation on children”, Ms Stern and Ms Moutot cite two Karolinska Institute researchers, Professors Jonas Ludvigsson and Mikael Landén who were involved in Sweden’s systematic review of the (very weak and uncertain) evidence base for hormonal interventions with dysphoric minors.
“What these professors are saying is that we have no idea… what the effect of administering opposite-sex hormones on children might be,” Stern and Moutot write.
They also alert French readers to the Tavistock gender clinic controversy and other landmarks of the international debate over paediatric gender clinics.
“It’s a lot, isn’t it? A lot of whistleblowers, a lot of serious concerns, a lot of admissions by medics who reckon they were encouraged to damage already vulnerable young patients, a lot of fears that a global health scandal is taking place right here, right now,” they write.
“That’s what the British, Swedish, Norwegian and Finnish medical authorities have concluded. Between 2020 and 2023 these four countries, who had been pioneers in medical transition, rejected the ‘Dutch protocol’ of affirmative therapy. They have slammed the brakes on hard. They urge vigilance. They are calling for more talking therapies.
“So why are some doctors still insisting that they don’t want to understand what’s going on? Is it really so difficult to say: ‘Actually, I think you’re wrong’ to a patient? Or, ‘Why don’t we wait a little while?’ What exactly are the endocrinologists and surgeons hoping for? The respect of their peers? Eternal fame and glory? Could it be that there is some kind of Munchausen-by-proxy thing going on, as we fear there may be with some parents?”7
In stark contrast, the media outlet La Depeche greeted news of the Republican draft law with a chatty explainer headed—“Puberty blockers: 5 things you need to know about this treatment for transgender minors”.
The article conflates hormone suppression for the medical condition of precocious puberty with trans hormone suppression of normally timed puberty, asserts the unproven reversibility of trans blockers, and repeats a claimed mental health benefit not supported by multiple systematic reviews of the evidence—
“This hormone treatment [with puberty blockers] can be stopped at any time. It has been around for 40 years8 and doctors say it has proved its worth. ‘We quickly see relief and a drop in suicidal thoughts among teenagers’, explains child psychiatrist Jean Chambry... Puberty blockers are also used for teenagers suffering from precocious puberty. ‘Here, again, we have 40 years’ experience’, says endocrinologist paediatrician Laëtitia Martinerie. What’s more, according to Martinerie, the treatment is reversible.”
Some readers of La Depeche were not reassured. The top comment on the article says: “At last, a responsible [draft law] to provide a framework for irreversible decisions taken too early, usually in the midst of the chaos of adolescence. We need to stop this trend whereby the views and thoughts of minorities carry more weight than those of the majority. I can understand adults making these kinds of choices, but teenagers can’t!”
Another comment: “The absolute scandal is to allow LGBT associations, who also have the right of entry into schools, to encourage minors who are fragile and easily influenced, by definition, to make gender transitions. In my view, this is no more and no less than child abuse and should be punishable by law.”
And a third: “I hope that our legislators will not give in to the suicide blackmail that is clearly being put forward.”
Critics of the bill say the two-year wait amounts to a de facto ban. However, Republican Senator Alain Milon cited interviews with clinicians who told the Senate inquiry that “it takes us an average of two years to be certain of the diagnosis.”
On May 5, about 2,500 people turned out for trans rights protests in Paris and several other cities, according to Le Figaro. Targets of their ire included the Republican expert report and draft law.
TERF, a term of abuse sometimes linked with threats of violence, stands for “trans-exclusionary radical feminist” but is also used more generally against those perceived to be “anti-trans”.
News coverage of the bill’s debate suggested some initial uncertainty about the government’s position. Before the vote in the Senate, “several parliamentary sources had been warned by the executive of a so-called ‘wise’ government opinion, neither favourable nor unfavourable, which had irritated even the presidential camp,” Le Figaro reported.
There are questions about conflicts of interest affecting the authority’s working group on treatment advice.
Thanks to Martin Eggleston for a sample of his English translation of Transmania.
The use of puberty blockers with dysphoric children early in puberty did not begin on any significant international scale until 2010-2015.
It is interesting to note that the challenges facing those who question the legitimacy of the affirmative approach to gender dysphoria in children that exist in France are mirrored in Australia and most likely around the world.
The French Health Minister Frédéric Valletoux statement that “when it comes to medical issues, I will never allow political decisions to take precedence unless they are informed by scientific debate.”
It is a twofold lost cause:
• The ‘scientific debate’ Valletoux referred to is simply the opinion of zealots in the medical profession who are convinced they know what they are doing and thus are justified in short-circuiting the standard demands of building an evidence base.
• Our politicians do not have the courage to undertake a serious review (aka Royal Commission) into the ethics and justification of this dreadful intervention.
After all this time, it still boggles my mind how so many so called “experts” have continued to hold the line on this outrageous and heinous “therapy,” “gender affirming care.” Any physician knows that it is a pile of bunk; that shutting down puberty, an essential part of human growth and maturation can never lead to a good outcome.
What also troubles me is that most of these offenders, and that is what physicians who prescribe this garbage are, will never be held accountable.