Gender gong

French critics of hasty medicalisation win a prestigious award

Two of France’s most prominent critics of youth gender medicine, clinical psychologist Céline Masson and child psychiatrist Caroline Eliacheff, have been honoured with a prize for their work carried out in the face of activist attacks.

In Paris this afternoon, they are to be awarded the 2023 Marcelle Blum bursary for the study of female psychology by the Academy of Moral and Political Sciences, which was founded in 1795 and conducts its ceremonies in the domed Palace of the Institute of France overlooking the river Seine.

“It is recognition by the academy, and therefore by academics, of our work on the hasty medicalisation of trans-identified children and adolescents, some of whom are not trans but rather influenced by social networks or peer groups,” Dr Masson told GCN.

She and Dr Eliacheff are co-presidents of The Little Mermaid, a watchdog on youth gender medicine bringing together hundreds of researchers and members of the professions; the group’s newsletter goes out to more than 1,200 subscribers.

Drs Eliacheff and Masson are also co-authors of the 2022 book The Factory of the Transgender Child, which argues that gender medicalisation may be “the first great health scandal of the 21st century.”

“We’ve been sounding the alarm, putting forward arguments to address the problem of the increase in the number of girls who identify as trans,” Dr Masson told GCN.

“We were attacked when our book came out, then little by little, professionals—including doctors and psychologists, but also researchers—realised that we were facing a dictatorship of minorities.”

In March 2022, France’s National Academy of Medicine issued a statement calling for “great medical caution” in the treatment of gender-distressed minors, noting that hormonal and surgical interventions can cause “many undesirable effects and even serious complications [including] risk of sterility.”

The government’s National Authority for Health has set up a working group to update a 2009 treatment guideline for trans-identified patients aged 16 and older.

“We have not been invited to take part in this group, which is made up of people who share the same opinion and are in line with the [“gender-affirming”] European Professional Association for Transgender Health,” Dr Masson said.

She said the treatment recommendations of the World Professional Association for Transgender Health were followed for patients aged 15 and younger; France is to create another working group for minors.

Meanwhile, Drs Masson and Eliacheff were invited to give expert assistance to a working group on trans-identified minors set up in May this year by the centre-right Republicans of France’s Senate.

“The working group will focus on the growing number of requests for gender reassignment among children, and especially adolescents, in recent years,” the Republican group said in a media release.

“At a time when the influence of social networks is giving new visibility to ‘gender dysphoria’—or the feeling of having been born in the ‘wrong body’—it seems only right that the subject should be given careful consideration by legislators.

“The working group, made up of 18 senators, will hear from a number of experts (doctors, associations, lawyers, international experts) before considering any changes to the legislative framework for minors.”

Video: Alexander L, from Norway, on the myths and realities of detransition

“Is gender reassignment always the solution for these young people? Can a child really be trans? We will show that in the majority of cases, what we call a ‘transgender child or adolescent’ is a young person suffering from psycho-social difficulties that are brushed aside in favour of an illusory ‘gender affirmation’.”—French journalist Pauline Arrighi, author of the new book The Ravages of Gender, 12 November 2023

Trans finance

A January 2022 report to France’s then Health Minister, neurologist Olivier Véran, pointed out that unlike other countries, medical transition could be fully paid for by French social security if the patient had access to a scheme for coverage of chronic illness known as ALD.

The number of people covered by ALD for trans identity or gender dysphoria had “risen sharply” over the previous 10 years; 70 per cent of these patients currently funded by ALD were aged 18-35.

“A total of 8,952 people had [ALD coverage] for ‘trans identity’ in 2020, including 294 aged 17 and under,” according to a September 2022 good practice recommendation from the National Authority for Health. This document claims that the effects of puberty blockers are reversible.

“Breast surgery is performed after a period of hormone therapy, sometimes before the age of majority,” the good practice document said.

“The consent of the teenager and both parents is required as long as the teenager is a minor.”

The document cited a May 2022 systematic review linked to Sweden’s Gillberg Neuropsychiatry Centre and noted its conclusion that larger studies with long-term follow-up were needed to guide treatment of adolescent gender dysphoria.

“We understand very little about the development of mental health problems prior to presentation at gender dysphoria services, and so do not have a clear understanding of the place of gender dysphoria within the broader context of young people’s mental health,” the Gillberg review said.

“To what extent gender dysphoria may be a reaction to a range of preceding psychosocial stressors for a sub-sample of those presenting for services needs to be understood.”

“If France allows the use of puberty blockers or cross-sex hormones with parental authorization and no age limitations, the greatest caution is needed in their use, taking into account the side-effects such as the impact on growth, bone weakening, risk of sterility, emotional and intellectual consequences and, for girls, menopause-like symptoms.”—National Academy of Medicine, media statement, March 2022

‘Take action’

In September this year, a coalition of 400 feminist groups from seven countries issued an open letter to France’s new Health Minister, Aurelien Rousseau, under the heading “Doctors mutilate suffering people.”

“In France, the law prohibits any form of mutilation [which is punishable with 10 years’ prison],” the letter said.

“It is very difficult for a woman who no longer wishes to have children to obtain sterilisation by tubal ligation.

“However, doctors do remove healthy organs from people who request it. Teenage girls and young women who say they ‘feel like a man’ have their breasts removed by surgeons, who also remove their uterus and ovaries, and perform phalloplasty (the creation of a ‘penis’ using skin taken from the forearm).

“Young men who so request have their penises amputated and artificial orifices called vaginas created.

“Doctors, whose names are exchanged on social [media] networks, prescribe or renew, sometimes by tele-consultation, hormone treatments that lead to lifelong dependence and after-effects. 

“However, these treatments have not been validated by any scientific, health or medical authority, and have not received any marketing authorisation for this indication.

“To get around the prohibition contained in the Code of Ethics, these practitioners are abusing [an exception] known as the ‘compassionate framework.’

“Hormones and surgery cause irreversible damage to people who are suffering and who, above all, need psychotherapeutic help.

“At a time when the number of people requesting sex reassignment has risen enormously over the last ten years, and their profile has changed radically (previously the majority were adult males, now it’s mainly teenage girls), the inaction of the Ministry of Health and the silence of the French Medical Council are tantamount to failing to assist people in danger.

“In the future, when complications arise from these abusive medical interventions, when it is recognised that consent to these hormone treatments and operations was neither free nor informed, when lawsuits are brought against doctors for abuse of weakness, it will be too late.

“Minister, in the face of this health scandal, which is growing every day, we are asking you to take action, as neighbouring countries [such as Sweden and the UK] have already done. Thousands of vulnerable people are at risk, thousands of families are suffering.

“Faced with the malaise of so many young people who believe that these mutilations and hormone treatments are the solution to their problems, and who are sacrificing their health with the complicity of doctors, the government must take action.”

The open letter from the International Feminist Front is signed by its leaders Marie-Noëlle Bas, Gérard Biard and Florence Montreynaud.