Medical professionals in France just came out in strong support of gender-affirming care for transgender minors, according to independent trans journalist Erin Reed.

The French Society of Pediatric Endocrinology and Diabetology released a set of guidelines that can be considered the first consensus to come out of France for gender-affirming care. The guidelines were thoroughly conducted: Each section of the review is broken up up into separate categories evaluated by smaller groups of study authors who incorporated input from external experts. The final guidelines were also refined by the broader group of authors.

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The authors and studies in the report unequivocally support gender-affirming care, backing puberty blockers and hormone replacement therapy for trans minors. The approach to care they suggest is individualized and evidence-based, promoting the right of trans youth to explore their gender identity and find where they fit in on their own time. By allowing youth to transition early, some elect to skip future surgeries entirely, the study said.

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The guidelines strongly oppose a beloved tactic among anti-trans activists, dubbed the “wait-and-see” approach, wherein medical providers render no care to see if the patient still desires transitional care — the approach has been likened to conversion therapy. The approach, also known as “gender exploratory therapy,” is swiftly criticized by the guideline’s authors who state that it “does not reduce psychological distress.” Instead, it “increases the risk of committing suicide and can affect psycho-affective and cognitive development.” 

A study published in September shows that anti-trans laws increase the likelihood of suicide by upwards of 72%, suggesting that attempts at implementing these bans on care and advocacy for the “wait-and-see” approach are only harming transgender individuals.

The guidelines even provide a definitive rebuke to the claim that puberty blockers cause lower bone mineral density (BMD) by saying, “Trans youth have an average BMD before the onset of puberty that is lower than that of the general population, regardless of treatment. This is probably related to the consequences of dysphoria: less physical activity, eating disorders, and/or poor dietary balance.” After taking the hormones that align with their gender identity, the guidelines’ authors not that trans patients’ BMD is “comparable to that of the experienced gender.”

The guidelines also directly push back against claims in the U.K. Cass Review that puberty blockers affect cognition, revealing that they have “no negative effect” on any measures of intelligence or academic success.

The French guidelines are especially detailed in that they contain information on how trans youth can alleviate dysphoria as well. They discuss binding techniques, how transfeminine people can tuck, and how to best treat youth in varying stages of their transition.

Editor’s note: If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. The Trans Lifeline (1-877-565-8860) is staffed by trans people and will not contact law enforcement. The Trevor Project provides a safe, judgement-free place to talk for youth via chat, text (678-678), or phone (1-866-488-7386). Help is available at all three resources in English and Spanish.

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