Fr | En
The e-mémoires of the Académie Nationale de Chirurgie

Transition support

Jean CHAMBRY

Seance of wednesday 19 april 2023 (La chirurgie transgenre)

DOI number : 10.26299/6eb8-mh22/emem.2023.15.02

Abstract

Among mammals, there are males and females, recognizable by their genitals. It is a binary system. But the human being is not a mammal like the others. Endowed with the prefrontal cortex, it has developed a complex function that dominates many of its cognitions and behaviors, reflexive consciousness. The human being thinks himself. Until now, it was argued that gender identity (being male and/or female) had to be built around the reality of the genitals. In other words “the penis makes the man, the vagina makes the woman”. With regard to sociological, anthropological and philosophical developments on gender issues, today there is no longer any legitimate theory, in our Western society, which can account for the process of identity development, the connections between realities and the biological limits of sexed body and gender experiences.

Due to the developmental rearrangements linked to the puberty process, adolescence is a stage where the search for identity takes a major place. Who am I ? What adult will I become? Today there are many possibilities to define oneself in its sexual dimension (cis gender, transgender, binary, non-binary) without this being part of a pathology. During this process, there is an important separation between the work of identity affirmation which is crossed by the notions of sex and gender, and the discovery of sexual desire and the practices of sexuality. It is also important to differentiate between the possibilities of asserting oneself in one's identity construction and the modalities of entry into a medico-surgical process of transition. Finally, it is essential to address these questions without ideological a priori and to welcome all the words of adolescents in order to develop with them the strategies best suited to their development.The support for trans people in the transition process will therefore depend on their age, that is to say on the maturation of their discernment.