Les enfants porteurs de Désordres du développement du sexe. Du devenir en termes de vécu de genre aux conditions d’assignation à la naissance

Abstract

The care of children and adolescents with a diagnosis of Sex Development Disorder (DSD) is today a matter of debate and discussion both in terms of care practices and in the social and political fields. One of the central concerns of the healthcare teams involved in the care and support of people with DDS is the ability to offer the most efficient care in order to promote the best possible development of the individuals concerned. While one of the central points of the current discussions concerns the question of indications for early medical and surgical care, the discussion also concerns the place and modalities of gender assignment of a child at birth and the different consequences for them in their future life. The question of the future of children born with DSD in terms of inclusion in a gender identity has been studied since the 1950s and has developed along very different theoretical presuppositions; from the psychodynamic and psychoanalytical field to biological presuppositions. The scientific literature is particularly heterogeneous on the subject and includes methodologies such as experience reports, case-control studies and methodologies from Evidence Based Medicine. In support of the elements from the scientific literature and in support of collaborative work by the national network of the Centers for Rare Diseases of Genital Development: from foetus to adult, this work aims to define the outlines of the current organisational arrangements and ethical aspects of the teams involved in this activity in France.