Évaluation de la formation théorique et pratique des internes en Île-de-France sur les connaissances et l’accompagnement de la transidentité chez l’enfant et l’adolescent

Abstract

IntroductionGender dysphoria, non-binarity, trans-identity, neutrality, gender fluid. faced with the emergence of a redefinition and reaffirmation of gender, what place and training are there for the doctors of tomorrow? A public health issue is coming to the fore as the suicide rate among these adolescents is seven times higher than among so-called “cisgender” adolescents. So how do you take care of these patients and their families, for whom access to care is so difficult? Several doctors have found themselves confronted with this real tidal wave of requests for gender consultations without any training or clear recommendations. MethodThis survey, carried out among resident doctors in the Île-de-France region, aims to assess the current practical and theoretical training concerning the care of children and adolescents with a trans-identity status. This survey was carried out during the month of June 2020, using an anonymous online questionnaire consisting of 16 questions including multiple choices as well as open-ended ones. The questions concerned a self-assessment of practical and theoretical knowledge according to the year and specialty of the residency. It also addressed the issue of training programs implemented by medical faculties and university hospitals as well as the confrontation to trans-identity in clinical practice and the reflections emerging from it. ResultsThe findings, collected from the answers of 143 resident doctors, show an overall lack of knowledge, theoretical and practical, without medical specialization distinction. It includes pediatric and child psychiatric specialties that are all the more directly concerned. This gap is mostly attributed to the lack of training and teaching in medical universities and hospitals, as well as to a subject still considered taboo within the medical profession itself. The overwhelming majority of doctors are thus in demand for more comprehensive education on the issue as part of their general medical training curriculum. ConclusionIt appears more than important to consider trans-identity status a real public health issue. This matter is taking on an increasingly crucial role in child and adolescent medical counselling. In the coming years, this will enable better patient support and better access to care within a population weakened by years of discrimination and inequality in relation to the fundamental right to health.