Between 1.2% and 2.7% of children and adolescents declare themselves transgender, according to the Global Professional Association for Transgender Health (WPATH). Chrystelle Lagrange is a clinical psychologist in private practice, as well as at the Pichon-Rivière medical-psycho-pedagogical center (CMPP) in Paris – member of the Olga-Spitzer foundation –, where she receives many trans minors in a specific consultation , funded by the Ile-de-France regional health agency.
She is also the main author of an article covering the clinical data of the specialized consultation for trans minors at the Pitié-Salpêtrière hospital (Paris), since its opening in 2012 until the end of 2020, published at the beginning of September, in the review Childhood and adolescent neuropsychiatry. The researcher warns of the need to strengthen support for these young people.
What do we know about the mental health state of trans minors?
Of the 239 people included in the cohort of the article concerning the Pitié-Salpêtrière consultation – aged from 3 to 20 years old, with a first appointment located, on average, around 14 and a half years old –, 24% had made a suicide attempt, 28% have a history of psychiatric hospitalization and 38% report having been victims of harassment, mainly at school, before their treatment. The cohort is certainly small, but these figures are corroborated by international literature, particularly in the Netherlands and Canada, countries which have between ten and twenty years of experience in the care of trans minors.
It is also congruent with what I observe from a clinical point of view in my consultations. Some adolescents have psychiatric co-occurrences – depressive, anxiety or social disorders, schizophrenia. For others, these problems arise through transidentity, due to the ostracism and rejection of these young people. Around a third have dropped out of school. But we are far from the fantasy that persists according to which trans people are psychotic, inherited from the psychiatrization of transidentity.
What factors improve their mental health?
The hormonal transition – whether estrogen, testosterone or puberty blockers – and the social transition – changing one’s first name for example – remain fundamental, as does the acceptance and support of the social environment. and family.
The transition pacifies the young person’s relationship with their body and induces resocialization. This results in a reduction in social anxiety and depressive disorders. Contrary to what people may hear, adolescents are quite measured in what they describe: taking hormones helps but is not miraculous. It takes time, in the event of depression for example, to get back into the circuit.
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