WORLD WORLDWIDE FRANCE News Journal Update - (en) France, UCL AL #336 - Antipatriarchy, Understanding gender transitions: Access to care, a real obstacle course (ca, de, fr, it, pt, tr)[machine translation]

 In France in 2018, 36% of trans people suffered discrimination from the medical

community, a figure on the rise. A problem common to the entire LGBTI community,
but which takes on a particular form and importance for a population whose mental
health and quality of life depend crucially on access to care. Third article in
the series. ---- In many countries, access to medical transition is mainly
through specialized "gender clinics", with queues that last several years and are
known for their archaic, obstructive and even dangerous practices. ---- France is
not to be outdone, with its "multidisciplinary courses" (understand by this that
several months of psychiatry are mandatory before any treatment). These
structures often require conforming to all the stereotypes of one's felt gender,
being heterosexual, or even having an "acceptable" physique. Prescribed hormone
dosages are often too low (sometimes to the point of a health hazard) and
unnecessary invasive tests are common.

It is nowadays easier to find private doctors with acceptable practices, but
these remain rare, and some are under pressure from the College of Physicians.
There is also a strong geographical disparity, which the use of teleconsultation
cannot entirely fill.

One of the main activities of trans associations is to circulate the names of
practitioners, a practice used including for usual care, so widespread is
discrimination and medical violence.

The health of trans people is prey to pernicious capitalist logics, which are
based on the failures of the public service and the distress of patients. We thus
observe a surge in prices among private surgeons, who promise reduced delays via
their clinic and a skill difficult to find in the public, at the price of several
thousand euros.

Two-speed medicine
On the social security side, if measures exist, everything is far from perfect.
When the CPAM does not obstruct, a trans person can obtain recognition of
Long-Term Affection (ALD), which allows care to be taken care of in connection
with their transition up to the security reimbursement base. For permanent laser
hair removal, this base is too low, representing a third or a quarter of the
advanced costs: count a good thousand euros out of your pocket to treat the face
alone (the torso being much more expensive). For surgeries, the CPAM requires a
three-party agreement: endorsement by a psychiatrist and an endocrinologist in
addition to the surgeon, despite the depsychiatrisation of transidentity in 2010[1].

There is still a long way to go from here to real access to care for trans
people. A path on which we will move forward through the fight, the collective
taking charge of our health, and through a long work to bring trans health into
the medical curriculum. On all these points, we particularly salute the Trans
Health Network (ReST) and Family Planning, for their essential training and care
work.

Chloe (UCL Grenoble)

https://www.unioncommunistelibertaire.org/?Comprendre-les-transitions-de-genre-Acces-aux-soins-un-veritable-parcours-du
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