Paradigm shift in France in the medical care of children with genital development variations: Medical care for children with genital development variations in France.

Abstract

In 2021, for the first time, a legal framework organizing the care of children with a variation in genital development (VGD), sometimes referred to as "intersex children" or "children with differences in sex development" (DSD), was introduced in France (article L. 2131-6 of the Code of Public Health). It should be immediately apparent that the chosen term, "variation" rather than "anomalies" or "disorders" - which was previously used in the medical world - reflects a political will to renew both the way of thinking and the medical practices in this field. The aim of the new legal framework is to guarantee optimum care for children with VGD by requiring the systematic involvement of expert centers (to establish diagnoses and therapeutic proposals), providing the most comprehensive information possible to their families and seeking the minor's consent. Among the possible medical care options, the law explicitly mentions "therapeutic abstention," reflecting a paradigm shift aimed at curbing the too-frequent recourse to treatments whose sole objective is the conformation of the genitalia. An order was subsequently issued on 15 November 2022 to provide the necessary details for the implementation of the changes introduced by the law.