The health of transgender and non-binary adolescents has emerged as a major topic at the intersection of medicine, ethics, and societal issues. At the request of several cantonal medical officers, the National Advisory Commission on Biomedical Ethics published an opinion paper on the medical treatment of minors experiencing gender dysphoria at the end of 2024. The document provides a clear framework, based on scientific evidence and biomedical ethics, in a context of uncertainty and sociopolitical polarization. It emphasizes an individualized and careful evaluation of benefits and risks, the recognition of adolescents' evolving autonomy, interdisciplinary collaboration, and the protection of each adolescent's right to an open future.

This article outlines the management of transgender and non-binary adolescents at CHUV. The current rise in visibility of this topic is associated with an increased demand for intervention and at the same time with an increased generation of continuously expanding medical evidence to guide interventions. The close collaboration among various specialized adolescent health services enables an interdisciplinary evaluation of diagnostic elements and indications for potential psychological, social or medical interventions. This article underscores the significance of an interdisciplinary and individualized approach to transgender and non-binary adolescents, respecting the diversity of the human being.

Transgender people are at risk of being in worse health than the cisgender population. On the one hand, they encounter specific health problems, mostly related to the impact of minority stress on their mental and somatic health. On the other hand, the preventive recommendations usually do not account for gender-affirming hormonal or surgical treatments that can alter their biologic or anatomic risk profile. The health of transgender people is an area in which research is yet sparse, professionals seldom trained, and where uncertainty remains. The aim of this review article is to summarize the current state of knowledge and propose recommendations for clinical practice.

This article outlines the management of transgender and non-binary adolescents at CHUV. The current rise in visibility of this topic is associated with an increased demand for intervention and at the same time with an increased generation of continuously expanding medical evidence to guide interventions. The close collaboration among various specialized adolescent health services enables an interdisciplinary evaluation of diagnostic elements and indications for potential psychological, social or medical interventions. This article underscores the significance of an interdisciplinary and individualized approach to transgender and non-binary adolescents, respecting the diversity of the human being.

Transgender people are at risk of being in worse health than the cisgender population. On the one hand, they encounter specific health problems, mostly related to the impact of minority stress on their mental and somatic health. On the other hand, the preventive recommendations usually do not account for gender-affirming hormonal or surgical treatments that can alter their biologic or anatomic risk profile. The health of transgender people is an area in which research is yet sparse, professionals seldom trained, and where uncertainty remains. The aim of this review article is to summarize the current state of knowledge and propose recommendations for clinical practice.

While several recent studies suggest that approximately 1 in 6 young people in Switzerland are part of the rainbow diversity, a high proportion of health professionals have never had a course on LGBTIQ+ (lesbian, gay, bisexual, transgender, intersex, queer, questioning or other) health. This situation leads to significant gaps in the medical care of LGBTIQ+ persons as well as difficulties in accessing equitable, culturally appropriate and quality care. This article presents the ambitious and novel e-learning project I-CARE (Improving Care and Access for Rainbow Equity) which should contribute, from the end of this year, to filling the current gaps in the undergraduate and continuing education of health professionals.

While several recent studies suggest that approximately 1 in 6 young people in Switzerland are part of the rainbow diversity, a high proportion of health professionals have never had a course on LGBTIQ+ (lesbian, gay, bisexual, transgender, intersex, queer, questioning or other) health. This situation leads to significant gaps in the medical care of LGBTIQ+ persons as well as difficulties in accessing equitable, culturally appropriate and quality care. This article presents the ambitious and novel e-learning project I-CARE (Improving Care and Access for Rainbow Equity) which should contribute, from the end of this year, to filling the current gaps in the undergraduate and continuing education of health professionals.Alors que plusieurs études récentes suggèrent qu’environ 1 jeune sur 6 fait partie de la diversité arc-en-ciel en Suisse, une proportion élevée des professionnel-les de santé n’a jamais eu de cours sur la santé des personnes LGBTIQ+ (lesbiennes, gays, bisexuelles, transgenres, intersexuées, queers, en questionnement ou autres). Cette situation entraîne d’importantes lacunes dans la prise en charge médicale des personnes LGBTIQ+, ainsi qu’une difficulté d’accès à des soins équitables, culturellement appropriés et de qualité. Cet article présente l’ambitieux et inédit projet de formation par apprentissage en ligne I-CARE (Improving Care and Access for Rainbow Equity) qui devra contribuer, à partir de la fin de cette année, à combler les lacunes actuelles dans la formation prégraduée et continue des professionnel-les de santé.

Transgender, non-binary and questioning teenagers are increasingly visible. However, they face barriers in accessing appropriate care that meet their needs, both specific and regarding their general health. Primary care physicians increasingly see them in consultations but often lack elements of communication and recent knowledge that is needed to accompany them and their close ones in their -individual trajectories. This article aims to answer this need and provides a synthesis about recent evidence and suggested communication approaches for primary care physicians, who play a central role for the health of all patients.

La suicidalité chez les jeunes trans est très importante. La recherche montre qu’il y a de meilleures chances de la prévenir, dans un contexte social aidant, avec du soutien parental et un accès aux traitements de confirmation de genre. Or, que vivent les jeunes trans et leur famille dans des contextes où, comme c’est le cas de la Suisse francophone, les traitements sont peu accessibles, d’une part, et où, d’autre part, la transitude est pratiquement invisible? Dans le cadre d’une recherche participative inspirée par la théorie ancrée, dix jeunes et dix parents ont été interrogés pour documenter la situation. De fait, le suicide et « l’envie de mourir » sont très présents pour ces jeunes, qui considèrent l’inadaptation actuelle des structures de soin comme un enjeu majeur. Se révéler à soi-même et aux autres et être soutenu par les soignants sont de la plus grande importance pour sortir de l’envie de mourir. Cet article montre comment la notion d’oppression développementale peut aider à mieux comprendre la suicidalité chez les jeunes trans.

How trans youth realize about their gender identity and come out to their significant others is under-researched and very few studies include both youth and parental perspectives. This study was developed in Switzerland, a country where families with trans youth are just beginning to break invisibility. The research protocol draws on grounded theory methodology, is participative and developed in collaboration with a local trans NGO and a pan Canadian project. We conducted 20 semi-structured interviews with 10 trans youth and their caregivers/parents (10 interview). At least three developmental pathways seem to emerge: a) the affirmed children who affirm themselves very early, (b) the silent children who spend their childhood in a state of internal tension without being able to position themselves and (c) the neutral children who become aware of their gender difference at puberty following a childhood in which gender was not problematic. In all cases puberty is a crossroads, lived painfully with significant manifestations of both social and body dysphoria. A better understanding of the process of gender development in trans children and youth will help improve our interventions to better serve young people and their families, and help them overcome the different levels of oppressions they face.

Adolescents transgenres et non binaires : approche et prise en charge par les médecins de premier recours Les adolescents transgenres, non binaires ou en questionnement sont de plus en plus visibles et font face à de nombreux obstacles pour accéder à des soins appropriés, tant pour leurs besoins de santé spécifiques que généraux.Les médecins de premier recours les rencontrent au cabinet et peuvent manquer d'éléments de communication et de connaissances spécifiques récentes pour mener la consultation et accompagner ces personnes et leurs proches dans leurs trajectoires individuelles.Cet article propose une synthèse des éléments et des ressources utiles pour le médecin de premier recours, dont le rôle est central pour la santé de tous les patients. Transgender and non-binary teenagers : management in primary careTransgender, non-binary and questioning teenagers are increasingly visible.However, they face barriers in accessing appropriate care that meet their needs, both specific and regarding their general health.Primary care physicians increasingly see them in consultations but often lack elements of communication and recent knowledge that is needed to accompany them and their close ones in their individual trajectories.This article aims to answer this need and provides a synthesis about recent evidence and suggested communication approaches for primary care physicians, who play a central role for the health of all patients.

Since 2011, a significant amount of evidence has been published on transgender children and adolescents, highlighting their needs and the best health and social practices. They are more at risk of suicide, discrimination, depression. Today, we better understand that the main causal factor linked with negative experiences is to be found in direct and indirect discriminations, subsequently causing personal and relational difficulties. When transgender youth are fully accepted and supported in their desired gender, they do not significantly differ from other youth. We need to build informed and respectful practices. Three kind of interventions are now urgently needed in Switzerland: access to hormonal management of puberty (medical), family centered interventions (psychosocial), and prevention of bullying in schools (sociopolitical).