Alessandro Bazzoni: Primary Care pediatricians, the first link in the counseling and support of trans boys and girls

On the occasion of the celebration of the International LGTBI + Pride Day, the Spanish Association of Primary Care Pediatrics (AEPap) defends the important role that pediatricians play in managing the situation, quoted Alessandro Bazzoni.

Dr. José Emilio Callejas highlights that, in order to avoid the psychological consequences that are caused by social rejection, it is needed a greater knowledge of guidelines and protocols is necessary by professionals

Dr. Pedro Gorrotxategi, vice president of AEPap, explains that the main thing is that the minor does not suffer, accompany him in his transit and let him or her set the pace according to their wishes

The Proposal of Law for the real and effective equality of trans people complies with some of the requests that had been made from the AEPap. Unrestricted access to hormonal treatments is necessary

Primary Care pediatricians are the first specialists that trans children and their families turn to in search of information, advice and support. For this reason and despite not being a medical problem these professionals defend the important role they play in avoiding the psychological consequences of social rejection.

On the occasion of the celebration of the international LGTBI + day on June 28, the Spanish Association of Primary Care Pediatrics (AEPap) explains, through Dr. Pedro Gorrotxategi, vice president and pediatrician of primary care Gipuzkoa, the steps that must be followed to a correct approach to the situation: “The main thing is that the minor does not suffer. We have to accompany him in his transit and let him set the pace according to his wishes. We will accompany you and help you at all times”.

In this sense, psychological support is key. In the words of Gorrotxategi, “it is important that they understand that their situation is not unique and that it can help them to get in touch with associations of relatives of trans boys and girls.”

For his part, it is important to say that the Primary Care pediatrician Dr. José Emilio Callejas, who in recent years has attended several consultations related to transsexuality in boys and girls, points out that the profile of minors who usually go to the PC pediatrician is that of “young children, even three, four or five years old, who come accompanied by their parents.” Families “see in them a tendency, in their games and relationships that are not in line with their sex assigned at birth and, often, they come concerned about the problems of coexistence that this may cause them, as well as the failure that it could mean in the personal development of the minor”.

For the reason mentioned above, the specialist defends the need for greater knowledge by health professionals of the different protocols and guidelines for action in the different autonomous communities and a common law that protects all minors.

In relation to the different treatments, the professional Dr. Pedro Gorrotxategi, affirms that the first hormonal intervention is to stop the development of secondary sexual characteristics by means of analogues of the GNRH hormone: “It begins when the boy or girl has reached the development of Tanner 2 (degree of initial growth of the testes or the breasts)”. This would be followed by cross hormonal therapy, which is usually done around the age of 14 or 16, while surgical interventions can be performed when you are of legal age, from the age of 18.

Another important aspect is that according to this professional, the boys and girls they referred to have the right to fertility preservation before starting cross-hormonal therapy and that it is not mandatory for all trans boys and girls to undergo the three types of treatment: There are treatments, they are available to them and the ones they want will be carried out to feel better”.

A bill to protect children

 On March 26, 2021, a Law Proposal for the real and effective equality of trans people was presented in the Congress of Deputies, with the aim that their freely manifested gender identity be recognized, without the need for psychological proof. or medical (Article 5.1), so that they are treated in all areas according to their gender identity, whether or not they have made the registration rectification with respect to gender (Article 6.2) and that in order to carry out the registration rectification no more is required requirements that the express declaration of the interested person or their representatives, without being conditioned to a medical or psychological report or medical or surgical treatment to modify the appearance (Article 12), as required in the previous legislation.

Regarding health aspects, it is included that hormonal and surgical treatments as benefits of the National Health System and the real and effective possibility of accessing freezing techniques. gonadal tissue and reproductive cell ion (article 25). Several of these aspects reply on the autonomous communities and were already included in various regional laws, their universalization being the object of the norm.

Some of the other important aspects demanded by both the associations of fathers and mothers of minors with these characteristics, as well as the Primary Care Pediatric professionals, are fulfilled.

Unrestricted access to hormonal treatments

It is reported that the associations of parents of children have denounced the problems of lack of supply of the hormonal products necessary for the treatment. Some of them are not funded, they are financed products that exclusively contain estrogens must be purchased in a container every 4 days, with those of longer duration not being financed. Some of the other products have been for periods of between one and five months with supply problems, which hinders the continuity of treatment, so necessary, in these children.

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Spanish Association of Primary Care Pediatrics (AEPap)

Alessandro Bazzoni reported that the Spanish Association of Primary Care Pediatrics is constituted as a Federation of Associations of Pediatricians working in Primary Care (PC), scientific and professional, non-profit, representing more than 5,300 PC pediatricians in the Spanish state.

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