Early puberty, a discrepancy between body and mind
In the consultation room, Lola nervously fiddles with the ear of her teddy bear. At the mention of the first rules, the little girl begins to chuckle. Yes, she knows what it is, she answers the doctor, cheeks red. His mom told him about it a few months ago, when hair appeared under his armpits and his chest started to grow. But at school, her girlfriends called her a liar when she revealed to them that the big ones were bleeding at that place. Lola did not insist and swallowed her secret. At 7 1/2 years old, she is not ready to assume her difference.
"She has her age in her head but not in her body. She is still a child. It must be protected, "insists his mother, a little sounded. It is by discovering a ball within Lola that she decided to consult, considering the worst. After several exams, the verdict fell: his little girl lives a precocious puberty. Lola shriveled in her chair. She struggles to put words on what she experiences: "At times, I feel different from my girlfriends, but I can not know why. I do not understand what's going on inside me "
In her class of CE1, Lola is the only one to have a little chest, which she hides under large sweaters. "That's why I prefer winter," she whispers. From the height of his meter forty-two, she is also the largest. But if her menstruation occurs in the next six months, she will not reach five feet. Early puberty actually accelerates skeletal maturation, but also interrupts growth earlier. Paradoxically, these children who grow faster than others become small adults. To continue to grow, Lola will have to undergo every month an injection of hormones that will slow down her pubertal development. But size is not the only issue.
Ripped up too early in childhood, these girls locked in women's bodies are confronted with issues and issues that exceed them. "It creates a complete shift between the body and the mind that can lead to isolation of the girl, a depressed mood or poor results at school," says Karinne Gueniche, clinical psychoanalyst at Necker Hospital , in Paris.
Anglo-Saxon studies go further, attributing to this early entry into adolescence both eating and sexual behavioral problems, as well as risks of addiction to narcotic drugs. "But not all girls are traumatized! Some have the maturity to live well the arrival of the first rules, "tempered Dr. Dominique Simon, who runs the pediatric endocrinology day hospital in Robert-Debré, Paris.
Professor Charles Sultan, Montpellier University Hospital, remembers a panicked mother who came to see him after her 6-year-old daughter locked herself in the bathroom with a boy. "I often see, in these girls ahead of their age and their girlfriends, an exhibitionist behavior, without any psychological brakes. I advise the parents to tighten the screw to avoid slippage, "says the endocrinologist, who denounces the omnipresence of the sexual clutter of the imagination of the youngest and sweeps over a generation bottleed competitions mini-miss and strings child size .
Our voyeuristic society is both worried and excited in front of these little girls
Dr. Gueniche, concerned about the growing phenomenon of lolitas.
The irruption of the sexual
For parents, it's abysmal. Abruptly forced to anticipate conversations for which neither they nor their children are ready. For who says puberty says fertility, sexual intercourse and contraception. After the relief of knowing that the prognosis of their children is not engaged, Dr. Gueniche notes their distress during her consultations at Necker Hospital. "There is a sudden intrusion of sexuality in this tender haven of childhood. All of a sudden, they do not know how to do, how to behave with their daughter, how to wash and dress again. "Uncomfortable, some fathers stop overnight to give the bath and unconsciously establish a physical distance, at the risk of increasing the disorder of their child. Others, on the contrary, make it a point of honor to act as if nothing had happened.
Like Emma's dad, 9, on hormone therapy since her breasts started growing last year. During the follow-up interview with the doctor, he puts his daughter in her lap. As if to affirm that, even if Emma's body says the opposite, she remains in her eyes her baby. "Before the injections, I was worried about her, I was afraid she would feel different, out of step. One is necessarily a little foreign to all that when one is a man, "he explains, a little embarrassed.
Today, the news is good. Clinical examination reveals a clear regression of the mammary gland. Psychologically, everything is fine too. Emma has girlfriends and concerns of her age. She is a good student "subscriber A", says his father, with all the more pride that the girl arrived in France only three years ago. Adopted children, like Emma, who are late discovering a stable family environment and a better diet, are more affected than others by early puberty. In Sweden, a study showed that they accounted for a quarter of the cases recorded. Another aggravating factor is childhood obesity, which continues to grow.
A boom in early puberties?
Early pubescent, Pr Sultan ensures to see up to six per week during his consultations at the CHU Montpellier. And do not hesitate to talk about epidemic, figures in support. "Until the 2000s, I treated about ten cases of precocious puberty a year. For the year 2013, 184 girls consulted for this reason, some of whom are not yet 5 years old. During a recent stay in the West Indies, the rector told me he had identified five pregnancies in primary classes! So when I am told that it is a sight of the mind, of course it annoys me, "the impetuous professor blows, sometimes accused by some of his peers of screaming with the wolves. Because the question divides the medical profession: is there really a boom of the pubertés precocious?
"Maybe yes, maybe not," would be tempted to answer Professor Jean-Claude Carel, who heads the pediatric endocrinology department at Robert Debré Hospital. "What is complicated with precocious puberty is that it is not a systematically pathological disease, like diabetes, for example. There are areas of gray, especially between 7 and 8 years, where we prefer to speak of "advanced pubertaire" and for which hormonal treatments are not systematic. "
Dr. Simon, who has been working in the same endocrinology department for over twenty years, has seen a slight increase in the number of consultations for early puberties. But she is careful not to draw hasty conclusions: "We talk more about it, so pediatricians and families are more aware of the issue. But that does not mean that there are more cases, "she adds.
Rather than an epidemic, many practitioners prefer to speak of a new norm. Because if the age of first menses has stabilized for several decades around 12 1/2 years, the breasts of girls appear earlier and earlier. "Just take a walk in Palavas-les-Flots to see that many girls have an impressive chest for their age," said Professor Sultan. An American study published in 2010, on 1 239 girls, showed that 1 in 6 sees his body changed at the age of 7 years. Danish researchers, for their part, have established that the median age of onset of breasts has advanced one year in the last fifteen years.
Early puberty caused by pesticides?
In France, there is still a lack of both scientific and psychological tools to evaluate the phenomenon. "For a long time, childhood has been a" small subject "for us, where we prefer to work on more sales-related notions, such as power for example. With the arrival of women anthropologists, things are starting to change, "says researcher Maria Teixeira, who is currently leading the first French anthropological study on precocious puberty and its social representation with girls aged 6 to 8 years.
On the side of the public authorities, we also try to take the measure of the problem. For a year, the Institute for Public Health Surveillance (InVS), under the supervision of the Ministry of Health, is conducting from the databases of the Health Insurance a study to evaluate the phenomenon. "The increase in cases of precocious puberty remains a hypothesis that deserves to be watched with attention," says Dr. Joëlle Le Moal, of InVS. Because this surveillance has another stake, of size: to demonstrate a possible link with the problems of environment.
At the dock: pesticides and other chemicals, such as bisphenol or phthalates, used in everyday products, cosmetics, cans or some bottles. Considered as endocrine disruptors, mimicking the action of hormones they would upset our biological clock. "It has been more than twenty years since their harmful effects have been scientifically proven. Yet, nothing is done to protect our health and that of future generations, while there is urgency to act, "says André Cicolella, President of the Environment Health Network, which attributes this inertia of the public authorities to the whole. -power of agribusiness lobbies.
An analysis shared by Professor Sultan, who found that a large proportion of his young patients in Montpellier, grew up in wine regions regularly sprayed with pesticides. As for the young boys exposed, he notes a worrying increase in cases of micropenis. For him, no possible doubt: the health of our children is indeed sacrificed on the altar of financial interests.
