Adulthood as a social construct: Critical discourse analysis of transition preparation consultations for youth with chronic conditions

Background Little is known about how interventions designed to empower youth with chronic conditions operate in natural clinical contexts during the transition from pediatric to adult care. Such interventions may contribute to social learning through discourse about the future, illness, and adolescence, thereby shaping youths’ understandings of identity and empowerment. This study examined how meanings of transition are discursively constructed during Transition Preparation Consultations (TPCs), a structured intervention delivered within the AD’venir transition unit in France for youth with diverse chronic conditions. Methods We conducted a critical discourse analysis of 26 TPCs, focusing on the discursive resources and positioning practices through which youth and physicians constructed meanings of transition. Results TPCs framed transition as a psychological and social process, encouraging youth to develop experiential understandings of illness and identity. Consultations primarily focused on self-management, living with a chronic condition in adulthood, and health maintenance, while discussions were frequently anchored in bodily changes associated with adolescence. Although physicians often adopted pedagogical and dialogic forms of communication, interactions remained largely structured by prescriptive discourses regarding responsibility, self-management, and adult health behaviors. Conclusions Transition programs function not only as organizational interventions but also as discursive spaces in which meanings of illness, responsibility, autonomy, and adulthood are actively produced. Recognizing these processes may support critical reflection and the ongoing refinement of transition practices.