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This article analyses the identity which health care professionals attribute to some of their users. It explores the way this identity definition interferes with the practices of these professionals, in particularly by leading them to not respect the rules they are supposed to apply. The study is led in French Guyana, where this identity definition process takes a peculiar figure: in front of users which should be excluded from the social protection system because they dont́ live in France, work some professionals who, themselves, as Metropolitans, are aware of their own strangeness towards this overseas society. It is in the light of this double otherness – theirs (which they perceive) and their users’ (which is such qualified by the law) – that professionals interpret the rule in order to finally decide to include or not these people into the health system.