July 18, 2018: In what is a historic announcement for activists, the World Health Organization (WHO) has acknowledged the rights of trans people[1] to have their gender identities without prejudice, persecution or stigma.
A new online version of the International Classification of Diseases version 11 (ICD11) has removed gender identity related diagnoses from the chapter on mental health disorders. Instead, the WHO has created a new set of trans-related diagnostic categories for adults, young people and children. These have been placed alongside physical illnesses, disorders and syndromes in the chapter “Conditions related to sexual health”.[2]
Patients will now receive the diagnosis of ‘Gender Incongruence’, which has three subsections:
· HA60 Gender incongruence of adolescence or adulthood
· HA61 Gender incongruence of childhood
· HA6Z Gender incongruence, unspecified
Effectively ICD11 acknowledges the reality of the experiences of people with trans- gender identities and gender incongruence, and that these are normal human variations. With ICD11, the WHO is signposting a requirement for trans health care to be provided without the added stigma of a mental health diagnosis.
Activists from the global trans community have been demanding these changes for well over twenty years. The medical psychopathologizing of gender incongruence, often based on nothing more than moral and religious indignation, allowed the systematic, institutional and personal abuse of trans people. Research has demonstrated a global, universal experience by trans people of transphobic prejudice, discrimination, harassment, violence, and criminalisation of trans people’s core identities.
The announcement and publication of ICD11 should signal the end for any vestiges of historical, abusive transgender ‘mental health’ practices such as aversion therapy, compulsory sterilisation and enforced hospitalisation.
Julia Ehrt, Executive Director of Transgender Europe, on hearing the announcement said
“This is the result of tremendous effort by trans and gender diverse activists from around the world to insist on our humanity, and I am elated that the WHO agrees that gender identity is not a mental illness.”[3]
Trans people in North America[4] will continue to experience the stigma associated with a mental health diagnosis. In the rest of the world, though, these new diagnostic codes should mean significant, positive changes for all trans people pursuing any health care, including gender-affirming and reassignment treatments.
Details of the WHO ICD11 categorisation of Gender Incongruence can be found here
[1] Trans refers to those people who experience their gender identity as different from that assigned at birth.
[2] World Health Organisation (2018) 11th Revision of the International Classification of Diseases (ICD-11) for Mortality and Morbidity Statistics, Chapter 17 Conditions related to sexual health: Gender Incongruence (Foundation Id : http://id.who.int/icd/entity/411470068) at https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f411470068 , acc. 19/06/2018
[3] Transgender Europe (2018) World Health Organisation moves to end classifying trans identities as mental illness, 18 June, at https://tgeu.org/world-health-organisation-moves-to-end-classifying-trans-identities-as-mental-illness/ acc. 19 June 2018
[4] American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (5th ed.) (DSM-5). Arlington, VA: American Psychiatric Publishing is used, primarily, to code mental health conditions in North America. DSM-5 replaced the previous categories contained under Gender Identity Disorder, to an overarching diagnosis of gender status of a mental health condition
