WHO: Transgender Identity is Not a Mental Disorder

In a massive step for global trans rights, the World Health Organization (WHO) has declassified transgender identity by removing “gender identity disorder” (GID) from its diagnostics manual.

First announced last year, equality activists say the change has been a long time in coming and could be a significant help to the push for global recognition that being transgender is not an illness.

“The WHO’s removal of ‘gender identity disorder’ from its diagnostic manual will have a liberating effect on transgender people worldwide,” Graeme Reid, LGBT rights director at Human Rights Watch, said in a press release. “Governments should swiftly reform national medical systems and laws that require this now officially outdated diagnosis.”

The change, which WHO finalized at the World Health Assembly on May 25, 2019, means that the International Classification of Diseases (labelled ICD-11 for this latest addition) no longer contains diagnostic criteria for “gender identity disorder”. Instead, it reframes the diagnosis as “gender incongruence”. Furthermore, WHO has also added the term “gender nonconformity” to the text on sexual health, rather than listing it under mental disorders as in previous versions of the diagnostics manual.

These changes might sound trivial, but to understand why they are important we first need to know a little bit more about the International Classification of Diseases and its relationship to trans health.

Over 194 member states use WHO’s ICD as either the basis for or as a supplement to how doctors diagnose patients. The notion of Gender Identity Disorder dates back as far as the 1950s and was adopted in diagnostic manuals to encompass a range of identities and behaviors. This carried its own problems, because it has meant that trans identity has been confused with sexual fetishist behavior.

There is, of course, nothing wrong with sexual exploration outside of what is arbitrarily considered mainstream, but it is not the same as being trans. This link has created unfortunate misconceptions about trans identity that persist even now and can be used to marginalize and discriminate against trans people.

A more recent problem with the term GID builds on previous issues with medicalizing trans identity. It has become a barrier to trans people accessing gender affirmation care.

In many countries, before a trans person can begin gender affirmation, they have to undergo an intrusive psychological evaluation and diagnosis of GID. This treats being trans itself as a disorder—for which there is no evidence. Instead, we know that gender identity and birth-assigned sex incongruence, though not considered widespread, is a normal part of human gender expression.

Conflating trans identity with mental health issues is harmful, and the GID diagnosis often comes with a number of, to be frank, terrible riders. In several countries, a diagnosis of GID would put trans people on the pathway of affirmation care but would also require them to be sterilized in order to officially “complete” their affirmation.

Human Rights Watch recently released the following video about compelled sterilization in Japan:

Such coercion is a violation of international human rights laws that WHO allowed to persist for far too long. The change from GID to gender incongruence is one way in which we may now close that deeply harmful chapter of our history.

This change also brings the WHO’s ICD in line with other key medical standpoints. For example, the American Psychiatric Association now uses the term gender dysphoria rather than GID.

It is not without its compromises however.

As activists readily point out, few people in the West in particular will be racing to accept the term “gender incongruence”, however this is not meant to frame a new way of looking at gender. Instead, it is a neutral term to enable people in less progressive countries to access healthcare and affirmation that may otherwise have been denied them if the term was more overtly linked to LGBT rights language.

Of course, this progress further emphasizes just how regressive the Trump administration’s push to systematically roll back trans rights is. The recent announcement that health care providers should be able to refuse trans people access to care and that federal health insurance should not cover affirmation related care for trans and gender non-binary people are particularly backward-thinking.

It will take a few years for the changes to ICD-11 to filter down into official clinical guidelines at the national level, but activists are keen to keep the pressure on and raise awareness of these changes so that trans people in the US and around the world are one step closer to being given the dignity and duty of care they deserve when accessing vital health services.

Photo credit: Getty Images.

49 comments

Chad Anderson
Chad Anderson4 hours ago

Thank you.

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Lizzy Q
Lizzy Qyesterday

many thanks

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Lizzy Q
Lizzy Qyesterday

many thanks

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Amparo Fabiana C

Thanks. No, is not. And religious families and heterosexuals are going to continue pro-creating. Don't worry, be happy. Let them be too.

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Knud T
Knud Thirup12 days ago

Noted

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Ganaisha Calvin
Ganaisha Calvin12 days ago

Imposing identities on others sounds more like a disorder than claiming your own

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Elaine W
Elaine W14 days ago

wonderful Post . thanks.

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Diane E
Diane E14 days ago

Thanks. People come with many characteristics. All humans deserve dignity and respect. People may have different needs but all human rights are equal.

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Hannah A
Hannah A14 days ago

thanks for sharing

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Lisa M
Lisa M14 days ago

Thanks.

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