Being Trans Officially Not a Mental Illness, World Health Group Says

In a move that stands to benefit transgender people around the world, the World Health Organization will no longer classify gender nonconformity as a mental illness.

The World Health Assembly, the governing body for WHO, which is the United Nations’ health agency, voted Saturday to change “gender identity disorder” to “gender incongruence” in its diagnostic manual and to move the term from the listing of mental disorders to the section on sexual health, according to a press release from Human Rights Watch. The manual, the International Classification of Diseases, is used by health care providers around the world, and the governing body represents 194 member countries.

The WHO had released the newest edition of the ICD, the 11th revision, last year to give member countries time to plan for implementation of the changes. The vote Saturday was for approval of the entire edition.

It remains up to each country to update laws to that reflect the old definition, as in some countries a diagnosis of “gender identity disorder” is a prerequisite for transition-related medical care or for changing gender markers on legal documents.

“The WHO’s removal of ‘gender identity disorder’ from its diagnostic manual will have a liberating effect on transgender people worldwide,” said Graeme Reid, lesbian, gay, bisexual, and transgender rights director at Human Rights Watch, in the press release. “Governments should swiftly reform national medical systems and laws that require this now officially outdated diagnosis.” The legal recognition of one’s gender identity should be separate from any medical intervention, HRW added.

“When you have a system that sets up someone’s very existence and identity in a diagnosis as a mental health condition, that feeds an enormous amount of stigma and drives people away,” Kyle Knight, a researcher in HRW’s LGBT rights program, told Time. “We have interviewed transgender people in Japan, Kazakhstan, Ukraine, and Indonesia, to name a few countries, and they don’t even want to begin to undergo the process of legal recognition because it requires them to go see a psychiatrist who will tell them they have a so-called mental disorder; something that they don’t feel corresponds with their own reality. People don’t feel like their gender identity is something diagnosable or needs a diagnosis.”

The WHO’s move follows a similar one by the American Psychiatric Association, which in 2012 changed its Diagnostic and Statistical Manual to replace the term “gender identity disorder” with “gender dysphoria,” defined as emotional distress over “a marked incongruence between one’s experienced/expressed gender and assigned gender.”  

“Transgender people are fighting stigma and discrimination that can be traced in part to medical systems that have historically diagnosed expressions of gender nonconformity as a mental pathology,” Reid added in the release. “But it’s the stigma, discrimination, and bullying — and not anything inherent in gender nonconformity — that can inflict mental health problems in transgender people.”

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