The Grapevine

Transgender People Are Not Mentally Ill, WHO Says, Changing Classification

Transgender people will no longer be classified as mentally ill by the World Health Organization (WHO). The change was made in the latest update to the ICD-11, their disease classification manual.

“The rationale being that while evidence is now clear that it is not a mental disorder, and indeed classifying it in this can cause enormous stigma for people who are transgender, there remain significant health care needs that can best be met if the condition is coded under the ICD,” stated WHO on their website.

Filed under the title “gender incongruence,” the organization moved it from the mental disorders chapter to the sexual health chapter. Dr. Lale Say, coordinator at the Department of Reproductive Health and Research at WHO, stated the organization now had “a better understanding that this wasn't actually a mental health condition and leaving it there was causing stigma.”

Experts and LGBT groups supported the decision as a step forward in ending discrimination, especially since the ICD-11 is used by health professionals around the world to understand conditions and diagnose patients.

“This is a historic move,” said Sam Winter, a public health professor at Curtin University, Australia. “An end to a classification that was a historical artifact, had little basis in science, and had massive consequences for the lives of trans people.”

Winter also supported WHO's decision to remove “residual” diagnoses related to same-sex attraction, which were used to justify dangerous practices like conversion therapy.

Lou Weaver, transgender programs coordinator for Equality Texas, noted how ending stigma could also encourage individuals to access health care. Before they can begin their medical transition process (which may include hormone replacement therapy or surgery), Weaver explained how trans people often require clearance by health professionals.

“My hope it will remove the mental health 'gatekeepers' that create barriers to trans folks getting the care that they need and want,” he said, adding these barriers essentially take away a person’s ability to make decisions for their own care.

Another major change in the manual was the classification of “gaming disorder” as a mental health condition. This change received more of a mixed reaction from experts as many found it to be premature and lacking in strong scientific evidence.

The new ICD will come into effect in 2022 if approved by the WHO member states. The process will take place when it is presented at the World Health Assembly in May 2019.

While the WHO manual is used by numerous countries around the world, psychiatrists in the United States use an equivalent known as the Diagnostic and Statistical Manual of Mental Disorders or the DSM. Produced by the American Psychiatric Association, the DSM-5 removed the term “Gender Identity Disorder” in 2012 and began using “Gender Dysphoria” instead.