The World Health Organisation (WHO) has voted to adopt new diagnostic guidelines that no longer classify gender nonconformity as a mental disorder.
The changes were first announced last year and officially adopted on May 25, 2019.
In the latest edition of WHO’s International Classification of Diseases, the ICD-11, "gender incongruence" is classified as a sexual health condition instead of its previous classification as a gender identity disorder in the mental and behavioural disorders chapter.
According to the ICD-11, gender incongruence is "characterized by a marked and persistent incongruence between an individual’s experienced gender and the assigned sex.”
Dr Lale Say, coordinator of WHO's Adolescents and at-Risk Populations team says "It was taken out from mental health disorders because we had a better understanding that this was not actually a mental health condition, and leaving it there was causing stigma.”
"So in order to reduce the stigma, while also ensuring access to necessary health interventions, this was placed in a different chapter."
Many governments around the world use the outdated ICD classification as the basis for discriminatory policies that require a mental health diagnosis and sometimes other medical procedures before transgender people can be legally recognized.
According to Transgender Europe, 36 countries in Europe and Central Asia require a mental health diagnosis before adapting identity documents and 16 countries still require sterilisation of trans people seeking recognition of their legal gender recognition.
GATE, a group of Nine organisations working on gender identity, said in a joint statement that the ICD-11 reclassification is "a temporary and imperfect solution to the needs of those trans and gender diverse people who require access to specific healthcare (e.g. surgeries and hormones) under health systems that otherwise will exclude them.”
“It has taken us a long time to get here. Until a few years ago, removing pathologizing categories affecting trans and gender diverse people from the ICD-10 list of mental disorders seemed impossible. Today, we know that full depathologization can be achieved and will be achieved in our lifetime,” they said.
UN Member States are responsible for making changes to their national policies based on the new classification, and have a deadline of January 2022 to do so.
Graeme Reid, lesbian, gay, bisexual, and transgender (LGBT) rights director at Human Rights Watch, said “The WHO’s removal of ‘gender identity disorder’ from its diagnostic manual will have a liberating effect on transgender people worldwide.”
“Governments should swiftly reform national medical systems and laws that require this now officially outdated diagnosis.”
“Transgender people are fighting stigma and discrimination that can be traced in part to medical systems that have historically diagnosed expressions of gender non-conformity as a mental pathology."
“But it’s the stigma, discrimination, and bullying – and not anything inherent in gender nonconformity – that can inflict mental health problems in transgender people.”
Whilst transgender activists are relatively happy with the ICD-11 reclassification, intersex organisations are condemning WHO for classifying variations in sex development as "disorders of sex development."
Dan Christian Ghattas, Executive Director of OII Europe, (Organisation Intersex International Europe) said in a statement that “OII Europe welcomes the positives changes that the ICD-11 makes in regards to trans people. Removing trans identities from the mental health chapter is an important and overdue step."
“However we are very concerned that WHO has let the chance pass to depathologise intersex people and hence to work towards decreasing human rights violations intersex people face in medical settings.”