Health Problems

Being Transgender Was Considered a Mental Illness—But That's Finally Changing

In a major step forward, the World Health Organization is no longer categorizing transgender people as having a mental illness. Gender incongruence–also known as gender dysphoria–is now considered a sexual health condition instead.

The change can be found in the WHO’s new International Classification of Disease (ICD-11), released this week. Not all transgender people suffer from gender dysphoria or incongruence, and advocates have expressed concern that the terms medicalize the feelings of the folks who do.

“We had better understanding that this wasn’t actually a mental health condition and leaving it there was causing stigma,” Lale Say, MD, coordinator of the adolescents and at-risk populations team at the WHO, said of moving gender incongruence from a mental health chapter of the ICD to the newly created sexual health chapter. “In order to reduce the stigma while also insuring access to necessary health interventions, this was placed to a different chapter,” Dr. Say continued in a video statement.

The ICD is a database of unique codes for diseases and other health concerns used by everyone from doctors and nurses to researchers, insurance agencies to patient organizations. For that reason, keeping gender incongruence in the ICD-11–but moving it to a different chapter–maintains access to health care like hormones or surgery that some trans people may be seeking.

The WHO hopes this change can help foster acceptance of trans people–and improve their health. “Removing gender incongruence from [the] mental health chapter is expected to reduce stigma and will help better social acceptance of individuals living with gender incongruence,” Dr. Say said in the statement. Reduced stigma can even lead individuals to feel more comfortable seeking health care in the first place, she added.

Homosexuality, which had also been categorized as a mental health condition in earlier versions of the ICD, is now completely gone from the newest edition, Dr. Say said, “based on scientific understanding that there was no clear evidence that this issue needs to be medicalized.” The American Psychiatric Association has also removed homosexuality from its own diagnosis database, the Diagnostic and Statistical Manual of Mental Disorders, but still includes gender dysphoria. We can only hope that the APA follows the WHO’s lead.

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