Trans Identity Not Mental Illness, Says World Health Organization

Gender incongruence, otherwise known as gender dysphoria, is no longer classified as a mental illness by the World Health Organization.

The United Nations health agency announced Monday that gender incongruence, which is described as "characterized by a marked and persistent incongruence between an individual's experienced gender and the assigned sex," has been reclassified as a sexual health condition to remove stigma applied to transgender people.

"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," reads a WHO summary of the change.

Other conditions addressed in the newest edition of International Classification of Diseases, or the ICD-11, include sexual dysfunction, changes in genital anatomy, paraphilic disorders, and some sexually transmitted infections.

The European Parliament called on WHO to remove what was then called gender identity disorder from its list of mental illnesses in 2011. The previous edition of the ICD included referred to transgender identity as "transsexualism" under a list of gender identity disorders.

France was the first country to declassify transgender identity as a mental illness, doing so in 2010. The American Psychiatric Association, which had introduced gender identity disorder into its Diagnostic and Statistical Manual in 1980, and reclassified "gender identity disorder" as "gender dysphoria" in 2012. Jack Drescher, an APA subcommittee member who worked on the revision, said at the time that in some cases, a diagnosis like GID helped justify insurance coverage of transition-related medical treatments that might otherwise be dismissed as cosmetic.

However, not all those who advocate for trans people agree. Stop Trans Pathologization, which called on WHO and APA to declassify transgender identity as a mental illness, lists "free access to hormonal treatments and surgery (without psychiatric monitoring)" and "public coverage of trans-specific healthcare" as its objectives, presumably to make such a classification entirely unnecessary.

The ICD-11 also no longer contains a section on psychological and behavioral disorders associated with sexual development and orientation. The ICD-10 noted that homosexuality itself was not a disorder (it was listed as a mental disorder in 1948 and has not had such a classification since the 1970s), but its listing of diagnoses such as "sexual maturation disorder" was criticized for its roots in Freudian theory, which viewed homosexuality as an illegitimate, immature form of sexuality.

The new ICD is subject to approval by WHO's governing body, the World Health Assembly, which meets in 2019.