It took until 1990 for the World Health Organization (WHO) to declassify homosexuality as a mental disorder — following the lead of the American Psychiatric Association and the American Psychological Association, in 1973 and 1975 respectively.
The WHO still officially considers being transgender a mental disorder, but that may soon change.
The organization is preparing its new edition of their global code book, the International Classification of Diseases (ICD). It helps inform national disease diagnostics manuals throughout the world. The ICD-11 will be the first update since 1990, and is expected to be approved in 2018.
Proposals to declassify transgender identity as a mental disorder have been approved by each committee that has considered it so far, reports the Chicago Tribune.
A study published in The Lancet Psychiatry journal last month seems to show that it was the distress caused by discrimination and rejection by friends and family that have caused the epidemic of transgender suicides and depression, not simply being transgender itself.
As the co-author of the study, Geoffrey Reed, a professor of psychology at the National Autonomous University of Mexico, as well as a consultant on the ICD-11, told the Washington Post, a condition is only considered a mental illness when the very fact of having it causes distress and dysfunction. The study argues that this is not the case with transgender identity.
The American Psychiatry Association revised its classification in the DSM-5 in how it speaks of transgender and gender nonconforming individuals. It currently diagnoses transgender people as having “Gender Dysphoria,” instead of the previous designation of “Gender Identity Disorder,” which the WHO still uses.
Gender dysphoria is described as the emotional distress that can result from “a marked incongruence between one’s experience/expressed gender and assigned gender.”
The American Psychological Association has a page on its website called “Answers to Your Questions About Transgender People, Gender Identity and Gender Expression,” which includes the question, “Is being transgender a mental disorder?”
“A psychological state is considered a mental disorder only if it causes significant distress or disability,” it reads. “Many transgender people do not experience their gender as distressing or disabling, which implies that identifying as transgender does not constitute a mental disorder. For these individuals, the significant problem is finding affordable resources, such as counseling, hormone therapy, medical procedures and the social support necessary to freely express their gender identity and minimize discrimination. Many other obstacles may lead to distress, including a lack of acceptance within society, direct or indirect experiences with discrimination, or assault. These experiences may lead many transgender people to suffer with anxiety, depression or related disorders at higher rates than nontransgender persons.
“According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people who experience intense, persistent gender incongruence can be given the diagnosis of ‘gender dysphoria.’ Some contend that the diagnosis inappropriately pathologizes gender noncongruence and should be eliminated. Others argue that it is essential to retain the diagnosis to ensure access to care. The International Classification of Diseases (ICD) is under revision and there may be changes to its current classification of intense persistent gender incongruence as ‘gender identity disorder.’”
Much progress is still needed in the field of transgender and gender nonconforming rights, as the battles in North Carolina over HB2 makes clear. An important step, just like in the fight for LGB rights, is to stop thinking of transgender people as mentally ill and stop inflicting them with the psychological violence that this discrimination has brought into their lives.