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Beyond Depathologization: Securing the Right to Health for Trans Communities 

It has been 7 years since the World Health Organization depathologized trans identities in the International Classification of Diseases – 11th Edition, yet trans and gender diverse communities still face higher levels of discrimination in healthcare than ever before. A declaration on paper means little when health systems are built around profit and the exclusion of minorities.

  • Published
  • 17 October 2026
International Day for Trans Depathologization GATE logo
© International Day for Trans Depathologization

Saturday 17 October – International Day of Action for Trans Depathologization

We all have the right to health. But when communities are pathologized and criminalized, the impact goes beyond basic access to healthcare. It leads to broader exclusion from day-to-day life, including access to safe housing, education and employment, which has a knock-on effect on overall mental and physical well-being. 

Although the World Health Organization depathologized trans identities 7 years ago, most trans people have yet to see the benefits of this groundbreaking decision. While the WHO can issue guidance, it remains the responsibility of governments to adopt and implement them. Unfortunately, after decades of depathologization activism, most countries are still lagging behind in the implementation of ICD-11 and its adoption into national processes and guidelines.

There are two critical intersecting issues that need to be addressed: access to legal gender recognition and access to healthcare. The first is a key determinant in ensuring basic access to healthcare. Identity documents that match a person’s gender identity are a precondition for dignified care, having an impact not only on healthcare access but also on the quality of care, as mismatched documents often lead to discrimination and humiliation from health workers. When people face discrimination, their general response is to avoid that situation in order to protect themselves. This is as true for trans people as it is for anyone else. In countries where trans people are criminalized, this becomes a barrier that prevents healthcare access altogether. Therefore, when considering the issue of depathologization, we also have to consider what other barriers might be impacting not only a person’s access to healthcare, but their right to health and well-being more broadly.

The OHCHR defines the right to health as including not only access to timely and appropriate health care, but also underlying determinants of health, including safe housing, food and water, a healthy environment, and access to health-related information. When communities are criminalized or denied access to legal gender recognition, they end up facing discrimination not only in healthcare but in employment, education, housing, and sometimes even extending to their ability to move safely and freely in public. 

There is another aspect to depathologization that has far-reaching implications but which is much harder to measure, and that is the social stigma that comes with being viewed through a pathologized lens. Trans communities are not unique in this respect, as many communities face discrimination on a similar basis, but what is unique to trans communities is the coordinated and deliberate attacks on our very existence at the hands of the anti-gender movement. Never have trans communities been more visible, and never have we been more targeted than we are now. 

So what can we do about it?

The power and influence of the anti-gender movement is a critical factor here. We can only counter it by building collective power, uniting against hate, and organizing within and across communities to push for justice, inclusion and equality.  

There are key actions governments can take to move towards depathologization:

  • Decriminalization of trans communities. A criminalized person cannot safely access healthcare without risking arrest and detention. In particular, governments should work towards repealing colonial-era laws that criminalize trans communities
  • Access to legal gender recognition. Without identity documents that reflect a person’s gender identity, they face discrimination and sometimes outright refusal to healthcare services. This should be guaranteed to all citizens.
  • Provision of gender-affirming healthcare. Universal health coverage should ensure healthcare that is free at the point of use and accessible to all. In general healthcare, this means providing an experience that affirms a person’s gender identity through the use of their correct name and pronouns and providing access to healthcare that is non-discriminatory and equitable. In transition-related healthcare, it means providing access to both surgical and non-surgical interventions through an informed consent model that is both affordable and accessible.

In the vast majority of countries around the world, the third point seems like a pipe dream without the first two. We need to start considering the entire ecosystem that impacts the overall experience of a person, centering their humanity as a primary consideration, and reminding ourselves that, at the heart of the matter, is a person who is just trying to live their life to the fullest. Isn’t that what we all want?