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On trans depathologization, mental health and stigma: ICD-11 is released

The unfolding news of the World Health Organization removing trans-related categories from the chapter on mental health at the International Classification of Diseases, while a welcome step forward in depathologization of trans identities, makes necessary for us to express our disagreement and discomfort with a rationale made explicit by WHO.

According to the video explaining the introduction of “gender incongruence” in ICD-11, Chapter 17 on Conditions Related to Sexual Health, and also in the poster shared by WHO on its website, removing trans and gender diverse people from the realm of mental health will contribute to “reduce stigma” on the basis of mental disorder.

This affirmation is very problematic for three main reasons:

  • it contributes to naturalize stigma associated with mental health issues,
  • it ignores the reality of trans and gender diverse people with mental disorders, and
  • it erases the historical use of diagnoses to differentiate between “normal”, i.e non-pathologized, and “pathologized” gender identities and expressions.

Identifying with a gender identity that differs from sex assigned at birth and/or expressing one’s gender in a way that contradicts social expectations and norms is not a mental disorder; however, many trans and gender diverse people suffer from different mental disorders, including those caused by systematic transphobic violence within structural cissexist societies. Furthermore, trans people are routinely denied access to gender legal recognition and/or gender affirming healthcare on the basis of their mental capacity. Therefore, mental health issues are our issues too, and removing stigma associated with all forms of mental illness is a top priority for our movement.

We deeply regret WHO reverting to such damaging language, which contributes to stigmatization of mental health issues instead of leading the way with dismantling this stigma. Depathologizing trans and gender diverse issues is a matter of human rights, of justice and of subversion of the gender hierarchies coded in classification systems. We strongly recommend, to allies and journalists covering this historical moment, to frame it without making our communities unwilling accomplices to further stigmatization and discrimination towards people with mental health issues.

In solidarity,

The GATE Team