World Health Organisation removed gender dysphoria as a medical classification - what does this mean for law and policy?

[FindTheTruth]

The World Health Organisation (WHO) updated it's International Classification of Diseases in ICD-11. WHO/Europe brief – transgender health in the context of ICD-11 renaming "gender identity disorders" as "gender incongruence". And listing it under "sexual health", instead of "mental disorders".

what does this mean for law and policy?

I can empathise trans people not wanting to be called mentally ill, so it’s good for them.

What’s worrying about the WHO summary is that it doesn’t acknowledge that there are people with gender dysphoria who are NOT transgender.

What about people who will become desisters, de-transitioners? People going through rapid onset dysphoria ROGD? Children who present for many other reasons? - parents who say “thank god they’re not gay”? What about under 18’s confused by what they’ve seen online and at school?

Also....where does it leave medical professionals who want better standards of care for kids with gender dysphoria. This WHO statement only mentions gender-affirmative health care.

The WHO changed it in May 2019 but I only found out about this today as . . .

24 Sep 2020: In the House of Commons, Labour MP Moyle said Gov must “comply with the World Health Organisation’s requirement that by 2020 we remove gender dysphoria as a medical classification, seeing as the GRA is based on that medical classification”. Liz Truss answered that this is a matter for medical clinicians. Will that be the end of the argument?

I think there was a thread about this at the time. But it is puzzling that a condition that can require a significant amount of medical, and often surgical,intervention would not require a medical classification.

I don't think it will mean much for law and policy. It's a sop.

It appears to have been all about 'reducing stigma' - because having a mental health condition is of course terrible and shameful

They make reference to 'scientific evidence' a couple of times but don't present any. The video says it wasn't changed just in response to pressure groups but was also approved by a panel of experts. That list of names would be very interesting.

It's still dual listed under '06 Mental, behavioural or neurodevelopmental disorders' and '17 Conditions related to sexual health'.

Interestingly, 'Paraphilic disorders' are also dual listed under those headings and a diagnosis of one of the paraphilic disorders excludes you from a diagnosis of gender incongruence.

The paraphilic disorders include: 6D30 Exhibitionistic disorder; 6D31 Voyeuristic disorder; 6D32 Pedophilic disorder; 6D33 Coercive sexual sadism disorder; 6D34 Frotteuristic disorder; 6D35 Other paraphilic disorder involving non-consenting individuals.

This is one reason why it was very important to keep the requirement for a diagnosis in the GRA, regardless of what it is called.

My impression is that TRAs would prefer gender dysphoria / gender incongruence not to be listed at all ('being trans is not an illness!') but then there would be no funding for all those surgeries and hormones.

What a dilemma!

So it hasn't been removed from the ICD really, just renamed and moved (kind of).

How can it be classifed under sexual health?!!

Anyhow here is the earlier thread www.mumsnet.com/Talk/womens_rights/3400380-WHO-International-Classification-of-Diseases

No, homosexuality has been removed altogether, as it should be.

Conditions related to sexual health include:

• Hypoactive sexual desire dysfunction
• Female sexual arousal dysfunction
• Male erectile dysfunction
• Anorgasmia
• Ejaculatory dysfunctions
• Sexual pain-penetration disorder

It's not clear why they think it's less stigmatising and more appropriate to include 'gender incongruence' with these conditions than with mental health conditions

The 'treatment' for gender incongruence frequently causes the above conditions though.

I suppose the 'Ace Community' could object to 'Hypoactive sexual desire dysfunction' being included but apart from that there isn't anything in there related to sexuality (unless you count paraphilias).

If it's classified as a sexual disorder, presumably it can't apply to children.

Apropos of nothing, where would fetishes go?

In the ICD I mean

What a dilemma!

Yes!

@Antibles

Apropos of nothing, where would fetishes go?

These are the paraphilic disorders mentioned above. They are dual listed under mental health and sexual health.

They only count as a disorder if they involve a lack of others' consent (including ability to consent), cause marked distress for the individual or significant risk of injury or death.

You can browse the ICD here:

icd.who.int/browse11/l-m/en

Doh thank you! I should have read the thread properly.

@OldCrone

If it's classified as a sexual disorder, presumably it can't apply to children.

That's a really good point. Just read the ICD doc again and did some research, looks like several bodies are arguing for the removal of this for children given they have no need for medical or sexual health treatment such as hormone therapy. Their primary need is access to support, counselling and information and Can access these care pathways already without a new classification ( same as any child presenting with depression or anxiety).

This would go a long way to preventing affirming treatment for children.

@OldCrone

If it's classified as a sexual disorder, presumably it can't apply to children.

icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f344733949

I just noticed that moving gender incongruence to conditions of sexual health puts it in the same category as FGM (also dual listed under 'Other conditions of the genitourinary system').

I have very mixed feelings about this.

It's not clear why they think it's less stigmatising and more appropriate to include 'gender incongruence' with these conditions than with mental health conditions

Institutional capture, what 'evidence' do they have beyond bogus self-reporting studies and TRA insistence? Basically nothing.

What about people who will become desisters, de-transitioners?

Detransitioners urgently need their health conditions included in the ICD. It doesn't particularly matter where - all sorts of politics plays out in the various classifications, renaming, moving and dual listing - but if it's not in there at all it will get no funding and nobody is monitoring it.

Suggested categories:

Iatrogenic disorders of the gonadal homone system
Iatrogenic mood disorders
Iatrogenic anxiety disorders
Iatrogenic neurocognitive disorders
Other iatrogenic mental disorders
Iatrogenic osteoporosis
Iatrogenic disorders of the female genital tract
Iatrogenic infertility (male and female)
Iatrogenic acquired absence of breast
Iatrogenic absence of genital organs (male and female)

etc.

I'm not holding my breath.

Going through the list to consider it regards to my childhood to see if it applies...

It includes a strong desire to be a different gender than the observed assigned sex;

Check

a strong dislike on the child’s part of his or her sexual anatomy or anticipated secondary sex characteristics

Check

and/or a strong desire for the primary and/or anticipated secondary sex characteristics that match the experienced gender;

Check

and make-believe or fantasy play, toys, games, or activities and playmates that are typical of the experienced gender rather than the assigned sex.

Check

The incongruence must have persisted for about 2 years.

Check

Gender variant behaviour and preferences alone are not a basis for assigning the diagnosis.

WTF is that supposed to mean? How would you be able to tell the difference without applying adult perspective, a far outlier from a child's mind?

This does not sit well with me - these symptoms can be caused by different early life or recent traumas. I wasn't born hating myself; I was taught to hate myself (sex and mind) through abuse (and I expect same for many based on psych research). The childhood development psychology classes I took made this crystal clear - children are blank canvases they become what they see... they only know what they observe (five senses) and are actively taught. How they express those 'lessons' and observations depends on many variables ranging from home ecosystem to culture etc.

With so many children experiencing performative love instead of actionable love it makes sense they would express performative behaviors. Example: children being forced to express love physically to anyone i.e. hugs/kisses/snuggling things that may seem benign can really violate a child's ability to form and enforce personal boundaries.

TLDR; these symptoms may be indicators which a child may apply as a coping mechanism(s) signaling the presence of certain childhood development issues and/or traumas (related or not to development issues mental or physical) that must be discovered however laborious to help a child to achieve stability and not hidden under an umbrella.

@LangClegsInSpace

What about people who will become desisters, de-transitioners?

Detransitioners urgently need their health conditions included in the ICD. It doesn't particularly matter where - all sorts of politics plays out in the various classifications, renaming, moving and dual listing - but if it's not in there at all it will get no funding and nobody is monitoring it.

Suggested categories:

Iatrogenic disorders of the gonadal homone system
Iatrogenic mood disorders
Iatrogenic anxiety disorders
Iatrogenic neurocognitive disorders
Other iatrogenic mental disorders
Iatrogenic osteoporosis
Iatrogenic disorders of the female genital tract
Iatrogenic infertility (male and female)
Iatrogenic acquired absence of breast
Iatrogenic absence of genital organs (male and female)

etc.

I'm not holding my breath.

Fantastic so much this!

Three checks for me too, Fire.

If we completely ignore the feminist analysis of sexual violence and trauma, my make-believe habits as a child would indicate I was an adult male trapped in a female child's body. GoT-level sexualised violence among my Sylvanian families was rampant. Once upon a time (briefly, at least) this would have been taken as an indication of trauma. Then it became an indicator that I needed hormones and surgery. Now we're expected to accept that there's nothing wrong at all and I should have been encouraged and affirmed in my compulsive re-enacting of trauma.

So much bollocks.

Detransitioners urgently need their health conditions included in the ICD ...

good post and suggested categories @FireUnderTheHand

if there are any WHO ICD petitions/ campaigns/ crowd funders I'd like to know

paraphilic, Voyeuristic, Pedophilic, Coercive sexual sadism etc disorders

OMG

This is one reason why it was very important to keep the requirement for a diagnosis in the GRA, regardless of what it is called.

thanks @LangClegsInSpace

Why all the suicide stats then? Seems to be pretty significant marker of poor mental health on which arguments are made for transitioning . Seems very contradictory.