And it didn’t happen here but across the big pond in Denmark.
Where Transgender Is No Longer a DiagnosisAnd it doesn’t end there,
Denmark becomes the first country to declassify it as a mental disorder
By Francine Russo
January 6, 2017
At the dawn of 2017 the Danish parliament struck a blow for transgender rights and became the first country to remove trans people’s classification as “mentally ill.” In this New Year’s Day move the government took official action to destigmatize transgender individuals, separating them from any association with words such as “problem,” “disorder” or dysphoria.
Words matter, says Linda Thor Pedersen of rights organization LGBT Denmark. “It was very important,” she says, “that terms like “incongruence,” “disturbance” and “problem” were left out of the code title used by the country’s medical community to track care. The change, she says, “makes it a code instead of a diagnosis.” The old system made indirect discrimination possible, she explains; job applications were sometimes rejected because of a “diagnosis.”
The change, although currently limited to Denmark, represents a new phase in the evolution of views on being transgender. An earlier change occurred in 2013, when “gender identity disorder” was dropped from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), U.S. psychiatry’s bible for diagnosing mental illness. A new condition called “gender dysphoria” was added to diagnose and treat those transgender individuals who felt distress at the mismatch between their identities and their bodies. The new diagnosis recognized that a mismatch between one’s birth gender and identity was not necessarily pathological, notes pediatric endocrinologist Norman Spack, a founder of the gender clinic at Boston Children’s Hospital. It shifted the emphasis in treatment from fixing a disorder to resolving distress over the mismatch.*
*Editor's Note (1/11/17): This paragraph was edited after posting. The original stated “gender identity disorder” in the DSM-5 was renamed “gender dysphoria.” In actuality, DSM-5 dropped the former term describing a pathology, and replaced it with the latter classification, which could be used to diagnose distress caused by gender mismatch.
As the brand-new measure takes effect, experts are speculating about its political, medical and financial ramifications in Denmark and around the world. Danish politicians had announced last year that they hoped to spur the World Health Organization (WHO) to remove transgender from a category of mental illnesses in its globally used International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), whose codes are used to mark health records, track epidemiological trends and inform insurance reimbursement. If WHO did not act by January 1, 2017, Denmark had promised to act unilaterally.Hopefully this will lead the way for the WHO to make the changes and spur the APA to take it out of the DSM.