Breaking News ICD-11 We Are No Longer A Mental Health Condition

We have long wanted Gender Dysphoria moved out of the mental health classifications and moved to medical classification now it has happened!

Gender incongruence has been moved sexual health conditions.
WHO releases new International Classification of Diseases (ICD 11)
18 June 2018 ¦ Geneva: The World Health Organization (WHO) is today releasing its new International Classification of Diseases (ICD-11).

The ICD is the foundation for identifying health trends and statistics worldwide, and contains around 55 000 unique codes for injuries, diseases and causes of death. It provides a common language that allows health professionals to share health information across the globe.

“The ICD is a product that WHO is truly proud of," says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “It enables us to understand so much about what makes people get sick and die, and to take action to prevent suffering and save lives."

ICD-11, which has been over a decade in the making, provides significant improvements on previous versions. For the first time, it is completely electronic and has a much more user-friendly format. And there has been unprecedented involvement of health care workers who have joined collaborative meetings and submitted proposals. The ICD team in WHO headquarters has received over 10 000 proposals for revisions.


ICD-11 will be presented at the World Health Assembly in May 2019 for adoption by Member States, and will come into effect on 1 January 2022. This release is an advance preview that will allow countries to plan how to use the new version, prepare translations, and train health professionals all over the country.
[…]
The new ICD also includes new chapters, one on traditional medicine: although millions of people use traditional medicine worldwide, it has never been classified in this system. Another new chapter on sexual health brings together conditions that were previously categorized in other ways (e.g. gender incongruence was listed under mental health conditions) or described differently. Gaming disorder has been added to the section on addictive disorders.

On another WHO webpage…

Gender incongruence, meanwhile, has also been moved out of mental disorders in the ICD, into sexual health conditions. The rationale being that while evidence is now clear that it is not a mental disorder, and indeed classifying it in this can cause enormous stigma for people who are transgender, there remain significant health care needs that can best be met if the condition is coded under the ICD.

What does this mean to us?

I am not an expert but to me it seems to me that this is where we want gender incongruence to be located and they created a new section; sexual health. We need it somewhere in the ICD so we can get our meds, therapy, and surgery covered by insurance.

According to a 2015 paper we will be grouped with…

According to ICD dimensions/criteria, the following concepts related to sexual health can be measured and reported:
Sexual dysfunctions
Female genital mutilation
Gender incongruence
Sexually transmitted infections
Violence against women
Unwanted pregnancy
Induced abortion
[…]
Gender Incongruence
Many proposals from multiple stakeholders have supported the process of the reconceptualization of the ICD-10 categories related to gender identity, currently classified in ICD-10 as Mental and Behavioural Disorders.19The ICD-10 categories “Trans-sexualism” and “Gender Identity Disorder of Childhood” have been proposed to be re-conceptualized in ICD-11 as ‘Gender Incongruence of Adolescence and Adulthood’ and ‘Gender Incongruence of Childhood’, respectively. Other categories related to gender identity in the ICD-10 (e.g., ‘Dual Role Transvestism’) have been recommended for deletion. TheICD-11 proposal defines “Gender Incongruence of Adolescence and Adulthood” as “a marked and persistent incongruence between an individual’s experienced gender and the assigned sex, generally including dislike or discomfort with primary and secondary sex characteristics of the assigned sex and a strong desire to have the primary or secondary sex characteristics of the experienced gender. As per suggested criteria, the diagnosis cannot ever be assigned prior to the onset of puberty. Gender Incongruence of Adolescence and Adulthood often leads to a desire to ‘transition’, in order to live and be accepted as a person of the experienced gender. Establishing congruence may include hormonal treatment, surgery or other health care services to make the individual’s body align, as much as desired and to the extent possible, with the experienced gender.

One of the biggest changes to these categories has been acceptance of the proposal to be moved out of the “Mental and behavioural disorders” chapter. Of the available options for the placement of this category, considering the goals of supporting access to health care services, reducing stigmatization, affirming human rights, and ensuring the depathologization of the diagnosis, the best option appeared to be to include them in the new chapter on “Conditions related to sexual health”, though with awareness of the important distinctions between sexuality and gender identity. These categories are important to the notion of sexuality as defined by WHO, as gender identity and roles, among the many dimensions that may influence or interact with a person’s sexuality. 

On the GID Reform Weblog by Kelley Winters guess blogger Sam Winter enumerates what is wrong with ICD-11

As most visitors to the GIDReform Advocates site will know, the World Health Organization (WHO) diagnostic manual (commonly known as the International Classification of Diseases) is currently under revision. The new edition, ICD-11, is slated for approval in 2017. I was a member of the WHO Working Group on Sexual Disorders and Sexual Health (WGSDSH), the eleven-member group which proposed a number of revisions relevant to trans people. The original WHO plans, for all our proposals to be loaded in October 2012 onto a website, for all the world to see (and comment on), never happened. Indeed, the WHO Secretariat running the show have imposed, apparently as it suits them and somewhat inconsistently, fairly onerous confidentiality rules which have prevented WGSDSH members and others from openly sharing what is going on. That said, WHO has shown itself to be comfortable with releasing material from time to time, particularly at academic conferences, as well as in the odd journal article.
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The arguments for GIC (commonly that it is needed to justify the existence of specialist clinics, for training purposes, to generate research) really don’t stand up to scrutiny. Worse, the GIC case was entirely undermined by the fact that we (WGSDSH and WHO) were making entirely different proposals in regard to young people exploring (and learning to become comfortable expressing) their sexual orientation. The proposal was that disease diagnoses for these individuals should be removed. And yet here we were, proposing a disease diagnosis for young children exploring (and learning to become comfortable expressing) their gender identity. It seemed to me that there was a hypocrisy at play, and a transphobic hypocrisy at that.

He goes on to list the reasons why children should not be diagnosed with gender incongruence

1. The view of gender-different children as sick and in need of health care is a culturally-specific one, not only modern but also peculiarly Western in origin.
2. Gender-different children have no need of hormones or surgery, or any other somatic gender health care. Insofar as they may benefit from any health care services at all (and an indeterminate number may not need it) their needs are focused on accessing counseling and (perhaps) other mental health care.
3. There is a grave inconsistency in the way the Working Group proposes to address the health care needs of (on one hand) gay and lesbian youth and (on the other) gender-different children.
4. There are important implications for the prospects of removing the proposed gender incongruence diagnoses from Chapter 5 [Mental and Behavioural Disorders].

[…]
A more detailed proposal for using ICD-11 Z Codes to facilitate access to support services for trans and gender different children was developed at the GATE (Global Action for Trans* Equality) Consensus Meeting in Buenos Aires, April 2013.1920 It recommended revisions to include gender identity, gender expression as well as sexual orientation in codes:

• Z60.4- “Exclusion and rejection on the basis of personal characteristics…”
• Z60.5- “Persecution or discrimination, perceived or real, on the basis of membership of some group…”
• Z70.4- “Counseling for a child to support gender identity or expression that differ from birth assignment.”
• Z70.2x- “Counseling for families and service providers related to gender identity or expression of a child.”

Importantly, where a child is genuinely suffering from anxiety and mood disorders associated with gender difference, Z Codes can be used to specify the nature of the distress, thereby enabling appropriate health care for the child involved. Further, when a child reaches puberty and is in need of puberty blockers (where they are available), Z Codes can be used to document a history of gender difference, thereby ensuring a prompt diagnosis of GIAA.21 Finally, when a gender-different child seeks adaptation at school (or elsewhere) to accommodate his or her gender difference, Z Codes can be used to provide a basis for the case being made.

So there is some disagreement about some of the parts of the changes to the ICD practically with gender incongruence in children.

However, we still have a long time to wait for the change to become effective, almost two years but hopefully the DSM will follow suit and take us out of it.

Many thanks to all that have worked toward this goal.