Will WHO declassify transgender identity as a mental illness?

In the first revision in decades of its global codebook of diseases, the World Health Organization is considering reclassifying transgender identity.

First Look

The World Health Organization, the United Nations' public health agency, is considering removing transgender identity from the mental disorder category in its list of medical conditions.

The list is to be updated for the first time since the 1980s.

The declassification is a hard-won change for LGBT activists, who have waged a decades-long battle to shift perceptions of alternate views of gender identity and sexual orientation.

“All people, including lesbian, gay, bisexual and transgender (LGBT) people, are entitled to enjoy the protections provided for by international human rights law, including in respect of rights to life, security of person and privacy, the right to be free from torture, arbitrary arrest and detention, the right to be free from discrimination and the right to freedom of expression, association and peaceful assembly,” says the WHO.

The update has been approved by all WHO committees that review the proposed changes to the organization’ classification of diseases, which helps determine the treatment of patients worldwide and is necessary for healthcare billing.

The WHO uses transgender as an umbrella term to describe “people whose gender identity and expression does not conform to the norms and expectations traditionally associated with the sex assigned to them at birth.” The organizational lumps it in a section with kleptomania, which is the overwhelming impulse to steal; trichotillomania, a compulsion to pull out one’s own hair; and pedophilia, which is a preference for having sex with children, as STAT points out.

In pressuring the WHO to act, Denmark recently promised to declassify "being transgender" as a mental illness next year.

"It is completely inappropriate to call it a sickness," the parliament health committee's deputy chairman Flemming Moller Mortensen told the Agence France-Presse.

"There is a longstanding wish from the trans community in Denmark to have it removed" from the health ministry's clinical guidelines on illnesses, he added.

In the United States, the categorization of transgenderism and homosexuality has evolved over time alongside public perceptions, as The New York Times reports:

The issue is reminiscent of the change in the way homosexuality was treated in the American bible of psychiatric diagnoses, the Diagnostic and Statistical Manual of Mental Disorders, known as the D.S.M. In 1973, the book, published by the American Psychiatric Association, changed the diagnosis of 'homosexuality' to 'sexual orientation disturbance,' and later to 'ego-dystonic homosexuality' before dropping it altogether in 1987.

Transgender identity has changed in the D.S.M. too, classified under 'sexual deviations' in 1968, 'psychosexual disorders' in 1980 and 'sexual and gender identity disorders' in 1994. In the fifth and most recent edition, D.S.M.-5 in 2013, the designation was changed to 'gender dysphoria,' and was defined to apply to only those transgender people who are experiencing distress or dysfunction, said Dr. Jack Drescher, a psychiatrist and psychoanalyst at New York Medical College, who serves on the W.H.O. working group and served on a similar working group for the D.S.M.-5.