Transgender identity is classified as a mental health disorder in the world’s main diagnostic manuals. This controversial definition is now being rewritten by a WHO working group. A Mexican study published on the transgender experiences in The Lancet today is being replicated in India, Brazil and South Africa to script a new chapter on conditions related to sexual health.
The first field trial in Mexico supports removing transgender diagnosis from mental disorders chapter within WHO classification of diseases. The study is the first field trial to evaluate a proposed change to the place of the diagnosis within the WHO International Classification of Diseases (ICD).
The research, published in The Lancet Psychiatry today – could well mark a beginning in changing the classification of transgender identity. The study is currently being replicated in India, Brazil, France, Lebanon and South Africa. Led by the National Institute of Psychiatry Ramón de le Fuente Muñiz, involved interviewing 250 transgender people and found that distress and dysfunction were more strongly predicted by experiences of social rejection and violence than by gender incongruence itself.
A major component of the definition of mental disorders is that they are associated with distress and impairment in functioning. The classification of transgender identity as a mental disorder is increasingly controversial. The definition of transgender as a mental disorder has been misused and health care has been denied to this community. A perception has also gained ground that the transgender people should be treated by psychiatric specialists.
According to mental health expert, Dr Vikram Patel the World Health Organisation is currently revising the International Classification of Diseases (ICD)-10 and ICD-11 is expected to be approved in May 2018. The proposal for WHO’s ICD-11 is to remove categories related to transgender identity from the Mental and Behavioural Disorders chapter and place them in a new ICD-11 chapter called Conditions Related to Sexual Health, which is conceptualised as a more medically oriented chapter.
“Stigma associated with both mental disorder and transgender identity has contributed to the precarious legal status, human rights violations and barriers to appropriate care among transgender people,” says senior author Professor Geoffrey Reed, National Autonomous University of Mexico. Very high observed rates of social rejection and violence experienced by the transgender individuals participating in this study suggest a continuing need for legal protection, social policies and family interventions to reduce these experiences,
“The India trial in this context is pertinent as the proposal has been long overdue to remove the definition of transgender identity as a mental disorder,” Patel added.