Political Activism Supplants Medical Evidence in New International Diagnostic Manual

By | June 6, 2019

WASHINGTON, D.C. June 7 (C-Fam) Transgender rights activists are claiming a major victory as the World Health Assembly (WHA) adopted an updated version of its diagnostic manual, removing “transsexualism” from its chapter on mental disorders and putting “gender incongruity” into a newly-created chapter on sexual health.

The proposed manual, called ICD-11 (International Classification of Diseases, 11thedition) was released last year by the World Health Organization (WHO), of which the WHA is the governing body.  However, the reclassification of transgender conditions had been anticipated for years.

News coverage of the change has underscored the fact that it stems predominantly from a rapidly evolving political landscape driven by a wave of transgender activism, not a notable scientific or medical discovery.

Though the manual doesn’t go into effect until the start of 2022, it is already being waved in the faces of lawmakers around the world.  Graeme Reid, the LGBT rights director at Human Rights Watch, stated that “Governments should swiftly reform national medical systems and laws that require this now officially outdated diagnosis.”

For example, some governments require diagnosis of a “gender disorder” before providing legal name and gender changes on official documents.

The ICD-11 moved transgender conditions out of the mental disorders chapter in response to claims by activists that this classification perpetuated stigma.  This argument, perhaps ironically, flies in the face of ongoing efforts to destigmatize mental illness more broadly.  But if being classified as ill is stigmatizing, why would transgender activists want “gender incongruity” to remain in a volume whose title refers to the classification of diseases, even in a different chapter?

As a WHO spokesperson said, “there remain significant health care needs that can best be met if the condition is coded under the ICD.”  In other words, for sex reassignment treatments such as surgery or hormones to be treated as normal health care and not elective procedures, there still needs to be a diagnosable condition.

However, the position of Human Rights Watch and its allies is that “the process for legal recognition of gender identity should be separate from any medical interventions.” Thus, if a diagnosis from a professional is necessary to require insurance or government health services to provide bodily transgender treatments, legal recognition of transgender status should require nothing more than the desire to obtain it.

For all the excitement over the new manual, a coalition of transgender activists is far from claiming victory, referring to the update as a “temporary and imperfect solution.” In addition to describing the term “gender incongruence” as a “pathologizing” and “stigmatizing,” the activists call for the “complete removal of “legal and bioethical gatekeepers,” “normative gender stereotypes,” and, for good measure, “all forms of socioeconomic injustice.”

The activist coalition also calls for the removal of the category of “gender incongruence of childhood,” pointing out that there is not reliable research to distinguish between a child who will continue to experience gender dysphoria and one who may ultimately identify as gay or lesbian.  As such, they argue, the category “amounts to a re-pathologization of homosexuality.”

Not mentioned in their statement, but widely reported elsewhere, is the fact that the majority of children who experience gender dysphoria “desist,” or go on to accept their bodies, by the time they reach adulthood.