ICD-11: Difference between revisions
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====Gender incongruence==== |
====Gender incongruence==== |
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[[Gender dysphoria]] of [[transgender]] people is called Gender incongruence in the ICD-11. In the ICD-10, the group Gender identity disorders ({{ICD10|F64}}) consisted of three main categories: [[Transsexualism]] ({{ICD10|F64.0}}), [[Dual-role transvestism]] ({{ICD10|F64.1}}), and [[Gender identity disorder of childhood]] ({{ICD10|F64.2}}). In the ICD-11, Dual-role transvestism was deleted due to a lack of public health or clinical relevance.<ref name="Reed_et_al._(2016)" /> Transsexualism was renamed Gender incongruence of adolescence or adulthood ({{ICD11|HA60}}), and Gender identity disorder of childhood was renamed Gender incongruence of childhood ({{ICD11|HA61}}). |
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In the ICD-10, the Gender identity disorders were placed in the mental disorders chapter, following what was customary at the time. Throughout the 20th century, both the ICD and the [[Diagnostic and Statistical Manual of Mental Disorders|DSM]] approached transgender health from a [[Psychopathology|psychopathological]] position, as transgender identity presents a discrepancy between someone's [[assigned sex]] and their [[gender identity]]. Since this may cause mental distress, it was consequently considered a mental disorder, with distress or discomfort being a core diagnostic feature.<ref>{{cite journal | vauthors = Drescher J, Cohen-Kettenis P, Winter S | title = Minding the body: situating gender identity diagnoses in the ICD-11 | journal = International Review of Psychiatry | volume = 24 | issue = 6 | pages = 568–77 | date = December 2012 | pmid = 23244612 | doi = 10.3109/09540261.2012.741575 | s2cid = 12805083 | url = https://www.academia.edu/12557295 | quote = Until the middle of the 20th century, with rare exceptions, transgender presentations were usually classified as psychopathological. }}</ref><ref>{{cite journal | vauthors = Cohen-Kettenis PT, Pfäfflin F | title = The DSM diagnostic criteria for gender identity disorder in adolescents and adults | journal = Archives of Sexual Behavior | volume = 39 | issue = 2 | pages = 499–513 | date = April 2010 | pmid = 19838784 | doi = 10.1007/s10508-009-9562-y | hdl = 1871/34512 | s2cid = 16336939 | url = https://www.researchgate.net/publication/38019925 | quote = The DSM has consistently approached gender problems from the position that a divergence between the assigned sex or "the" physical sex (assuming that "physical sex" is a one-dimensional construct) and "the" psychological sex (gender) per se signals a psychiatric disorder. Although the terminology and place of the gender identity disorders in the DSM have varied in the different versions, the distress about one's assigned sex has remained, since DSM-III, the core feature of the diagnosis. | hdl-access = free }}</ref><ref>{{Cite book | first=Anne A. | last=Lawrence | name-list-style = vanc | chapter=Gender Dysphoria | chapter-url=https://books.google.com/books?id=Q8hTDwAAQBAJ&pg=PA634 | editor-first1=Deborah C. | editor-last1= Beidel | editor-first2=B. Christopher | editor-last2= Frueh | date=2018 | title=Adult Psychopathology and Diagnosis | edition=8th | page=634 | publisher=[[Wiley (publisher)|John Wiley & Sons]] | isbn=978-1-119-38360-4 | quote=The World Professional Association for Transgender Health (WPATH), for example, defined {{abbr|GD|Gender Dysphoria}} as "discomfort or distress that is caused by a discrepancy between a person's gender identity and that person's sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics)"}}</ref> In the 2000s and 2010s, this notion became increasingly challenged, as the idea of viewing transgender people as having a mental disorder was believed by some to be stigmatizing. It has been suggested that distress and dysfunction among transgender people should be more appropriately viewed as the result of social rejection, discrimination, and violence toward individuals with [[gender variant]] appearance and behavior.<ref>{{cite journal | vauthors = Robles R, Fresán A, Vega-Ramírez H, Cruz-Islas J, Rodríguez-Pérez V, Domínguez-Martínez T, Reed GM | title = Removing transgender identity from the classification of mental disorders: a Mexican field study for ICD-11 | journal = The Lancet. Psychiatry | volume = 3 | issue = 9 | pages = 850–9 | date = September 2016 | pmid = 27474250 | doi = 10.1016/S2215-0366(16)30165-1 | s2cid = 206196912 | url = https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(16)30165-1/fulltext }}</ref> Studies have shown transgender people to be at higher risk of developing mental health problems than other populations, but that health services aimed at transgender people are often insufficient or nonexistent. Since an official ICD code is usually needed to gain access to and reimbursement for therapy, the WHO found it ill-advised to remove transgender health from the ICD-11 altogether. It was therefore decided to transpose the concept from the mental disorders chapter to the new sexual health chapter.<ref name="Reed_et_al._(2016)" /> |
In the ICD-10, the Gender identity disorders were placed in the mental disorders chapter, following what was customary at the time. Throughout the 20th century, both the ICD and the [[Diagnostic and Statistical Manual of Mental Disorders|DSM]] approached transgender health from a [[Psychopathology|psychopathological]] position, as transgender identity presents a discrepancy between someone's [[assigned sex]] and their [[gender identity]]. Since this may cause mental distress, it was consequently considered a mental disorder, with distress or discomfort being a core diagnostic feature.<ref>{{cite journal | vauthors = Drescher J, Cohen-Kettenis P, Winter S | title = Minding the body: situating gender identity diagnoses in the ICD-11 | journal = International Review of Psychiatry | volume = 24 | issue = 6 | pages = 568–77 | date = December 2012 | pmid = 23244612 | doi = 10.3109/09540261.2012.741575 | s2cid = 12805083 | url = https://www.academia.edu/12557295 | quote = Until the middle of the 20th century, with rare exceptions, transgender presentations were usually classified as psychopathological. }}</ref><ref>{{cite journal | vauthors = Cohen-Kettenis PT, Pfäfflin F | title = The DSM diagnostic criteria for gender identity disorder in adolescents and adults | journal = Archives of Sexual Behavior | volume = 39 | issue = 2 | pages = 499–513 | date = April 2010 | pmid = 19838784 | doi = 10.1007/s10508-009-9562-y | hdl = 1871/34512 | s2cid = 16336939 | url = https://www.researchgate.net/publication/38019925 | quote = The DSM has consistently approached gender problems from the position that a divergence between the assigned sex or "the" physical sex (assuming that "physical sex" is a one-dimensional construct) and "the" psychological sex (gender) per se signals a psychiatric disorder. Although the terminology and place of the gender identity disorders in the DSM have varied in the different versions, the distress about one's assigned sex has remained, since DSM-III, the core feature of the diagnosis. | hdl-access = free }}</ref><ref>{{Cite book | first=Anne A. | last=Lawrence | name-list-style = vanc | chapter=Gender Dysphoria | chapter-url=https://books.google.com/books?id=Q8hTDwAAQBAJ&pg=PA634 | editor-first1=Deborah C. | editor-last1= Beidel | editor-first2=B. Christopher | editor-last2= Frueh | date=2018 | title=Adult Psychopathology and Diagnosis | edition=8th | page=634 | publisher=[[Wiley (publisher)|John Wiley & Sons]] | isbn=978-1-119-38360-4 | quote=The World Professional Association for Transgender Health (WPATH), for example, defined {{abbr|GD|Gender Dysphoria}} as "discomfort or distress that is caused by a discrepancy between a person's gender identity and that person's sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics)"}}</ref> In the 2000s and 2010s, this notion became increasingly challenged, as the idea of viewing transgender people as having a mental disorder was believed by some to be stigmatizing. It has been suggested that distress and dysfunction among transgender people should be more appropriately viewed as the result of social rejection, discrimination, and violence toward individuals with [[gender variant]] appearance and behavior.<ref>{{cite journal | vauthors = Robles R, Fresán A, Vega-Ramírez H, Cruz-Islas J, Rodríguez-Pérez V, Domínguez-Martínez T, Reed GM | title = Removing transgender identity from the classification of mental disorders: a Mexican field study for ICD-11 | journal = The Lancet. Psychiatry | volume = 3 | issue = 9 | pages = 850–9 | date = September 2016 | pmid = 27474250 | doi = 10.1016/S2215-0366(16)30165-1 | s2cid = 206196912 | url = https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(16)30165-1/fulltext }}</ref> Studies have shown transgender people to be at higher risk of developing mental health problems than other populations, but that health services aimed at transgender people are often insufficient or nonexistent. Since an official ICD code is usually needed to gain access to and reimbursement for therapy, the WHO found it ill-advised to remove transgender health from the ICD-11 altogether. It was therefore decided to transpose the concept from the mental disorders chapter to the new sexual health chapter.<ref name="Reed_et_al._(2016)" /> |
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