In a landmark decision, the World Health Organization has removed gender identity disorder from its list of mental health diagnoses.Now called “gender incongruence,” it will be classified as a “condition related to sexual health.”Gender identity disorder is a condition in which someone’s gender identity does not align with their assigned sex at birth.“To move away from the language of ‘disorder’ towards ‘incongruence’ recognizes that a particular assignment doesn’t fit who someone has grown into,” said Jacq Hixson-Vulpe, a senior consultant at Toronto-based LGBTQ+ service centre The 519.“Hopefully, this change in language will continue to expand our notions of sex and gender to recognize that relying on these as fundamental markers of humanity is inaccurate and limiting.”The condition’s status has been updated in the eleventh revision of the International Statistical Classification of Diseases and Related Health Problems, a document that WHO says “defines the universe of diseases, disorders, injuries and other related health conditions.”The latest version of the document was approved earlier this week by the World Health Assembly, WHO’s decision-making body, and effectively declassifies the condition as a mental disorder.Previously, it was defined as a “disorder, usually first manifest during early childhood (and always well before puberty), characterized by a persistent and intense distress about assigned sex, together with a desire to be (or insistence that one is) of the other sex.”WHO first announced this change last summer, saying the classification of gender identity disorder as a mental disorder was inaccurate and stigmatized those experiencing gender incongruence.
Cotton candy is given away during the annual Pride Festival on July 3, 2016 in Toronto.
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Many major psychiatric bodies, including the American Psychiatric Association, have eliminated “gender identity disorder” from their lexicon, opting to use the term “gender dysphoria” instead.In Canada, gender dysphoria continues to be classified as a mental disorder. Gender-confirming surgery is currently covered by most provincial health insurance plans, but provinces such as Ontario require at least two letters from medical professionals or social workers confirming that an individual has “a diagnosis of persistent gender dysphoria.”Dr. Kenneth Zucker is the former chair of the DSM-5 Workgroup on Sexual and Gender Identity Disorders. Zucker says the change could present challenges to mental health professionals attempting to diagnose and treat those experiencing gender dysphoria.“If it isn’t a mental health diagnosis, what is it,” asks Zucker, who is also a practising psychologist. “No one would want it to be considered a lifestyle and one would be hard-pressed to say it’s a physical mental condition.”The current language and practices also assume that medical professionals have a right to define someoneJacq Hixson-Vulpe
He adds that lifting gender dysphoria from the realm of mental health could force insurers to change the way they cover treatments such as hormones and mastectomies for transgender individuals.Many LGBTQ+ activists are celebrating the move.“Current practices are incongruent with bodily and self-autonomy,” Hixson-Vulpe, who uses they/them pronouns, said in an email to the Post.“The current language and practices also assume that medical professionals have a right to define someone, and we see this definition process starting at birth.”They added that the semantic change in the new edition of the WHO’s list of mental health diagnoses is a step in the right direction.Member states, including Canada, will have until January 2022 to implement the changes.