Transgender identity should be removed from the ICD classification of mental disorders to increase ‘access to appropriate services’ and reduce ‘the victimisation of transgender people’ according to a study published in Lancet Psychiatry.
Researchers in Mexico found that transgender people largely experience distress as a result of social rejection, rather than as a result of their gender identity.
WHO’s classification of diseases, the latest of which is ICD-10, currently lists ‘transgender identity disorders’ as a mental illness, under the category ‘disorders of adult personality and behaviour’. ICD-10 is what most clinicians in the UK use to diagnose mental disorders.
However, the researchers suggest that gender identity categories should be removed from the ICD classification of mental disorders, as ‘distress and dysfunction, considered to be defining features of mental disorders, were not universal and were found to be more strongly related to experiences of stigmatisation and violence than to gender incongruence’.
This would be ‘a useful instrument in the discussion of public health policies aimed at increasing access to appropriate services and reducing the victimisation of transgender people.’
This is in line with the proposed guidelines for the upcoming ICD-11, which – if implemented – would remove gender incongruence from the classification of mental disorders and put it into a different category on conditions related to sexual health.
The study participants, who were 250 transgender adults receiving healthcare at a specialist centre, often had distress and dysfunction, but this was by no means universal and this was ‘more strongly predicted by experiences of social rejection and violence than by gender incongruence’. This suggests that this distress was caused by ‘stigmatisation and maltreatment rather than integral aspects of transgender identity.’
Lead investigator, Dr Rebeca Robles from Mexican National Institute of Psychiatry said: ’Our findings support the idea that distress and dysfunction may be the result of stigmatization and maltreatment, rather than integral aspects of transgender identity… The next step is to confirm this in further studies in different countries, ahead of the approval of the WHO revision to International Classification of Diseases in 2018.”
This comes after the GMC advised GPs to initiate hormones in patients with gender dysphoria in specific circumstances, which the GPC has argued would lead to GPs prescribing outside their competence.