The psycho-medical case against a gender incongruence of childhood diagnosis

Ehrensaft, Diane; Pickstone-Taylor, Simon; Cuypere, Griet De; Tando, Darlene

doi:10.1016/s2215-0366(16)30042-6

Cited by 13 publications

(10 citation statements)

References 6 publications

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“…By introducing an anatomic dysphoria requirement and lengthening the required duration of the gender incongruence, the ICD-11 diagnosis for children has been narrowed considerably. However, despite this tightening of requirements and the move away from the mental disorder chapter, there are still differences of opinion regarding the retention of gender incongruence of childhood in the ICD-11; some feel that even a non-psychiatric diagnosis can be harmful to children [134]. However, although prepubertal children do not need a diagnosis for medical treatment, they may need specialized supportive mental health services as well as family and social (for example, school) interventions.…”

Section: Gender Identity-related Diagnosesmentioning

confidence: 99%

Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

Stein

Szatmári

Gäebel

et al. 2020

BMC Med

162

121

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An update of the chapter on Mental, Behavioral and Neurodevelopmental Disorders in the International Classification of Diseases and Related Health Problems (ICD) is of great interest around the world. The recent approval of the 11th Revision of the ICD (ICD-11) by the World Health Organization (WHO) raises broad questions about the status of nosology of mental disorders as a whole as well as more focused questions regarding changes to the diagnostic guidelines for specific conditions and the implications of these changes for practice and research. This Forum brings together a broad range of experts to reflect on key changes and controversies in the ICD-11 classification of mental disorders. Taken together, there is consensus that the WHO's focus on global applicability and clinical utility in developing the diagnostic guidelines for this chapter will maximize the likelihood that it will be adopted by mental health professionals and administrators. This focus is also expected to enhance the application of the guidelines in non-specialist settings and their usefulness for scaling up evidence-based interventions. The new mental disorders classification in ICD-11 and its accompanying diagnostic guidelines therefore represent an important, albeit iterative, advance for the field.

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Section: Gender Identity-related Diagnosesmentioning

confidence: 99%

Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

Stein

Szatmári

Gäebel

et al. 2020

BMC Med

162

121

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“…Over the last few years, the demand of depathologizing gender diversity in childhood and adolescence has achieved an increased relevance in trans depathologization activism [1,2,28,30,33,[54][55][56][57][58][59][60][61][62][122][123][124][125], including the following demands: (1) removal of the diagnostic classification of gender diversity in childhood from DSM and ICD; (2) support to gender diversity in childhood and adolescence in the family, social, school, and health care context; and (3) legal gender recognition for children and adolescents.…”

Section: Depathologization Of Gender Diversity In Childhood and Adolementioning

confidence: 99%

“…Regarding the diagnostic classification of gender diversity in childhood, various international and regional activist networks published declarations demanding the removal of the diagnostic code "Gender incongruence of childhood" from ICD, and trans authors and allies contributed critical theoretical reflections on the diagnostic classification of gender diversity in childhood in the DSM and ICD [1,2,28,30,33,[54][55][56][57][58][59][60][61], preceded by critical reflections elaborated over the last decades [20,21]. This demand also received the support of clinicians and researchers [62] and European bodies [90,91].…”

Section: Depathologization Of Gender Diversity In Childhood and Adolementioning

confidence: 99%

“…Among the main arguments in favor of removing the diagnostic code, trans authors and allies highlight the lack of clinical utility, the Western character of a conceptualization of gender diversity in childhood as a problem that requires health care, the potential stigmatizing effect, and a contradiction between a removal of diagnostic codes related to sexual orientation and the maintenance of the Gender Incongruence of Childhood code [1,2,20,21,28,30,33,[54][55][56][57][58][59][60][61][62]. Furthermore, the critical discourses counter reasons contributed by the defenders of the diagnosis [126,127], arguing that a specific diagnosis for gender diverse children is not necessary for covering psychological support, justifying access to puberty blockers, or promoting research and training [1,2,20,21,28,30,33,[54][55][56][57][58][59][60][61][62].…”

Section: Depathologization Of Gender Diversity In Childhood and Adolementioning

confidence: 99%

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Trans health care from a depathologization and human rights perspective

Schwend

2020

Public Health Rev

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Trans people are exposed to multiple human right violations in clinical practice and research. From 1975 on, gender transition processes have been classified as a mental disorder in diagnostic classification manuals, a classification that was removed recently from ICD, International Classification of Diseases, and continues in DSM, Diagnostic and Statistical Manual of Mental Disorders. Trans people in different world regions are forced to accept psychiatric diagnoses and assessment in order to get access to trans health care, subject to reparative therapies and exposed to transphobic institutional and social discrimination and violence. In many countries, gender identity laws include medical requirements, such as psychiatric diagnosis, hormone treatment, genital surgery, or sterilization. In the scientific literature, a frequent pathologization of trans experiences can be identified, by means of pathologizing conceptualizations, terminologies, visual representations, and practices, as well as ethnocentric biases. Trans activism and scholarship have questioned widely the pathologization of trans people in clinical practice and research. Over the last decade, an international trans depathologization movement emerged, demanding, among other claims, the removal of the diagnostic classification of transexuality as a mental disorder, as well as changes in the health care and legal context. International and regional bodies built up a human rights framework related to sexual, gender and bodily diversity that constitute a relevant reference point for trans depathologization activism. The Yogyakarta Principles, published in 2007 and extended in 2017 by means of the Yogyakarta Principles plus 10, establish an application of international human rights law in relation to sexual orientation, gender expression, gender identity, and sex characteristics. International and regional human rights bodies included demands related to depathologization in their agenda. More recently, advancements towards trans depathologization can be observed in the diagnostic classifications, as well as in the health care and legal context. At the same time, trans people continue being exposed to pathologization and transphobic violence. The Human Rights in Patient Care (HRPC) framework offers a human right-based approach on health care practices. The paper aims at analyzing the shared human rights focus and potential alliances between the trans depathologization perspective and the HRPC framework.

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“…Pourtant, plusieurs s'entendent pour dire que la pathologisation de l'identité de genre chez les enfants est un phénomène culturel, puisqu'on ne remarque que très peu de souffrance chez les populations qui affirment le genre de l'enfant ou le laissent explorer librement son identité de genre (Suess Schwend et al, 2018). Ainsi, une première étape vers une société plus inclusive à l'égard des personnes trans doit passer par un accroissement de la conscience sociale et la dépathologisation de leur existence (Winter et al, 2016). Selon nous, cela n'est réellement possible qu'à travers la création de lois et de politiques sociales permettant explicitement l'expression de toutes les identités de genre.…”

Section: Agir Au Niveau Social Et Politique Pour Instaurer Une Sociétunclassified

Pour des interventions anti-oppressives auprès des jeunes trans : nécessités sociales, évidences scientifiques et recommandations issues de la pratique

Médico

Pullen-Sansfaçon

2017

Service social

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Depuis 2011, de plus en plus d’études documentent les besoins et enjeux des jeunes et des enfants qui se sentent différent.e.s dans leur genre. S’il en ressort qu’illes sont encore parmi les jeunes les plus à risque de suicide, de violence par les pairs, d’échec scolaire, de dépression, d’anxiété et de troubles alimentaires, un milieu de vie qui les accepte et les soutient semble le facteur le plus déterminant pour leur santé tant psychique que relationnelle et somatique et leur insertion sociale et professionnelle. Pour favoriser un développement harmonieux pour les jeunes trans et en questionnement, une perspective anti-oppressive est aujourd’hui nécessaire.

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The psycho-medical case against a gender incongruence of childhood diagnosis

Cited by 13 publications

References 6 publications

Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

Trans health care from a depathologization and human rights perspective

Pour des interventions anti-oppressives auprès des jeunes trans : nécessités sociales, évidences scientifiques et recommandations issues de la pratique

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