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UN experts hail move to ‘depathologise’ trans identities

GENEVA (29 May 2019) – UN experts say the World Health Organisation’s move to end the categorisation of trans-related conditions as mental and behavioural disorders is a major step towards full respect for human rights connected to gender identity and diversity.

Following last week’s approval of an updated International Classification of Disease (ICD-11) by the World Health Assembly, trans-related categories have now been added to a new chapter on conditions related to sexual health.

“We expect that this reclassification will impact very positively the wrong perception that some forms of gender diversity are pathologies, or sickness, and that it will facilitate access to better health care,” said Victor Madrigal-Borloz, Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity, and Dainius Pras, Special Rapporteur on the right to health.

“For years, and intensively over the last decade, different civil society groups and other stakeholders have worked systematically to challenge this stigmatising and scientifically unfounded classification of trans identities. The revision of ICD-11 has only been possible thanks to the leadership and the mobilisation of hundreds and hundreds of trans and gender diverse people who must be commended for their tireless efforts and persistence.

Madrigal-Borloz and Pras reminded that the World Health Organisation also considered homosexuality as an illness until almost 30 years ago, when it removed it from the International Classification of Diseases.

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They said the misperception of some forms of sexual orientation or gender identity as pathologies has deep impact on public policy, legislation and jurisprudence, penetrating all realms of State action around the world and permeating the collective conscience. They noted that pathologisation has historically been, and continues to be, one of the root causes of human rights violations against persons who identify as trans or gender diverse.

“Although the reclassification is a major improvement, there are a number of problematic issues that remain to be addressed to achieve full depathologisation of trans and gender-diverse people, while guaranteeing equal access to health-care services,” the UN experts said.

The World Health Organisation International Classification of Disease contains codes that are used globally for various purposes, including legal gender recognition, access to specific healthcare (e.g. gender affirming procedures) and healthcare coverage. Some countries use other classificatory systems for the same purposes.

“We welcome this major breakthrough and we call on States to review their medical classifications and adopt strong proactive measures, including education and sensitisation campaigns, to eliminate the social stigma associated with gender diversity. It often takes years before global classifications have full effect on the lives of people. We are, for example, dismayed that homosexuality continues to be pathologised by some national medical associations despite clear and univocal views from all quarters and for decades that homosexuality is not a disease.

“Diversity in sexual orientations, gender identities and gender expressions are part of human nature, and have always existed, everywhere in the world. Denying the existence of diversity or promoting the idea according to which gay, lesbian, bisexual, trans and gender diverse people ‘choose a lifestyle’ leads to violence, including so-called ‘corrective rape’ and ‘conversion therapy’, and to forced, coercive and otherwise involuntary treatments and procedures to ‘normalise’ sexual attraction or human bodies. It is time for the world to recognise and celebrate the rich diversity of human nature,” Madrigal-Borloz and Pras said.


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