Declassifying transgender as a mental illness

Recent moves to declassify being transgender as a mental illness has been lauded by many, given that this perspective sounds similar to how queerness was regarded as a mental illness before.

But it’s more complicated than that and this involves questions of medical care and insurance.

This issue comes in the wake of reports that World Health Organization (WHO)– the public health agency of the United Nations (UN)– is moving to declassify transgender as a mental disorder.

A study debunking transgender as a mental illness

Reinforcing the WHO’s move is a new study in The Lancet Psychiatry that concluded that transgender identity shouldn’t be diagnosed as a mental disorder.

The study assessed 250 transgenders (aged 18–65) and noted that their distress came from social rejection and violence against them and not over their transgender identity.

“Our findings support the idea that distress and dysfunction may be the result of stigmatization and maltreatment, rather than integral aspects of transgender identity,” said lead investigator Rebeca Robles from the Mexican National Institute of Psychiatry.

Meanwhile, lead researcher Geoffrey Reed from the National Autonomous University of Mexico said, “The definition of transgender identity as a mental disorder has been misused to justify denial of health care and contributed to the perception that transgender people must be treated by psychiatric specialists, creating barriers to health care services.”

“The definition has even been misused by some governments to deny self-determination and decision-making authority to transgender people in matters ranging from changing legal documents to child custody and reproduction,” Reed added.

The issues with transgender as a mental illness

However, this move is regarded both a step forward– and a step backward. This is because the solution pushed by the WHO will influence how doctors will act and how health insurance policies will be affected.

Trans people want or need services provided by doctors– but doctors (and indirectly insurance companies) will only provide these services to “treat” something.

As such, the question being raised now is: what are transgender people– who want to affirm who they are and are seeking the doctor’s service for it– being “treated” for?

Speaking to Huffington Post, Dr. Celia B. Fisher, Director of the Center for Ethics Education and Professor of Psychology at Fordham University, said WHO’s move to declassify transgender as a mental illness and changing its terminology from “gender incongruence” to “transsexualism” has good intentions.

However, she said this “runs the risk of perpetuating stereotypes that conflate gender identity and sexual orientation and lead to continued misclassification of transgender personhood as a sexual problem.”

“Our data demonstrate that these young persons exhibit a wide range of sexual attractions and orientations, and in some cases are resistant to identifying with traditional sexual orientation categories. As a result, assigning transgender persons’ health care needs to a sexual health condition may erroneously communicate to young people that they have some sort of sexual impairment,” Fisher said.