Changing Minds: The Psycho-Pathologization of Trans People

The concepts of psychiatric diagnosis and gender are both contested, and they are at their most controversial where they intersect around the diagnosis of trans and gender variant people as mentally disordered. The World Health Organization is in the process of revising the International Statistical Classification of Diseases and Related Health Problems (ICD), with the eleventh edition expected in May 2018. This provides an opportunity to debate whether gender variance should continue to be classified as a mental disorder, be reclassified as a physical health or "other" disorder, or be removed from ICD-11 altogether. This article evaluates some of the assumptions on which the labelling of trans people as mentally disordered is grounded. It concludes that this process is based on the erroneous sex binary, outmoded views of gender, and the misattribution of the causes of distress trans people sometimes experience. It reflects Western society's medicalization of social issues and is an example of the power that medical, particularly psychiatric, diagnoses have to define "normality." In the 21st century, the labelling of trans people as mentally disordered is as anachronistic as the psychiatric labelling of lesbian, gay, and bisexual people. Medical professionals, policy makers, academics, and practitioners have a duty to end the pathologization of this group.