The World Health Organization and the American Psychiatric Association should no longer classify transgender individuals as having a mental disorder. This is the conclusion of a new study, which finds that mental health issues among transgender individuals are largely fueled by stigma, rather than transgender identity itself.
Senior author Prof. Geoffrey Reed of the National Autonomous University of Mexico, and colleagues recently reported their findings in The Lancet Psychiatry.
The American Psychological Association define transgender as an umbrella term used to describe a person “whose gender identity, gender expression or behavior does not conform to that typically associated with the sex to which they were assigned at birth.”
The ICD-10 diagnostic manual of the World Health Organization (WHO) and the American Psychiatric Association’s DSM-5 diagnostic manual both classify transgender as a mental disorder, bioethics.com reported.
2A mental disorder, however, is considered a condition that causes significant stress or impairment. Since many transgender individuals do not experience such problems, the classification of transgender as a mental disorder has attracted much criticism.
“The definition of transgender identity as a mental disorder has been misused to justify denial of healthcare and contributed to the perception that transgender people must be treated by psychiatric specialists, creating barriers to healthcare services,” says Reed.
“It has even been misused by some governments to deny self-determination and decision-making authority to transgender people in matters like changing legal documents.”
With ICD-11 - the updated diagnostic manual for the WHO - due to come into effect in May 2018, Reed and colleagues decided to embark on the first ever field trial to assess the feasibility of reclassifying transgender identity.
For their study, the team interviewed 250 transgender individuals aged 18-65.
They were asked to recall any experiences of psychological distress, functional impairment, social rejection, and violence.
All participants reported becoming aware of their transgender identities before the age of 17.
A total of 208 subjects (83%) reported experiencing psychological distress – primarily depression - associated with gender incongruence during adolescence, while 226 participants (90%) reported experiencing family, social, or work or academic problems relating to gender identity.
Social rejection associated with gender incongruence was reported by 191 subjects (76%); such rejection most commonly occurred with family members, the team found, followed by schoolmates, co-workers, and friends.
A total of 157 participants (63%) reported that they had been a victim of violence due to their gender identity, the most common being psychological and physical violence.
According to the authors, their findings highlight the stigma many transgender individuals continue to face.
“Unfortunately, the level of maltreatment experienced in this sample is consistent with other studies from around the world.”
Global statistics reveal that one in every 70,000 men and one in every 100,000 women have this condition.
Transgender Status in Iran
Iran recognizes transgender people under a religious decree issued by Imam Khomeini, founder of the Islamic Republic.
The bill to provide better protection in the form of social status and rights to people with Gender Identity Disorder (GID) or transgender, drafted by the Ministry of Cooperatives, Labor and Welfare, was first presented in the previous Majlis (parliament). The bill should now be approved by the new legislature that convened in May.
It outlines the obligations of every organization towards transgender people and after its approval, “policies will be clear to every ministry and organization vis-a-vis GID people,” Valiollah Nasr, director of Trauma & Critical Care Office at the State Welfare Organization (SWO) had earlier told ISNA.
Nasr said people with GID have faced numerous problems in treatment, ID card registration, national identity, military service, and residence in students’ dormitory, which are all addressed in the bill.
The Iranian Legal Medicine Organization plays the lead role in identifying and helping this group. Medical experts at the organization determine whether a person has GID and/or needs surgery.
