Perspectives of Thai Transgender Adults on Diagnostic Criteria for Transsexualism, Gender Incongruence, and Gender Dysphoria

Abstract

Objectives Our study aimed to assess perspectives of the Thai transgender adults toward three diagnostic criteria: 1) transsexualism (the World Health Organisation’s International Statistical Classification of Diseases and Related Health Problems, tenth revision; ICD-10), 2) gender incongruence (the International Classification of Diseases, eleventh revision; ICD-11), and 3) gender dysphoria (the Diagnostic and Statistical Manual of Mental Disorders, fifth edition; DSM-5). We also gathered comments and suggestions on these criteria for future refinement, especially specific to Thai sociocultural contexts. Methods During February to November 2023, we conducted a survey among transgender individuals from five major Thai transgender communities. Participants were requested to 1) indicate their agreement whether each criterion could describe their identity and be suitable for the Thai transgender community using ten-point Likert scales, 2) select three keywords from each criterion and one most appropriate criterion, and 3) provide additional suggestions. Results A total of 266 transgender individuals, participated in the study (62.4% and 25.2% transgender men and women, and 12.4% other identities). Both ICD-10 and DSM-5 criteria received the highest levels of agreement, averaging scores of 8.7 across most categories. Suggestions for refining criteria included a sufficiently long duration, using terms indicating inclusivity of all identities as a person, and noting positive outcomes of transitioning within the criteria. Conclusions The DSM-5 criteria garnered the highest levels of agreement in terms of identity description and suitability for the Thai sociocultural contexts. Nonetheless, further refinement can be improved, especially to ensure the inclusivity of transgender individuals with identities beyond the binary.