Summary of the most important changes in sexual dysfunction and sexual health introduced in the latest revision of the International Classification of Diseases and Related Health Problems ICD-11

Abstract

Aim
 The aim of this publication is to review the changes introduced by the latest revision of the International Classification of Diseases and Health Problems, within sexual health and to compare them to the previously valid ICD-10.
 Method
 This paper reviews both classifications and compares them with each other, presents diagnostic criteria for the most important changes within sexual dysfunctions, paraphilic disorders, gender non-conformity, sexual orientation and compulsive sexual disorders. The changes introduced in ICD-11 were proposed based on advances in research and clinical practice, as well as significant changes in social attitudes and human rights. This article describes and compares the main changes that have occurred in this area.
 Results
 The World Health Organization has introduced far-reaching changes in the area of understanding and diagnosis of sexual dysfunctions by combining its psychological and physiological components, creating a bio-psycho-social model of sexual disorders. Another revolutionary change is the depathologisation and de-medicalisation of gender identity by introducing the term gender non-conformity and regrouping it from the previous category of personality and behavioural disorders to the newly created category of sexual health. ICD-11 also uses less oppressive and empowering terms. ICD-11 removed the category ‘Mental and behavioural disorders related to sexual development and orientation’, deeming it outdated and clinically irrelevant, and made significant changes to paraphilic disorders by excluding normative but atypical sexual behaviours such as fetishism, sadomasochism, fetishistic transvestism, and introducing diagnoses of dripping and compulsive sexual sadism. In the area of paraphilic disorders, a clear distinction is made between clinically significant and public health-relevant conditions and those that merely reflect private atypical sexual behaviour. The last significant change is the introduction of the category of compulsive sexual behaviour in the group of impulse control disorders.