Trans Depathologization: A Sexual Rights Issue

Abstract

The International Classification of Diseases (ICD) is under a major process of revision and reform, coordinated by the World Health Organization (WHO). For trans and gender diverse people around the world, this process represents a historical opportunity of achieving depathologization by the removal of current diagnostic categories under the ICD-10 Chapter V on Mental and Behavioral Disorders and the introduction of a new and less pathologizing category (Gender Incongruence) in a new chapter in ICD-11. The proposed chapter will be called Conditions Related to Sexual Health. Trans and gender diverse people have been historically marginalized (or even excluded) from the sexual rights framework. This situation has been determined by (1) the conceptualization of sexual difference as binary and depending on sex assignment at birth and (2) the subsequent dynamics of othering re-produced by the distinction between healthy men and women (namely, cisgender) and their pathological others (namely, transgender). In spite of their progressive approach to embodiment, gender and sexuality, the sexual rights framework has introduced trans and gender diverse issues following those distinctions. The re-classification of trans and gender diverse people under ICD-11 Chapter on Sexual Health poses specific challenges to the sexual rights framework at three main levels: ontological, epistemological and normative.