The movement of the World Health Organization (WHO) to declassify transgender identity as a mental disorder is simultaneously a step forward in affirming the personhood of gender minority individuals, and a step backward in diagnoses that adequately reflect their health needs. The solutions posited by the WHO reveal the systemic influence of health insurance policies in defining not only medical disorders, but also social categories.
Currently, in the United States and abroad, in order to qualify for health insurance coverage for gender affirming surgery or hormone replacement therapy (HRT), mentally healthy transgender individuals must receive a diagnosis indicating a gender-related mental disorder based on either the WHO classification or the “gender dysphoria” diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders (DSM). In the hopes of fostering greater acceptance while still satisfying insurers, after 25 years, the WHO is considering a new diagnostic category: “Conditions related to sexual health.”
According to Dr. Celia B. Fisher, Director of the Center for Ethics Education and Professor of Psychology at Fordham University, the new terminology, while well-intentioned, “runs the risk of perpetuating stereotypes that conflate gender identity and sexual orientation and lead to continued misclassification of transgender personhood as a sexual problem.”
Fisher’s research, sponsored by National Institute on Minority Health and Health Disparities (NIMHD), has demonstrated that regardless of whether transgender youth and young adults are receiving or desire to receive HRT in the future, “they do not necessarily see their bodies as creating sexual problems.”
“Our data demonstrate that these young persons exhibit a wide range of sexual attractions and orientations, and in some cases are resistant to identifying with traditional sexual orientation categories.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.